Centric Relation in Dentistry
Kushal GadhiaBDS, MFDS (RCS Eng.), MSc (Cons), FDS (Rest. Dent)
Consultant in Restorative Dentistry, Eastman Dental HospitalClinical Director at Centre Of Dental Excellence
Clinical Director at Royston Dental careDirector at Advanced Centre of Excellence (ACE)
Specialist in Periodontology, Endodontics, ProsthodonticsSpecial Interest in Implant Surgery
Study Club Director Dentinal Tubules (North London)
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V1 – impressions –> study casts
V2 – record the CR -> lucia jig, facebow, bite records
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Step 1: Examine the occlusion of the subject
Step 2: Cotton wool between the anterior teeth for 10 minutesAssess the amount of separation at the most posterior teethIdeally you want 2 – 2.5mm separation (for michigan splint)
Step 3: Vaseline the anterior teethLet the patient know to inform you if the teeth feel hot
Step 4: Mix the Duralay (pattern resin)Ensure the cotton woll roll is always in place and the teeth don’t contact
Step 5: Construct the duralay jig and let is setTake it in and out as the consistency hardensDon’t lock it in between the teethDon’t let it get too hot - Very important
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Step 6: Once set, assess there is no rocking of the Jig when fully seated
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Step 7: Check that the separation between the 7’s is at least 2mm
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Step 8: With the jig in place, ask the patient to slide mandible in protrusion and backwards multiple time, OBSERVE THE OCCLUSION CAREFULLY FALL INTO CR
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Step 9: Check which anterior teeth contact with a BLUE / BLACK articulating paper
Step 10: Record Protrusive marks
Step 11: VISUALISE WHAT HAPPENS IN LATERAL EXCURSIONS AND PICK A TOOTH
Step 12: WITH A TOOTH OF YOUR CHOICE, AS PATIENT TO MAKE THE FOLLOWING MOVEMENTS
PROTRUSION
RIGHT LATERAL EXCURSION
PROTRUSION
LEFT LATERAL EXCURSION
PROTRUSIONwww.ace-courses.co.uk
Step 12: PROTRUSION AND RIGHT LATERAL MOVEMENTS ONLY. ELIMINATE THE UNWANTED LINES
Step 12: PROTRUSION AND RIGHT LATERAL MOVEMENTS ONLY. ELIMINATE THE UNWANTED LINES
Step 13: WITH A TOOTH OF YOUR CHOICE, AS PATIENT TO MAKE THE FOLLOWING MOVEMENTS
PROTRUSION
RIGHT LATERAL EXCURSION
PROTRUSION
LEFT LATERAL EXCURSION
PROTRUSIONwww.ace-courses.co.uk
Step 13: VISUALISE AND MARK WHAT HAPPENS IN LEFT LATERAL EXCURSIONS
Step 13: ELIMINATE THE LINES YOU DON’T WANT
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MIP
LLERLE
CR
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Step 14: RECORD THE CENTRIC RELATION
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Step 14: RECORD THE CENTRIC RELATION
Take Moyco beauty waxRun it under Hot WaterFold it in 3Trim the wax to fit the dentitionAsk the patient to bite into the beauty wax and let it set
You want light indentationsYou can reline it later with temp bond to get accurate indentation
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Step 14: VERIFY THE BITE REG ON YOUR DIRECTORS STUDY CASTS
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