METHODS OF RECORDING

CENTRIC RELATION

GUIDED BY-Dr. VINAY KUMAR PRESENTED BY –

SIR
DR. SHREYA SHASTRY
DEPARTMENT OF
PROSTHODONTICS MDS 2ND YEAR PG
COLLEGE OF DENTAL SCIENCES DEPARTMENT OF PROSTHODONTICS
 CONTEN
T
▶ INTRODUCTION

▶ TERMINOLOGIES

▶ MUSCLES INVOLVED IN CENTRIC RELATION

▶ THEORIES OF CENTRIC RELATION

▶ RELATING CENTRIC RELATION TO CENTRIC OCCLUSION

▶ RELATING CENTRIC RELATION TO HINGE AXIS

▶ RELATING CENTRIC AND VERTICAL RELATIONS

 CONTEN
▶ RECORDING CENTRIC RELATION :
T
o CONFLICTING CONCEPTS AND OBJECTIVES IN RECORDING
CENTRIC RELATION

o COMPLICATIONS IN RECORDING CENTRIC RELATION

o RETRUDING THE MANDIBLE IN CENTRIC RELATION

• METHODS OF RECORDING CENTRIC RELATION

• SIGNIFICANCE OF CENTRIC RELATION

• CONCLUSION

• REFERENCES
 INTRODUCTION

▶ Following the orientation of maxilla and determination of vertical dimension, the

final relation to be recorded is the horizontal relation.

▶ Horizontal jaw relation is the relation that is

established antero-posteriorly and medio-laterally.
▶ IT IS CLASSIFIED AS: INTRODUCTION
▶ 1. Centric relation.

▶ 2. Eccentric relation.

▶ A. Protrusive relation.

▶ B. Lateral relation.

▶ I. Right lateral relation.

▶ II. Left lateral relation

Palaskar, J.N., Murali, R. & Bansal, S. Centric
Relation Definition: A Historical and
Contemporary Prosthodontic Perspective. J
Indian Prosthodont Soc

Jaw relations are the relationships of the mandile with maxilla.

▶ In this context too much importance was given to the position of the head of
the condyles in the glenoid fossa which ultimately resulted in a lot of confusion.

▶ This confusion was due to the invisibility of the

most unique,enigmatic temporomandibular joint.
Palaskar, J.N., Murali, R. & Bansal, S.
Centric Relation Definition: A Historical
and Contemporary Prosthodontic
Perspective. J Indian Prosthodont Soc

CENTRIC RELATION
▶ For almost the last six decades we assumed CR to be the most retruded position
of the heads of the condyles in the glenoid fossae.

▶ Recently we could come to a conclusion that it is not the most retruded position
of the heads of the condyles but rather the most anterior and superior position.

▶ The acceptance of one definition is necessary to improve communication at

all levels of dentistry.

▶ Definition of CR has created more controversy than any

other dental subjects, several factors contributed to this confusion.
CHRONOLOGY OF CHANGING DEFINATIONS
1920- Mc Collum- Rearmost position

1952-Granger-uppermost,rearmost

1969-Stuart-RUM position

1977-American equilibration society –AS position

• 1978- Celenza
Condyle disk assembly braced superiorly and anteriorly against posterior
slope of eminence

 BOUCHER (1953)

•The most posterior relation of the lower jaw to the upper jaw from which lateral
movements can be made at a given vertical dimension
• GPT (1) -1956
The most retruded relation of the mandible to the maxillae when the condyles are in
the most posterior unstrained position in the glenoid fossae from which lateral
movements can be made at any given degree of jaw separation.

GPT-(2) [1960]
defined the CR as ‘the most posterior relation of the mandible to the maxilla at the
established vertical relation’,

• GPT (3) -1968

The most retruded physiologic relation of the mandible to the maxilla to and from
which the individual can make lateral movements. It is a condition that can exist at
various degrees of jaw separation. It occurs around the terminal hinge axis.
GPT-4 [1977] defined CR as ‘the jaw relation when the condyles are in the most
posterior, unstrained position in the glenoid fossa at any given degree of jaw
separation from which lateral movements can be made’
GPT-5 and 8 [1987, 1994]
the maxillomandibular relationship in which the condyles articulate with the
thinnest avascular portion of their respective disks with the complex in the
anterior– superior position against the shapes of the articular eminencies. This
position is independent of tooth contact. This position is clinically discernible
when the mandible is directed superior and anteriorly. It is restricted to a purely
rotary movement about the transverse horizontal axis
▶GPT 9(2017)
Centric relation is defined as a maxillomandibular relationship independent
of tooth contact, in which the condyles articulate in the anterior-superior
position against the posterior slopes of the articular eminences; in this position
the mandible is restricted to a purely rotary movement; from this
unstrained, physiologic, maxillomandibular relationship, the patient can make
vertical, lateral or protrusive movements; it is a clinically useful,
repeatable reference position
 MEANING AND CONTROVERSIES IN
DEFINITIONS GPT 4 AND
GPT5(ANATOMICAL AND
SIGNIFICANCE BASED DEFINITION)
▶ The two definitions taken from glossary of prosthodontic terms (GPT-4 and GPT-
5) appear to contradict each other.

▶ The earlier definition mentions of a most posterior position of condyles in glenoid

fossa while the latter definition speaks of an anterior superior position of condyle
against the slopes of the articular eminence.
▶ But surprisingly, the discrepancy between the two positions is only approximately
0.2 mm.

▶ Theoretically, the difference is only on the emphasis of the condylar position.

▶ Maximal intercuspal position (MIP): The complete intercuspation of the opposing
teeth independent of condylar position, sometimes referred to as the best fit of the
teeth regardless of the condylar position, is also called maximal intercuspation.

▶ Centric occlusion (CO): The occlusion of opposing teeth when the mandible is in
CR. This may or may not coincide with the MIP.

▶ CR is a bone-to-bone relation, while MIP and CO are tooth-to-tooth relation.

 MUSCLES INVOLVED IN CENTRIC
RELATION
▶ Centric relation is not resting or postural position of the mandible.

▶ Contraction of muscles is necessary to move and fix the mandible in this position.

▶ The anatomic attachments of the posterior and middle parts of the temporal and
suprahyoid muscles together with EMG studies show that these muscles move and
fix the mandible in its most retruded relation to maxilla.

▶ Temporal , masseter and medial pterygoid muscles elevate the mandible.

▶ The lateral pterygoid muscle shows little activity when mandible is in centric
relation.
 THEORIES OF CENTRIC
RELATION
THE
MUSCLE
THEORY

THEORIES
THE OF THE
MENISCUS CENTRIC LIGAMENT
THEORY RELATION THEORY

THE
OSTEOFIBRE
Saizer [Link] relation and condylar movement: anatomic mechanism. J THEORY
Prosthet Dent 1971;26(6):581-91.
 DEFENCE REFLEX THE MUSCLE THEORY

CONTRACTION OF LATERAL
PTERYGOID MUSCLE

HALTS THE JAW

1. centric relation is always the same at any vertical level,

2. nor does it explain the most posterior mandibular position.
3. no anatomic explanation is provided for the posterior hinge movement,
4. nor for the acuteness of the “needle-point” tracing.
 THE LIGAMENT
THEORY
LIGAMENTS WHEN BECOME TENSE THEY
DETERMINE THE LIMITS OF RETRUSIVE
MOVEMENTS

Ligaments bind the elements of the articulations, limit

their possibilities of movement, and are also capable of
determining terminal border positions.

When the condyle is seen in lateral radiographic views in

centric relation, it appears to be “suspended” or “floating.”

1. the anatomic arrangement of the temporomandibular ligaments is not

well suited to halt the retrusive condylar movement.
2. ligamentous retrusive terminal stop provides no satisfactory location for
the hinge axis.
3. does not explain satisfactorily the lateral border movements,
 THE OSTEOFIBER
THEORY
retrusive terminal stop formed by the soft tissues of
the posterior part of the roof of the glenoid fossa.

this fibrous stop acts as a buffer.

these tissues to be loose, fibrous, and

functionally differentiated. He named this
structure the “retroarticular cushion.”
 THE MENISCUS THEORY

When the disc is in its postural position, or close to

it, the upper synovial cavity continues down and
backward, within the retroarticular fibrous tissues

Discs with their retromeniscal fibrous tissues--stop

the retrusive condylar movements
 RELATING CENTRIC RELATION
TO CENTRIC OCCLUSION
▶ Centric relation must be accurately recorded so that centric occlusion can be made
to coincide with it.
 In the natural dentition CO is usually located anterior to CR, the average
distance being 0.5 to 1 mm. If natural tooth has interferences in CR

it initiate impulses and responses that direct the mandible

away from deflective occlusal contacts into CO.

 Impulses created by closure of the teeth into CO establish memory

patterns that

 permit the mandible to return to this position, usually without tooth

interferences
 RELATING CENTRIC RELATION
TO CENTRIC OCCLUSION

The edentulous patient cannot control mandibular movements

or avoid deflective occlusal contacts in CR
manner as the dentulous in the same
patient.
Deflective occlusal contacts in CR cause movement of
denture bases and displacement of the supporting
tissues or direct the mandible away from this relation
 RELATING CENTRIC RELATION TO
HINGE AXIS

The upper cast can be accurately oriented to the opening axis of the articulator
by the location of the physiologic transverse hinge axis and a facebow
transfer.
Opening and closing the jaws with mandible in its most retruded position to maxilla
( terminal hinge axis ) is the method used to locate transverse hinge axis.
They occur without translation.

Centric relation is the most retruded relation of mandible to maxilla at a

particular vertical relation along pathway of terminal hinge movement.

So the lower cast automatically gets oriented to opening axis of articulator

with accurate centric relation recorded.
 RELATING CENTRIC AND
VERTICAL RELATIONS

There is a most retruded relation of mandible to maxilla for each

vertical relation, and there is a change in the horizontal relationship
of mandible to maxilla with each change in vertical relation

Thus when the centric relation record is made at or very close to

the desired vertical relation of occlusion, little or no vertical change
will be required on the articulator and the likelihood of the errors
will be reduced.
 SIGNIFICANCE OF CENTRIC
RELATION

 Most comfortable position(home of the mandible)

 Optimum position for health comfort and functioning of
TMJ
 Movements of mandible start from here and end up here.
 physiologically acceptable position for mastication of food.
 Most posterior border position
 Acts as a reference point.
 SIGNIFICANCE OF CENTRIC
RELATION

 Pure rotations take place.

 Bone to bone relation
 Independent of position of tooth.
 Constant for an individual.
 Reproducible, repeatable and
recordable.
 FACTORS INFLUENCING
CENTRIC RELATION
RECORDS
 Resiliency of supporting tissues

 Fit of denture bases – Stability - Retention

 The TMJ and its associated neuromuscular mechanism

 The character of the pressure applied in making the recording.

 The technique used in making the recording and the associated recording devices
used.

 Maxillo-mandibular relationship . Yurkstas AA, Kapur KK. Factors influencing centric

relation records in edentulous mouths. J Prosthet Dent
2005;93:305-10.
 FACTORS INFLUENCING
CENTRIC RELATION
RECORDS
 The skill of the dentist.

 The health and co-operation of the patient.

 Posture of the patient.

 Character or size of the residual alveolar

arch.

 Amount and character of saliva.

Yurkstas AA, Kapur KK. Factors influencing

 Size and position of the tongue. centric relation records in edentulous mouths. J
Prosthet Dent 2005;93:305-10.
RECORDING
CENTRIC
RELATION
 CONFLICTING CONCEPTS AND OBJECTIVES
IN RECORDING CENTRIC RELATION

•MINIMAL CLOSING PRESSURE HEAVY CLOSING PRESSURE

• ▶ Tissues supporting the ▶ Tissues under the base will

base will not be displaced displace

• ▶ objective: to make ▶ objective: to produce the same

opposing denture teeth displacement of the soft
touch uniformly & tissues that occur when patient
simultaneously at first masticates
contact
 COMPLICATIONS IN RECORDING
CENTRIC RELATION

▶ The structure of TMJs are such that one joint can be displaced
downward by uneven pressure when records are made and yet the
condyles be in their most retruded position. This situation cannot occur
on the articulator and thus a deflective occlusal contact may be the
source of instability, soreness and resorption despite the correctness of
the other relations.
▶ Even though a balanced and equilized registration has been made it
often is lost due to:

I. Cast mounting procedures

II. Processing of denture

 COMPLICATIONS IN RECORDING
CENTRIC RELATION

▶ REALEFF EFFECT BY HANAU: according to it, there is uneven

resiliency in the soft tissues. This resiliency is present in both the
mucosa and the TMJs, thus undue pressure in securing the relation must
be avoided to eliminate the possibilities of excessive displacement of soft
tissues .
 RETRUDING THE MANDIBLE IN
CENTRIC RELATION

BIOLOGIC PSYCHOLOGIC MECHANICAL

 Lack of  Inability to follow  Poorly fitting base
coordination the dentist plate
between muscles. instructions
 Habitual
eccentric jaw
positions
 Senility or
neuro- muscular
disorder
 METHOD
S
PASSIVE METHODS : The mandible is retruded by the patients themselves,
following the dentist’s instructions without any physical participation by the
dentist. The patient is instructed to

1. Relax, pull the jaw back and close on the back teeth.

2. Get the feeling of pushing the upper jaw out and close on back teeth.

3. Touch the posterior part of the upper denture with tongue and close till the
rims contact.
 METHOD
S
4. Swallow and close.

5. Tap the occlusal rims together repeatedly and rapidly.

6. Tilt the head back while performing the above exercises.

[Link] and retrude the mandible repeatedly holding his/her fingers

lightly against the chin.
 METHOD
S
ACTIVE METHODS : The patient is guided to retrude the mandible with
physical assistance from the dentist.

1. The dentist places his thumb and forefinger on the patient’s chin to exert a
mild but firm posterior force while patient closes on the rims. This will
prevent the patient from moving the jaw anteriorly

2. Dentist palpates the temporal and masseter muscles to relax them.

 METHOD
S
Dawson’s bimanual palpation – the dentist stands behind
the patient and places all four fingers of both hands on the
lower border of the mandible on either side. The thumbs are
placed over the symphysis such that they contact in the
midline. The patient is instructed to open the mouth and
then close slowly. As the patient closes, dentist applies an
upwards lifting force with the fingers on the inferior border
and simultaneously applies a downward force with the
thumbs . This guides the patient to close in CR.
 METHODS OF RECORDING
CENTRIC RELATION

1. BY BOUCHER

a. Static methods — interocclusal record with/with out central bearing devices

and tracing devices

b. Functional methods — chew-in technique

a) Needles technique
b) House technique
c) Patterson technique
2. BY HEARTWELL :

1. Functional methods (chew-in)

a) Needles House method

b) Patterson method

2. Graphic Method

a) Intraoral devices

b) Extraoral devices

3. Physiological or tactile or inter occlusal check record

method
 3. MEYER
1. Functional method
a. Patterson Technique
b. Needles-House Technique
c. Meyer’s Technique
d. Shanahan’s Technique
2. Static or pressureless method :
3. Graphic :
a. intra-oral
b. extra-oral
4. Direct checkbite interocclusal
recordings
5. Cephalometrics
▶ According to smith in 1941 , moylar 1955, & kapur in 1957 following are
the methods for recording the centric relation:-

▶ Direct recording

1. Interocclusal-check record method

2. Pressure-less method

3. Pressure method

 Graphic recording
 Functional recording
 STATIC METHOD
 Involves guiding the mandible in CR with the maxillae then making a record of
the relationship of the two occlusion rims to each other.
 ADVANTAGE - minimal displacement of the recording bases
 Record made with wax or plaster
 DISADVANTAGES:
 • Inaccuracy can result from lack of equalized pressure.
 • Difficult to verify the accuracy of the record.
 • Not as accurate as graphic method.
 NICK AND NOTCH METHOD: This is the recommended method for sealing the
rims as there is less resistance to closure and the movement during sealing is
tackled. After the rims are evened, V-shaped notches are then placed in the
molar region of the maxillary occlusal rim to prevent anteroposterior
movement

 A nick is cut anterior to the notch in the premolar regions, not extending throughout
occlusal rims to prevent lateral movements.
 A trough is created in the posterior regions of the mandibular occlusal
rims
 The patient is trained to retrude and close at CR position.

 Soft wax, zinc oxide eugenol impression paste, quick setting plaster and elastomeric
bite materials may be used .
 The recording material is loaded in the trough created on the mandibular
rim.
 Occlusal rims are inserted in the patient’s mouth and the patient is instructed
to retrude and close.

 Contact should be observed in the maxillary and mandibular rims anteriorly.

 Once the intervening recording material sets, the rims get sealed and are removed
together
 2. INTER-OCCLUAL CHECK RECORDS

 As the name suggests, these records are used to verify the centric jaw
relation at the time of try-in or denture insertion.

 They are also used to check the occlusion of teeth in existing dentures.

 These are also called ‘physiologic’methods as the patient’s

proprioception and tactile sense is essential in the making of an accurate
record.

 The same recording mediums used for static registrations can also be
used for this procedure
 After the occlusal rims have been articulated with a static record, the artificial
teeth are arranged and a trial denture is fabricated.

 At the time of try-in (or denture insertion) if the dentist feels the need to verify the
CR, then this procedure is adopted.

 Patient is asked to rehearse retruding the mandible.

 The maxillary trial denture is inserted in the patient’s mouth.

 The recording medium like aluwax is loaded onto the occlusal surface of the teeth in
the mandibular occlusal rim
 The patient is asked to slowly retrude the mandible and close on the wax till the
tooth contact occurs .

 They should not bite through the material.

 The recording material is allowed to set and the trial dentures are removed with the
recording material.

 The maxillary trial denture is removed from the record and placed on the mounted
maxillary cast in the articulator.

 The mandibular trial denture with the record is now returned to the mandibular cast
on the articulator.
 The maxillary teeth are now seated over the record.

 If the previous recording of CR is the same as the check record, then both the
condylar elements of the articulator will contact the centric stops, i.e. the
articulated casts need not move to fit into the check records.

 If anyone or both of the condylar elements of the articulator does not contact the
centric stops, it indicates that one of the records is inaccurate.
 INDICATIONS: It may be advisable to make interocclusal check records to verify
the CR in the following conditions:
 Abnormally related jaws

 Displaceable, flabby tissues

 Large tongue

 Uncontrolled mandibular movements

 Factors affecting the success of interocclusal records:

 Uniform consistency of the recording material

 Accurate vertical jaw relation records

 Stability and fit of the record base

 FUNCTIONAL METHOD
 Involves functional activity or movement of the mandible at the time the record is
made.

 Disadvantage - causes lateral and anteroposterior displacement of the

recording bases

 Includes the various chew-in techniques :

 Needlehouse
 Patterson
 Meyers
 HISTORICAL
DEVELOPMENT

 Greene – Used plaster and pumice mixture.

 Needles – Mounted three studs on maxillary rims.

 Patterson – Used corborandum and plaster

mixture.
 Meyer – Used soft wax occlusal rims, tin foil placed and movements
functional done.

 Boose – Used Gnathodynomometer.

 Shanahan – Cones of soft wax.

 In 1905 Christenson used 'impression wax' for bite
records.
 One early method was to have the patient close in a retruded position and attach the
rims together for mounting on an articulator usually with staples or by sealing the
rims with a hot instrument.
 Schuylor (1932) said that modeling compound was preferable to wax ffor
occlusal records because it can be softened more evenly, cools slower and doesn't
distort as much as wax.
 Boos (1959) felt that it was important to avoid torsion when recording Centric
relation. Wax or compound, which required application of force, could displace the
mandible. Thus a material such as plaster or ZnO Eugenol paste was more accurate.
 Hanau was one of the first individuals to be concerned about equailization
of
pressure when recording the bite. He coined the term "Realeff' which is formed
by the beginning letters of the words 'resilient and like effects‘
 Payne (1955) and Hickey (1964) stated a preference for plaster because less
material had to be placed in the patient's mouth for the record.
 In 1910 Green invented his 'PRESSOMETER' in an early attempt to equalize the
pressure of recording centric relation . It consisted of celluloid strips placed
between the maxillary and mandibular occlusion rims on the right and left
sides. If the pressure were unequal, the rims would "hold" one strip while the
other could be removed.
 In 1954 Brown recommended repeated closure into softened wax
rims.
​ Wright(1939) described the four factors he believed affected accuracy of
records:
(i) resiliency of tissue
(ii) saliva film
(iii) fit of bases
(iv) pressure applied.
He concluded that the best technique was to record the occlusal record at
zero pressure
 PHYSIOLOGIC
TECHNIQUE

 Shanahan (1955)
 cones of soft wax placed on the mandibular occlusal rim
 patient was asked to swallow repeatedly.
 Hebelieved that during swallowing, the tongue forced the into Centric
mandible
relation position.
 The cones of soft were then moved and Centric relation was recorded
using this method.

Shanahan TEJ. Physiologic jaw relations and occlusion of complete dentures. J Prosthet
Dent 2004;91(3):203-05.
 INDICATIONS :

▶ Supporting tissues are excessively

displaceable
▶ Large awkward tongues

▶ Uncontrollable/ abnormal mandibular

movements

▶ Check occlusion of teeth in existing dentures.

 NEEDLE–HOUSE

METHOD:
Occlusal rims are fabricated from impression compound.

 Four metal balls or styli are embedded in the canine and molar areas of the maxillary
occlusal rim.

 The occlusal rims are inserted and the patient is asked to perform various functional
and excursive movements of the mandible with the styli contacting the lower rim.

 The vertical height is reduced as the styli cuts through the lower rim and the patient
is stopped at the appropriate vertical dimension.
 The styli makes three-dimensional diamond-shaped tracings, which can be
transferred to a suitable articulator to duplicate the movements.
 The most anterior point of the marking denotes CR and can be used to mount on any
articulator
 Wax occlusal rims are fabricated. PATTERSON METHOD:
 A trench or trough is made in the mandibular occlusal rim which is filled with
equal mixture of carborundum paste and plaster .

 The occlusal rims are inserted and the functional mandibular movements
will produce compensating curves in the plaster lower rim.

 As the vertical height reaches the appropriate level, the patient is asked to retrude his
jaw and the occlusal rims are joined together with metal staples.
▶ Used soft wax occlusal rims. MEYER’S METHOD:
▶ Tinfoil was placed over the wax and lubricated.

▶ Patient performed functional movements to produce a wax

path

▶ Plaster index was made

 GRAPHIC METHODS
 The earliest graphic recordings were based on studies of mandibular movements
by Balkwill in 1866.
 The intersection of the arcs produced by the right and left condyles formed the
apex of what is known as GOTHIC ARCH
TRACING.
 Hesse (1897)– First to make a Needle point tracing.
 Gysi (1910)– Improved needle point tracing.

 Phillips (1927)– He developed a plate for the maxillar occlusal rims and a tripoded

ball bearing mounted on a jackscrew for the mandibular occlusal rim. He called

this as the "Central Bearing Point".

 WHAT DOES THE TRACING REPRESENTS ?

 Border movements of the mandible in the horizontal plane and its apex in retruded
position (relaxed position) of the mandible.
 Advantage of reproducibility – can verify the centric relation.
 CONCEPT:

 The concept consists of attaching a stylus (a writing device with a pointed end) to
one occlusal rim and a plate to the other rim. The stylus traces or marks the
path in the plate as the mandible performs excursive movements from the
centric position. The tracing is typically in the shape of a ‘gothic arch’ or
‘arrow head’ if the patient is trained to move the mandible from centric to
protrusive,
positions. right and left lateral
 COMPONENTS:

 The tracing can be made intraorally or extraorally.

 The extraoral tracing device consists of a central bearing device and a tracing
device.

 The central bearing device consists of a central bearing point and a central bearing
plate.

 The tracing device consists of a stylus and a recording plate.

 The stylus or stud and central bearing plate attached to the maxillary occlusal rim,
while the central bearing point and recording plates are attached to the
mandibular rim.
 COMPONENTS:

 In theintraoral tracer, the central bearing device also performs the function
of a tracing device. So there is only one set of device
 Central bearing device is a very important aspect of the
device.
 It should be placed in the geometric centre of the maxillary and mandibular arches to
serve the following functions:

 ▪ Maintains vertical dimension.

 ▪ Equalizes the pressure by distributing the forces throughout the supporting

tissues.

 ▪ Allows mandibular movement to be dictated by the condyles.

 ADVANTAGES DISADVANTAGES

▶ Documented to be ▶ May be difficult

the most accurate method to locate the centre

of recording of
very the arches
important for central

CR. which
bearingisfunction and accuracy
of tracing.
▶ Allows equalization of pressure
▶ More time consuming.
on the supporting tissues.
▶ Training patient in making
▶ Easily verifiable.
mandibular movements is
▶ Can also be used strenuous.
to record eccentric
 INDICATIONS CONTRAINDICATIONS

▶ Broad edentulous ridges. ▶ Severely resorbed

▶ Adequate interarch space. ridges and excessively

flabby
they lead to ridges
instability
▶ In patients with habitual
centric, the use of the graphic denture bases. as

method eliminates all occlusal ▶ Decreased interarch space of–

contacts on the rims, thus difficult to place central
breaking the neuromuscular bearing device without raising
reflex and allows the patient to
the vertical dimension.
record his true centric.
▶ TMJ arthropathy.
 PROCEDURE FOR EXTRAORAL
TRACING:
 The maxillary cast is mounted on the articulator with a facebow transfer.
 The mandibular cast is oriented to the maxillary cast at the established
vertical
dimension with a static CR record.
 The condylar elements of the articulator are secured against the centric stops.
 The central bearing and tracing devices are mounted on the respective rims
 The patient is seated with head upright, in a comfortable position on the dental
chair.
 The record bases with the attached devices are inserted in the patient’s mouth.

 They are checked for stability, contact during mandibular movements

and interference
 The stylus is retracted and patient is trained to make various excursive movements
passively and actively (if needed).

 Patient is instructed to move the jaw forwards, right and left from centric position.

 The Ney Excursion Guide has been used as an aid in training the patient but
patient responds better to specific locations than numbers
 When the patient is well trained in making the movements, the recording plate is
coated with a thin coating of lacquer, precipitated chalk or dark coloured wax.

 The coating material should not provide any resistance to movement and produce a
clearly visible tracing .

 The stylus is made to contact the recording plate and the patient is instructed to
make
the specific movements.
 When an
acceptable tracing
is made with a
single sharp apex,
a centric record is
obtained.

 The rims and

tracing are
prepared to receive
the centric record
 The patient is instructed to retrude the mandible such that the stylus contacts the
apex of the tracing.

 Quick setting plaster is injected between the rims and allowed to harden thus, the
centric record is obtained.
 The rims are remounted on the articulator with the new
record
 DEVICES:
▶ a. Hight tracer

b. Sears tracer

c. Phillips tracer

d. Chandra tracer

e. Stansbery tracing
device
 PROCEDURE FOR INTRAORAL
TRACING:

 The procedure with intraoral tracer is similar, but as the tracing is not
visible while being made, a thin plastic disc with a central hole is fixed on
the recording plate such that the hole is placed on the apex of the tracing.

 The patient closes with the tip of the stylus in the hole and this
ensures that the patient closes in centric and maintains the position while
the record is being made.
 DEVICES :
▶ a. Coble tracer
b. Swissdent ball bearing bite
tracer
c. Micro tracer
EVALUATION OF GOTHIC ARCH
TRACINGS :
Classical, pointed form
The symmetry indicates an undisturbed
movement sequence in the joints and
uniform muscle guidance.

Classical flat form

Indicates distinct flat lateral movements of
the condyles in the fossa.
EVALUATION OF GOTHIC ARCH
TRACINGS :
Weak Gothic arch tracing
Indicates a negligent performance of the
movements. The registration must be repeated:
Stronger movements must be demanded from
the patient.

Asymmetrical form
The tracing indicates a distinct inhibition of
the forward component of the lateral
movement in the either one of the joint.
EVALUATION OF GOTHIC ARCH
TRACINGS :
Miniature Gothic arch tracing
This tracing points restricted mandibular
movements.
• Due to badly fitting and pain-causing record bases
or
• Long standing edentulous state with
inhibited movement in the joints.

Vertical line protrudes beyond the arrow

point
forcible retraction or pushing of the
mandible or tracing obtained with protruded
mandible
 PANTOGRAPHIC TRACING:
 Pantograph: An instrument used to graphically record in, one or more
planes, paths of mandibular movement and to provide information for
the programming of an articulator (GPT8).

 Pantographic tracing (pantogram): A graphic record of mandibular

movement usually recorded in the horizontal, sagittal and frontal planes
as registered by styli on the recording tables of a pantograph or by means
of electronic sensors (GPT8).
 PANTOGRAPHIC TRACING:
 It consist of styli and recording plates placed in all three planes and the various jaw
movements from centric position are traced in all the planes .

 The recordings are transferred to a fully adjustable articulator, which is capable of

accepting and reproducing these movements.

 This can also be used to record eccentric relations.

 Records are very accurate but procedure is complex

 CEPHALOMETRICS:

•▶ Use of cephalometrics to record CR was described by Pyott and Schaeffer.

• ▶ The proper CR and vertical dimension of occlusion were determined

by cephalometric radiographs.

• ▶ This method, however, was somewhat impractical and never gained

widespread usage.
 ECCENTRIC RECORDS
 DEFINITION: Any relationship of the mandible to the maxilla other than
CR (GPT8).

• The relation recorded by moving the mandible forward is called protrusive

relation record.

• The relation recorded by moving the mandible mesio- laterally is called

lateral relation record.

• Eccentric relation depends on the shape of the mandibular fossae.

 ECCENTRIC RECORDS
1. Functional method- Needles-House and patterson
technique.
2. Graphic method.
3. Tactile or Direct check methods.
4. Pantography
 GRAPHIC METHOD :
 A distance of 5-6 mm is measured from the apex and is marked.
 Instruct the patient to protrude until the stylus rests on the marked
point.
 Inject the plaster between the occlusal rims and allow it to set.
 Remove the occlusal rims from the mouth and transfer this relation to the articulator.
 the eccentric jaw relation is made with a protrusive distance of 5-6 mm because it
is believed that with a shorter distance, the condyle would not move down its path
and the distance is sufficient to be recorded on the articulator.
 TACTILE OR DIRECT CHECK RECORD METHOD :
 This is the most common method to make a protrusive relation record using soft
wax.
 The preferred time to make the eccentric jaw relation records is after the teeth
have been arranged for try in.
 LATERAL RECORDS :
 more harmony will exist between the mandibular movements and cuspal inclines.
 The most common methods of lateral relation record are.

1. Graphic method.
2. Check bites of wax.
3. pantography.
 GRAPHIC METHOD :
 Requires 2 records
▶ -one on left side
▶ -one on right side
 Articulator is adjusted as record is made
 Additional layers of wax are placed on balancing
side
Hanau formula- L=H/8+12
▶ WAX CHECK BITES: taken at lateral positions and it is desire able to have
more
than one record at each position.
 SUMMARY
▶ Centric relation is a most reproducible, reliable, repeatable, recordable and acts a
reference point.
The goal of complete denture thearpy is to achieve harmonious relationship with
masticatory system. centric relation is the starting point to achieve occlusal harmony.

Irrespective of the method used clinical checking and rechecking must be done
throughout the entire denture construction.

Skill of dentist and cooperation of patient most important factors.

 REFERENCES
▶ Charles M .Heartwell JR. and rahn a. o:syllabus
of complete [Link] edition.
▶ John sharry, complete denture prosthodontics.
▶ Winklers, essentials of complete denture prosthodontics
▶ Carl . O. boucher :prosthodontic treatment for edentulous patients,10 edition.
▶ Ernest.r. granger:centric relation,j.p.d 1952:2 160-169
▶ Kingery.r.h:problems associated with centric relation;j.p.d1952;2;307..
▶ Shanahan T E. Physiologic jaw relations and occlusion of complete dentures. J
Prosthet Dent 1955; 5: 319-322
Bansal, e t al, Critical evaluation of methods to record centric jaw relation, The Journol of lndion Prosthodontic Society ; July 2OO9 ,Vol 9: lssue 3
 REFERENCES
▶ Prosthodontic treatment foe edentulous patients- zarb-bolender 12th edn.
▶ The Academy of Prosthodontics. Glossary of prosthodontic terms. J Prosthet Dent 1999; 81:48-106.
▶ The Academy of Prosthodontics. Glossary of prosthodontic terms. J Prosthet Dent 1994; 71:40-116.
▶ The Academy of Prosthodontics. Glossary of prosthodontic terms. J Prosthet Dent 2005; 94:10-85.
▶ Saizer P. Centric relation and condylar movement: anatomic
mechanism. J Prosthet Dent 1971;26(6):581-91.
▶ Palaskar, J.N., Murali, R. & Bansal, S. Centric Relation Definition: A Historical and
Contemporary
Prosthodontic Perspective. J Indian Prosthodont Soc
▶ Yurkstas AA, Kapur KK. Factors influencing centric relation records in edentulous mouths. J Prosthet
Dent 2005;93:305-10.

▶
CBanesanl,tertical, rCeritliacatl ieovanluartieoncoof mredthsod-sHtoisrectoordriccenatrlic rjaewvreileatwion, The Journol of
lndion Prosthodontic Society ; July 2OO9 ,Vol 9: lssue 3
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