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Centric relation: A matter of form and substance

A matter of form and substance
Authors: Fornai, Cinzia; Tester, Ian; Parlett, Kim; Basili, Cristian; Costa, Helder Nunes;

Centric relation: A matter of form and substance

Abstract

AbstractThe recent review article by Zonnenberg, Türp and Greene ‘Centric relation critically revisited – What are the clinical implications’? opens an important debate by addressing topics of central relevance in Dentistry, namely the relationship between occlusion and the condyle‐to‐glenoid‐fossa position, and the need for diagnostic assessment and therapeutic alteration of the condylar position in orthodontic patients. Zonnenberg, Türp and Greene concluded that the mandibular condyle is correctly situated in most orthodontic patients. Thus, in their view, orthodontists can disregard this aspect during treatment, and rely on the plastic properties of the masticatory supporting structures, while aiming at finishing the cases in a good occlusal relationship.We think that this approach fails to consider that biological variation of the stomatognathic structures can also be pathological and that, as dental occlusion determines condylar relative position within the glenoid fossa, changes in the occlusion are likely to alter the original condylar‐to‐glenoid‐fossa relation. Hence, we claim that whenever the occlusal relationship must be changed, the clinician should carefully monitor the condyle position and the mandibular function to prevent possible iatrogenic effects.To advance the discourse on the topic, we invite Zonnenberg, Türp and Greene to clarify their definition of ‘average patient’ and their interpretation of ‘full‐mouth orthodontic and orthognathic treatment’, their understanding of ‘biologically acceptable condylar relationship’, their justification of maximum intercuspation as reference position, the extent to which they think it is safe to rely on the TMJ resilience, and finally their alternative to centric relation in the treatment of patients needing condylar repositioning.

Countries
Switzerland, Portugal, Austria
Keywords

Dental Occlusion, Centric, Temporomandibular Joint, Occlusion, 106018 Human biology, Mandibular Condyle, 610 Medicine & health, Orthodontics, occlusion, Centric Relation, Functional diagnostic, 3500 General Dentistry, 106018 Humanbiologie, Temporomandibular joint, functional diagnostic, Iatrogenic effects, 11294 Institute of Evolutionary Medicine, Commentary, Humans, Reference position, iatrogenic effects, temporomandibular joint, orthodontics, reference position, General Dentistry

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    citations
    This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    4
    popularity
    This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
    Top 10%
    influence
    This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    Average
    impulse
    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
    Average
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citations
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
4
Top 10%
Average
Average
Green
hybrid