What Materials and Reproducible Techniques May Be Used in Recording Centric Relation?
TAKE-HOME MESSAGE
This best evidence consensus statement identifies that variance in recording the CR position occurs as a result of the technique and materials used as well as a circadian influence, with small variations (100ths of a mm) not being clinically significant. Evidence from the literature suggests that techniques using chin point guidance, bimanual manipulation, power centric, Gothic arch tracing, leaf gauge, and Lucia jig to record CR can all be comparable in precision and accuracy while polyvinyl siloxane and poly ether materials provide the most accurate records.
- The review suggests that practitioner training, experience, and familiarity with the techniques are associated with precision of the CR record, while most techniques seem to be comparable, except for the Myomonitor technique, which produced inconsistent and generally poorer results. Multiple CR records to validate the recorded position also seem to reduce the potential for error.
PURPOSE
The purpose of this Best Evidence Consensus Statement was to evaluate the existing literature relative to two focus questions: What are the techniques used and their reproducibility in recording centric relation (CR) in a dentate and partially dentate population and what effect do different recording materials have on the reproducibility of CR?
MATERIALS AND METHODS
Keywords used in the initial search were: CR, interocclusal records, CR accuracy, CR reproducibility, and CR technique. The search was then limited to Systematic Reviews, Randomized Controlled Studies, Meta-analyses, and Clinical Trials.
RESULTS
Initial search related to the selected search terms resulted in more than 3500 articles. When subsequent search was limited to Systematic Reviews, Randomized Controlled Studies, and Meta-Analysis and Clinical Trials, this resulted in 291 articles selected for further analysis.
CONCLUSIONS
Techniques using chin point guidance, bimanual manipulation, power centric, Gothic arch tracing, leaf gauge, and anterior deprogramming devices to record CR can all be comparable in precision and clinical accuracy in regards to clinical relevance. Practitioner experience and familiarity with a particular technique is critical for accuracy when recording CR. Polyvinyl siloxane and polyether consistently performed better in the broad range of studies on recording materials. Virtual capture of CR could serve as a comparable recording medium but requires further clinical study.
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