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Centric relation: A historical and contemporary orthodontic perspective.
Donald J Rinchuse1, Sanjivan Kandasamy
1Orthodontics and Dentofacial Orthopedics, University of Pittsburgh, School of Dental Medicine, USA. bracebrothers@aol.com
Journal of the American Dental Association (1939)
|April 28, 2006
Summary
Centric relation (CR) records in orthodontics lack scientific validity and diagnostic value for temporomandibular joint disorders. Their use with gnathologic articulators offers no proven benefit for patients.
Area of Science:
- Dental Science
- Orthodontics
- Temporomandibular Joint (TMJ) Research
Background:
- Centric relation (CR) has been a long-standing, controversial topic in dentistry, particularly for orthodontists over the past 40 years.
- The definition of CR has evolved from a posterior-superior condyle position to an anterior-superior condyle position.
Purpose of the Study:
- To review the historical and contemporary orthodontic perspectives on centric relation (CR).
- To evaluate the evidence supporting the use of CR records and articulators in orthodontic treatment.
Main Methods:
- Literature review and author's accumulated research over 30 years.
- Evaluation of evidence at EB model level 2 (experience plus best available sample studies) due to lack of level 3 reviews.
Main Results:
- While CR records show reliability, their validity for diagnosing temporomandibular disorders (TMD) lacks evidentiary support.
- Population studies and consensus statements indicate CR condyle positions are not diagnostic of TMD.
- Gnathologic records and articulator-mounted casts offer little to no benefit in identifying discrepancies in orthodontic patients.
Conclusions:
- The scientific evidence does not substantiate the benefits of using gnathologic CR records and articulators in orthodontics.
- Current evidence suggests limited clinical utility for these methods in routine orthodontic practice.