Horizontal jaw relations

Preeti KaliaIst year PG student

Department of Prosthodontics A.E.C.S Maaruti Dental College

Horizontal jaw relation

Definition

Theories of centric relation

Techniques

Physiologic

Functional GraphicOther

Eccentric relation records

Definition GPT 1’ defines centric relation as “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 movement can be made, at any given degree of jaw separation.”

Definition GPT 8 is “The maxillomandibular relationship in which the

condyles articulate with the thinnest avascular portion of their respective discs with the complex in the anterior superior position against the slopes of the articular eminences. 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”

Centric relationAnatomical

S. Davies and R. M. J. Gray, What is occlusion? British Dental Journal, Vol 191, No. 5, September 2001

Centric relationConceptual

S. Davies and R. M. J. Gray, What is occlusion? British Dental Journal, Vol 191, No. 5, September 2001

Centric relationGeometrical

S. Davies and R. M. J. Gray, What is occlusion? British Dental Journal, Vol 191, No. 5, September 2001

Theories of centric relation

Muscle theory

Theories of centric relation

The ligament theory

Theories of centric relation

Osteofibre theory

Theories of centric relation

Meniscus theory

Centric relation

Techniques

According to John.J.Sharry

Checkbites

Excursive recordings

Deglutition

Terminal hinge axis

Techniques

Techniques

Physiological

Tactile

Pressureless

Pressure

Functional

Needlehouse

Patterson

GraphicIntraoral

Extraoral

TechniquesPhysiological method

Indications

Flabby tissue

Physiological method

Materials used

Aluwax Aluwax Aluwax

Aluwax

Physiological method

Tactile sense or interocclusal record method

It involves 2 steps.

First a tentative centric jaw relation is recorded using wax occlusal rims.

In the second step an interocclusal check record is made using the trial denture during try-in

Physiological method

Pressure less method

Physiological method

Nick and notch method

Physiological method

Pressure method

The lower occlusal rim is fabricated to be of excess height

occlusal rim is softened in a water bath and inserted carefully into the patient’s mouth

patient is guided to close his mouth in centric relation

Physiological method

Staple pin method

Functional or chew-in method

Needle house method

Functional or Chew-in-method

Patterson’s technique

Graphic methods

Intraoral tracing device

Graphic methods

Graphic methodsExtaoral tracing device

Graphic methodsExtaoral tracing device

Graphic method

Indications

Well healed broad edentulous ridges.

Adequate interarch space

Graphic methodContraindications

Severely resorbed ridges

Excessively flabby ridges

Instability of denture bases

Decreased arch space

In patients with temporomandibular joint disorders

In patients with abnormal jaw relation

Classification of Gothic arch tracings

Greber 19661) Classical pointed form

2) Classical flat form

3) Asymmetrical form

4) Miniature tracing

5) Vertical line protrudes beyond the arrow point

Pantographic tracing

Other methods of recording centric relation

Swallowing

Chin point guidance

Chin point guidance with anterior jig

Bilateral manipulation

Martin E. Kantor, Sidney I. Silverman and Lawrence Garfinkel ,Centric-relation recording techniques-a comparative investigation,J Prosthet Dent 1972:28;6,593-600

Swallowing

Chin point guidance

Chin point guidance with anterior jig

Bilateral manipulation

Protrusive interocclusal record

Whip mix

Protrusive interocclusal record

Hanau

Protrusive interocclusal record

Hanau

Lateral interocclusal records

Whip mix Set side shift guide at 45o.

6mm from centric relation along LL.

Right condyle is in protrusion.

Lateral interocclusal records

Hanau

Factors contributing to inaccuracy of eccenrtric records Unstability of records

Resiliency and displaceability of denture bearing tissues

Materials used in record making

Equipment used in record making

Lack of muscle coordination by the patient

Use of articulators not adjusting to all introcclusal check records

Clinical protocol

Clinical protocol

Clinical protocol

Centric relation versus centric occlusion

Review of literature

Ansari.I.H, A one appointment complete denture impression and centric relation record method for compromised complete denture patients, J Prosthet. Dent,December, 1997:78;320-323

Review of literature

Ansari.I.H, A one appointment complete denture impression and centric relation record method for compromised complete denture patients, J Prosthet. Dent,December, 1997:78;320-323

Review of literature

Bissasu.M, Use of the tongue for recording centric relation for edentulous patients, J Prosthet Dent 1999;82:369-70

References Sheldon Winkler,Essentials of Complete

Denture Prosthodontics,2nd edition,A.I.B.T.S publishers and distributors, India, pp-183-201

John.J.Sharry, Complete denture prosthodontics, 3rd edition, Mcgraw-Hill book company,USA, pp-215-222

Charles.L.Bolender,Prosthodontic treatment for edentulous patients,12th edition,2003,Mosby publications,St.Louis,pp-268-297

A.O Rahn and C.M Heartwell,Textbook of complete dentures,4th edition,1993,Lea and Fabiger,USA,pp-290-308

References

Deepak Nallaswamy,Textbook of Prosthodontics, Ist edition,2003,Jaypee publishers,New Delhi,pp-108-151

A.O Rahn and C.M Heartwell,Textbook of complete dentures,4th edition,1993,Lea and Fabiger,USA,pp-290-308

Granger.E.R. Centric relation, J Prosthet Dent

1953:2;2 pp:160-177 Cohen.R, Hinge axis and its practical

application in the determination of centric relation,Jprosthet Dent 1960:20;2 pp:248-257

References Martin E. Kantor, Sidney I. Silverman and Lawrence Garfinkel Centric- relation recording techniques-a comparative investigation,J Prosthet Dent 1972:28;6,59

James Hart long, An instrument for locating centric relation ,J Prosthet Dent 1973:30;1,50-52

William E. Avant , Using the term “centric”, J Prosthet Dent 1971:25;1,pp:12-15

References

Lawrence A. Weinberg, Temporomandibular joint function and its on centric relation,J Prosthet Dent 1973:30;2,176-195

Ansari.I.H, A one appointment complete denture impression and centric relation record method for compromised complete denture patients, J Prosthet. Dent,December, 1997:78;320-323

Bissasu.M, Use of the tongue for recording centric relation for edentulous patients, J Prosthet Dent 1999;82:369-70.

References S. Davies and R. M. J. Gray, What is

occlusion? British Dental Journal, Vol 191, No. 5, September 2001,

Thomas E.J. Shanahan, Physiologic vertical dimension and centric relation ,J Prosthet Dent 2004: 91;3,203-209

13) Yoshiyuki Watanabe,Observation of horizontal mandibular positions in an edentulous patient using a digital gothic arch tracer:A clinical report,J Prosthet Dent 2004 :91;1,15-19

References

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