Consensus Statement on the Relationship Between Centric Occlusion and the Maximal Intercuspal Position and Their Use as Treatment Positions for Complete Mouth Rehabilitation

 

TAKE-HOME MESSAGE

  • This best evidence consensus statement aimed to examine the relationship between centric occlusion (CO) and maximal intercuspation position (MIP) and the use of either as a treatment position for complete mouth rehabilitations in dentate or partially dentate patients. A total of 313 articles contributed to this review, finding that CO and MIP are not coincident in a majority of the population. With regard to complete mouth rehabilitation, most reports suggest that CO provides a physiologic, reliable, and reproducible position, with limited reports finding an association between TMJ symptomatology and CO-MIP discrepancies in the treated dentition.

  • While CO-MIP discrepancies are the norm in the natural dentition, complete rehabilitations seem to perform better at CO rather than MIP based on available evidence. It should be noted that the authors could not include lower-quality evidence supporting the use of MIP as the treatment position due to the inclusion criteria of this review, suggesting that further well-controlled studies with a longer follow-up directly comparing the two positions would be desirable.
–  Tapan N. Koticha, BDS, MDS

PURPOSE

The purpose of this Best Evidence Consensus Statement was to evaluate the existing literature relative to two focus questions: How often does centric occlusion coincide with maximal intercuspal position in dentate and partially dentate populations?; and should centric occlusion or maximal intercuspal positions be equivalent for dentate and partially dentate patients undergoing complete mouth rehabilitation?

MATERIALS AND METHODS

Keywords used in the initial search were: intercuspal position, centric occlusion, centric relation, maximal intercuspal position, prosthodontic rehabilitation, and occlusion. The search was then limited to Systematic Reviews, Randomized Controlled Studies, Meta-analyses and Clinical Trials.

RESULTS

The initial search strategy related to the selected search terms resulted in more than 15,000 articles. When the subsequent search was limited to Systematic Reviews, Randomized Controlled Studies, and Meta-Analysis and Clinical Trials, 313 articles were selected for further analysis.

CONCLUSIONS

Review of the literature reveals that most dentate and partially dentate patients do not have coincident centric occlusion and maximal intercuspal position. There is support for coincidence between centric occlusion and maximal intercuspal position as the preferred occlusal relationship in complete mouth rehabilitations. The literature does not report conclusive evidence of adverse prosthodontic outcomes with complete rehabilitations in centric occlusion or maximal intercuspal position in a healthy population. However, there is support for an association between centric occlusion-maximal intercuspal position discrepancies and occlusal instability as well as temporomandibular joint disorders. Hence, it is concluded that partially and completely dentate patients requiring complete mouth rehabilitation should be restored in centric occlusion.

Copyright © 2021 Elsevier Inc. All rights reserved.

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