Centric Relation: All Methods of Registration and Clinical Application

Category: Gnathology

Instructor(s): Lukas Lassmann, Mike Racich, Marcelo Matos, Kamil Stefanski, Jean-Daniel Orthlieb

Course structure: Lessons: 9 lessons | Duration: 11 h 03 min

Course overview

Centric relation is the key to successful dental treatment!
We've put together EVERYTHING every dentist needs to know about the centric relation in one course where you'll learn:
– All popular centric relation registration protocols: classical and digital
– Treatment planning taking into account the centric relation
– Centric relation in the work of an orthodontist and prosthodontist.
This course is required for all dentists involved in prosthetics, orthodontics and the treatment of tooth wear. After completing the training, you will be able to choose the optimal concept for CR registration!

Curriculum

Centric relation: introduction

• Lesson program:
• – Centric Relation: modern definition
• – Centric Relation: evolution of terminology
• – Centric Occlusion: definition
• – Vertical dimension of occlusion (VDO): definition
• – Rule of thirds
• – Mutually Protected Occlusion
• – TMJ examination: clinical and laboratory
• – Habit bite
• – Centric Relation: clinical recommendations
• – Chewing studies.
• Recommended for: Orthodontists, Prosthodontists, Functional dentists, Dental technicians, General dentists.

From the historical mechanic "centric relation" to a biological model

• Lesson program:
• – The importance of CR in dentistry
• – The modifications of the concept of centric relation (CR) over the years
• – The problem and limitations of use CR for diagnosis and treatment
• – Imaging and the jaw relationship
• – Condyle position from a biological perspective
• – TMJ pathology and its impact on occlusion
• – Dental based vs orthopedic based occlusion.
• Recommended for: Orthodontists, Prosthodontists, Functional dentists, Dental technicians, General dentists.

CR registration using hard wax

• Lesson program:
• – The terminal hinge axis movement concept
• – Stable centric relation: definition
• – P.K. Thomas and Lauritzen manipulation and the P. Dawson maneuver: disadvantages
• – Method of registration of the centric relation using wax plates
• – Creation of an anterior occlusal stop: indications and methodology
• – Reproducibility of the central ratio: Split cast technique.
• Recommended for: Orthodontist, Gnathologist, Prosthetist, Dental Technician, General Dentist

CR registration using neuromuscular approach. How to achieve stable results

• Lesson program:
• – Occlusion and malocclusion: definition
• – Rationale behind the neuromuscular approach to occlusion
• – The concept of habitual bite
• – Physiologic vs accommodative trajectory
• – Available equipments used to diagnose and treat cases via neuromuscular approach
• – Patient examination algorithm in the concept of neuromuscular dentistry
• – CR registration using neuromuscular approach
• – 3 keys to work in the concept of neuromuscular dentistry
• – The method of obtaining the registry
• – Orthotic: types and advantages of application
• – Goals of the phase II of treatment
• – What final options are available and an example of approaching a worn dentition rehabilitation
• – Framework to approach occlusal stability.
• Recommended for: Prosthodontists, Functional dentists, Restorers, General dentists.

Dawson method of centric relation determination

• Lesson program:
• – Centric Relation: definition and history
• – Factors that affect Centric Relation records
• – Central occlusion and maximal intercuspidation
• – TMJ problems during orthodontic treatment
• – Posselt diagram
• – Occlusal diseases
• – FACE Digital Mounting: principles
• – Evaluation of Centric Relation term
• – Centric Relation registration method: Dawson method and Lucia jig
• – Preparation for orthodontic treatment
• – Preparation for Centric Relation establishment: muscles deprogramming
• – Mountings in Centric Relation
• – Mistakes in Centric Relation determination.
• Recommended for: Orthodontists, Prosthodontists, Functional dentists, Dental technicians, General dentists.

Digital methods of centric relation determination

• Lesson program:
• – The reliability of radiological methods for determining central occlusion
• – Digital bite from IOS
• – The concept of Tx: vertical control
• – Centric Relation in case aligner treatment
• – Prescription for technicians
• – Aligners — save distalization appliance to hight-angle patients
• – TMJ disk lock
• – Pros and cons of digital treatment planning in arc of closure
• – Hybrid treatment with Stop&Go: protocol
• – Axioprisa: advantages of the technique
• – Digital mounting protocols
• – Surgery cases simulation.
• Recommended for: Orthodontists, Prosthodontists, Functional dentists, Dental technicians, General dentists.

Determining the CR using Lucia Jig

• Lesson program:
• – Patient deprogramation
• – Dawson Maneuver
• – Placing the Lucia Jig: the technique, materials, typical mistakes
• – Denar Wax or silicon bite registration: which method is better? Typical mistakes. Proper sequence of workflow
• – Facebow
• – Analogue models mounting in the articulator
• – Models CR analysis.
• Recommended for: Orthodontists, Prosthodontists, Functional dentists, Dental technicians, General dentists.

Interdisciplinary treatment planning in the concept of centric relation

• Lesson program:
• – Surgical cases in orthodontic treatment:
• transverse analysis
• suture maturity
• expantion
• Silesia Expander by Dr. Kamil.
• – Digital assistent in dental office
• – Molar torque correction
• – Torque selection based on CBCT
• – Assessment of long-term results of treatment.
• Recommended for: Orthodontists, Prosthodontists, Functional dentists, Dental technicians, General dentists.

Clinical application of CR in prosthodontics and orthodontics

• Lesson program:
• – MRI and CBCT positioning of the condyle – when does it make sense?
• – 4/7 position and rearmost position – why they were used and why they were stopped
• – Centric slide – a physiological phenomenon or a big mistake?
• – Constricted Chewing Pattern (CCP) and the “long centric”
• – Compression and decompression in TMJ – is the joint space important for us?
• – Rotation / translation – are we actually separating these two movements?
• – Defining the Central Relation – dental cabaret
• – Adapted centric posture. How do I know when an intervention is needed?
• – Muscle vectors of the stomatognathic system
• – Establishing a centric relation (deprogrammers and maneuvers)
• – Triple centric relation and determining the position of the articular fossa
• – Forward position – splint reposition, functional orthodontics, apnea treatment
• – Neuromuscular position – main principles and doubts
• – What position should we choose and when should we look for it?
• – Does an incorrect position in the joint guarantee TMD?
• Recommended for: Prosthodontists, Functional dentists.