The misconceptions about verifying and and using centric relation (CR) are unfortunately all too common for new and even experienced dentists. The myths that are often associated with CR, ultimately prevent patients from receiving optimal care.
How to classify a dental occlusion.
For the vast majority of dentists and orthodontists, dental occlusion has been classified using the molar relationship as well as the canine relationship. However, a Complete Dentist looks at occlusion in a slightly different manner. A Complete Dentist looks at occlusion starting with the joint position first.
When we think about centric relation, there are a lot of facts and there's some fiction that we have to understand about this position. Probably the most fictitious thing that we think about today is that centric relation is the rearmost position and that patients don't utilize it.
Have you ever had a patient in your chair, you're doing a complete exam, you're evaluating the wear, and you notice that the wear on their anterior teeth is more than the posterior teeth? Are you wondering, "Why is this happening?" Well, let's talk about some possibilities that could be causing this.
Form follows function.
We've all heard the old adage everywhere, in all facets of life. And when it comes to anterior teeth we have to think of it as if we can get the function dialed in and honed in really well, the esthetics effortlessly fall into place.
If we have a symptomatic TMD patient and are trying to figure out, can we make this patient better or comfortable? How can we stabilize the joints?
So I want to take just a second and talk about the three basic requirements of occlusal therapy. And if we think about this, good occlusal therapy is going to be about force management and putting the appropriate forces on the teeth.
What is fremitus?
Fremitus is the vibration or movement of a tooth when teeth come into contact together. If you were to take your fingernail and put it on the front surface of a tooth and have the patient close together, and the tooth moved, that's fremitus.
Properly loading the joints tells you several things about the root cause of some patients' problems. This will also determine how functio nally stable the patients is. Let's start with the first item.
Why is the physiologically correct position in centric relation the most superior position in the joint space itself?
Now, if you're like me and you went through dental school earlier, maybe 20 years ago, you were probably taught that centric relation was actually a distalized position of the condyles.
It was a very frustrating experience not only for the dentist, but also for the patients because you're trying to put the mandible and the condyle into a very unnatural position.