4.3 Review

Centric relation critically revisited-What are the clinical implications?

Journal

JOURNAL OF ORAL REHABILITATION
Volume 48, Issue 9, Pages 1050-1055

Publisher

WILEY
DOI: 10.1111/joor.13215

Keywords

centric relation; condylar position; maximum intercuspation

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The article discusses the changes in the dental term "centric relation" over the years, leading to significant clinical controversies. Analysis of dental literature reveals ongoing misunderstanding and disagreements among clinicians and academic dentists. The term "centric relation" is considered flawed and should be abandoned in favor of recognizing unique temporomandibular joint relationships in individuals.
Purpose of the article Centric relation is a dental term that has undergone many alterations over the years, which in turn have led to significant clinical controversies. These continuing changes in the meaning of the term CR have not only led to confusion, but they also have resulted in a variety of unnecessary diagnostic and therapeutic procedures. Analysis of the dental literature reveals ongoing misunderstanding and disagreement regarding that term among both clinicians and academic dentists. Materials and methods A search of the PubMed database was performed with the following search terms: centric relation, masticatory muscles, maxillomandibular relationship and condylar position. Relevant literature from the past 70 years until the present day was meticulously scrutinised. Results As expected, the literature review on the topic of CR revealed a problematic pattern of changing definitions and clinical disagreements, all of which have had a significant impact on the practice of dentistry. Conclusion There are semantic, conceptual and practical reasons for concluding that the term 'centric relation' is flawed. Those flaws have a significant impact on dental practice. Based on our analysis, argumentation is provided to conclude that the term 'centric relation' should be abandoned. Instead, it appears that every individual has a unique temporomandibular joint relationship which cannot be described by any singular term. In healthy dentate patients, this relationship is determined by the maximum intercuspation of the teeth and should therefore be considered as biologically acceptable.

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