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A Finite Element Approach for Locating the Center of Resistance of Maxillary Teeth
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Centric relation critically revisited-What are the clinical implications?

Adriaan J J Zonnenberg1, Jens Christoph Türp2, Charles S Greene3

  • 1Retired Senior Lecturer at the ZMK, University of Bern, Switzerland.

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|June 24, 2021
PubMed
Summary

The dental term "centric relation" (CR) is flawed due to changing definitions and clinical controversies, causing confusion and unnecessary procedures. Researchers suggest abandoning CR in favor of maximum intercuspation for healthy patients.

Keywords:
centric relationcondylar positionmaximum intercuspation

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Area of Science:

  • Dentistry
  • Dental Anatomy
  • Biomechanics

Background:

  • The definition and application of centric relation (CR) in dentistry have evolved significantly over time.
  • These changes have resulted in considerable clinical controversies, confusion, and the implementation of unnecessary diagnostic and therapeutic procedures.
  • Misunderstanding and disagreement regarding CR persist among dental professionals.

Purpose of the Study:

  • To analyze the dental literature concerning the term 'centric relation' (CR).
  • To identify the reasons for ongoing controversies and misunderstandings surrounding CR.
  • To propose a re-evaluation of the term and its clinical implications.

Main Methods:

  • A comprehensive literature search was conducted using PubMed.
  • Search terms included 'centric relation,' 'masticatory muscles,' 'maxillomandibular relationship,' and 'condylar position.'
  • Relevant literature from the past 70 years was meticulously reviewed.

Main Results:

  • The literature review confirmed a problematic pattern of shifting definitions for CR.
  • Significant clinical disagreements regarding CR were identified.
  • These issues have demonstrably impacted dental practice.

Conclusions:

  • The term 'centric relation' is considered flawed due to semantic, conceptual, and practical issues.
  • These flaws significantly impact dental practice, leading to confusion and unnecessary interventions.
  • It is recommended to abandon the term 'centric relation' and instead consider the unique temporomandibular joint relationship determined by maximum intercuspation in healthy dentate patients as biologically acceptable.