Área de Céntrica, Revisión del Concepto. Una Revisión Narrativa / Central Area, Review of the Concept. A Narrative Review

La búsqueda de una oclusión ideal es uno de los principales objetivos de los tratamientos rehabilitadores. Para que esta se cumpla, es necesario que se presenten ciertas características, en base a esto, se ha constituido el concepto de "tríada en céntrica", que se define como la coincidencia entre la relación céntrica fisiológica (RCF), posición muscular de contacto (PMC) y posición de máxima intercuspidación (PMI), existiendo de esta forma un equilibrio morfofuncional óptimo de los diferentes componentes del sistema estomatognático. Así nace la necesidad de analizar los conceptos que involucren la relación existente entre las distintas posiciones mandibulares, dentro de estos conceptos encontramos el "área de céntrica", que debido a sus características, se le atribuye relevancia y utilidad clínica cuando se entiende su aplicación. El objetivo de este estudio fue analizar el concepto de área céntrica, actualizar los conceptos oclusales asociados y proponer nuevas metodologías para su evaluación. En ocasiones existen interferencias oclusales que impiden que la mandíbula continúe su recorrido habitual para llegar a determinada posición, estas interferencias se conocen como contactos prematuros, cuando estos existen, naturalmente la mandíbula se desvía hacia una posición de acomodo. El deslizamiento en céntrica se define como el movimiento de la mandíbula mientras se encuentra posición retruida de contacto no forzada, es decir, la posición de contacto que se produce cuando la mandíbula se cierra en RCF, hasta llegar a PMI, este deslizamiento se produce debido a la presencia de contactos prematuros, cuando no existen contactos prematuros, esta posición coincidirá con PMI. El área de céntrica se define como el deslizamiento de la mandíbula entre la posición retruída ligamentosa (PRL) y PMI. Idealmente, la PMI se da cuando los cóndilos están en RCF y coincide con la PMC, debe existir siempre un área de céntrica, pues fisiológicamente ninguna articulación adoptara naturalmente una posición extrema como la PRL.

The search for an ideal occlusion is one of the main objectives of rehabilitation treatments. For this to be fulfilled, some characteristics need to be present, based on this, the concept of "centric triad" has been constituted, which is defined as the coincidence between the physiological centric relation (CR), muscular contact position (MCP) and maximum intercuspal position (MIP), thus existing an optimal morphofunctional balance of the different components of the stomatognathic system. In this way, the need arises to analyze the concepts that involve the relationship between the different mandibular positions, within these concepts we find the "centric area", which due to its characteristics, it is attributed relevance and clinical utility when its application is understood. The objective of this study was to analyze the concept of centric area, update the associated occlusal concepts and propose new methodologies for its evaluation. Sometimes there are occlusal interferences that prevent the jaw from continuing its usual path to reach a certain position, these interferences are known as premature contacts, when they exist, the jaw naturally deviates towards a position of accommodation. Centric slide is defined as the movement of the mandible when it is in a retruded contact position unforced, that is, the contact position that occurs when the mandible closes in CR, until reaching MIP, this sliding occurs due to in the presence of premature contacts, when there are no premature contacts, this position will coincide with PMI. The centric area is defined as the slippage of the mandible between the retruded ligamentous position (RLP) and MIP. Ideally, the PMI occurs when the condyles are in CR and coincides with the MCP, there should always be a centric area, since physiologically no joint will naturally adopt an extreme position like PRL.

Control vertical mediante bite block en relación céntrica / Vertical control through bite block in centric relation

Paciente femenina de ocho años y cuatro meses, con patrón esquelético de clase II severa y overjet de 10 mm, fue tratada con Bite-Block Céntrico como método de control vertical. Después de cinco meses de terapia con aparatología fija de primera fase se logró control vertical y reducción de las desviaciones de la clase esquelética. Posteriormente se continuó con tratamiento activo durante 18 meses, se dio de alta de la primera fase cuando los objetivos del tratamiento como alineación, nivelación, overbite y overjet fueron adecuados. Los registros postratamiento demostraron una buena estabilidad articular, oclusión funcional y una mejora en la estética facial. El montaje en céntrica postratamiento demuestra estabilidad condilar con el uso de Bite-Block Céntrico como método de control vertical (AU)

Female patient of eight years and four months, with skeletal pattern of severe class II and 10 mm overjet, was treated with Bite-Block Centric as a vertical control method. After five months of therapy with fixed appliances of the first phase, vertical control and reduction of the deviations of the skeletal class were achieved. Subsequently continued with active treatment for 18 months, was discharged from the first phase when the treatment objectives such as alignment, leveling, overbite and overjet appropriate. Post-treatment records showed good joint stability, functional occlusion and an improvement in facial aesthetics. The posttreatment centric assembly demonstrates condylar stability with the use of Centric Bite-Block as a vertical control method (AU)

Comparison of the accuracy of three methods for determining maxillomandibular horizontal relationship of the complete denture / 华西口腔医学杂志

OBJECTIVE@#To observe the changes of forward displacement of maxillary complete denture during centric occlusion, three different methods were used to record the changes of vertical overlap and the comfort level of patients before and after the selective grinding of the three dentures made according to maxillo-mandibular horizontal relationship record.@*METHODS@#Twelve edentulous patients with normal stomatognathic system were recruited in this study. Three types of complete dentures for these 12 edentulous patients were made according to their different maxilla-mandibular horizontal relationship record methods. The amount of displacement of the maxillary complete denture, the vertical overlap of the anterior teeth as well as patient comfort level were recorded before and after selective grinding. Statistical analysis was performed using the SPSS 17.0 software package.@*RESULTS@#Before selective grinding, the amount of displacement of denture A was significantly larger than those of dentures B and C (P0.05). During selective grinding, the vertical overlap variation of denture A was significantly greater than those of dentures B and C (P0.05). After selective grinding, no statistical difference was found among the three dentures (P>0.05).@*CONCLUSIONS@#Among the complete dentures with anatomical teeth, the dentures whose horizontal relationship was recorded at 1 mm before the apex of the Gothic arch apex and with checkbite are more in line with clinical repair requirements. Complete dentures whose horizontal relationship was recorded at the apex of Gothic arch need to be adjusted with selective grinding to meet the clinical restoration requirements.

Terapia combinada de láser diódico y plano desprogramador neuromuscular en pacientes con disfunción temporomandibular / Combined therapy of diode laser and neuromuscular deprogrammer splint in patients with temporomandibular disorder

La desprogramación neuromuscular juega un papel importante en el tratamiento de la disfunción temporomandibular, uno de los principales inconvenientes es el periodo prolongado del tratamiento, lo cual influye en la aceptación del paciente o el abandono del tratamiento. El diagnóstico es crucial para planificar el tratamiento ya que cubre una amplia gama de variables para tratarlo, por lo que en este caso es un paciente dolicofacial, con problemas de disfunción temporomandibular de origen muscular, por lo cual se optó por utilizar laserterapia de bajo nivel como coadyuvante de tratamiento, dando como resultado una mejor aceptación y colaboración de la desprogramación del paciente en un periodo de tiempo más corto (AU)

Neuromuscular deprogramming plays an important role in the treatment of temporomandibular dysfunction, one of the main drawbacks is the prolonged period of treatment, which influences the acceptance of the patient or the abandonment of treatment. The diagnosis is crucial to plan the treatment since it covers a wide range of variables to treat it, so in this case it is a dolichofacial patient, with problems of temporomandibular dysfunction of muscular origin, which is why we chose to use low-level laser therapy, level as a coadjutant of treatment, resulting in a better acceptance and collaboration of the deprogramming of the patient in a shorter period of time (AU)

Research progress on the relationship between centric relation and orthodontic treatment / 华西口腔医学杂志

Centric relation (CR) is one of the core research contents in orthodontics, prosthodontics, and gnathology, acting as an important physiological factor in reconstructing the occlusion and adjusting the occlusal relationship. For over a century, CR is still a controversial subject in dentistry. CR has been redefined for several times, and recently, its application has been widened in orthodontics, including orthodontic diagnosis, clinical examination and analysis, and treatment goals. The purpose of this article is to review the definition of CR, its relationship with malocclusion, and the application of this relationship in orthodontic treatment.

Restablecimiento de dimensión vertical en paciente con presión retrodiscal / Restoring of Vertical Dimension in a Patient with Retrodiscal Pressure

RESUMEN Cuando realizamos la rehabilitación oral, debemos considerar la importancia de lograr la estabilidad ortopédica al finalizar el tratamiento. Dicha condición depende de la Articulación Temporomandibular y todos los componentes neuroclusomusculares. Para lograrlo es necesario tomar en cuenta diferentes parámetros como son la oclusión en céntrica y la dimensión vertical. Al hacerlo disminuimos la probabilidad de que se presenten diferentes problemas neuroclusomusculares como son Trastornos de la Articulación Temporomandibular, Bruxismo, problemas periodontales, abfracciones, fractura de restauraciones, entre otros.

ABSTRACT When oral rehabilitation is performed, an important consideration is to reach an orthopedic stabilization, at the end of the treatment. This condition depends on the Temporomandibular Joint and all neuroclusomuscular components. To achieve this, it is necessary to take into account different parameters such as centric occlusion and vertical dimension. In doing so, we decrease the likelihood of different neuroclusomuscular problems, such as Temporomandibular Joint Disorders, Bruxism, periodontal problems, abfractions, fracture of restorations, among others.

Evaluation of electromyogram activity and masticatory efficiency in edentulous individuals whose maxillomandibular horizontal relationship records were obtained with three different methods / 华西口腔医学杂志

<p><b>OBJECTIVE</b>This study was performed to investigate the electromyographic (EMG) activity of the masseter muscle and the anterior temporalis muscle, as well as the masticatory efficiency after insertion of the dentures in edentulous individuals whose maxillomandibular horizontal relationship records were obtained with three different methods.</p><p><b>METHODS</b>Ten edentulous individuals were enrolled in this study. Three types of complete dentures for these 10 edentulous patients were made according to their different maxillomandibular horizontal relationship records. The maxillomandibular horizontal relationship of complete dentures was recorded by three methods. In the first method (A), the maxillomandibular horizontal relationship was determined at the gothic arch tracing apex. In the second method (B), the relationship was 1 mm anterior to the tracing apex with the gothic arch. In the last method (C), the horizontal jaw relation was recorded by natural chewing. The muscular activities of the three complete dentures were examined by EMG. The masticatory efficiency was evaluated based on the absorbance. The differences among the dentures were statistically analyzed with SPSS 17.0.</p><p><b>RESULTS</b>The muscular activities of dentures B and C were much higher than that of denture A during clenching in the center occlusion and during chewing (P<0.05). The highest asymmetry index was found indenture C, which was significantly higher than those of dentures A and B (P<0.05). A statistically significant increase in the absorbance was observed between dentures B and C (P<0.05); otherwise, no statistically significant differences were observed (P>0.05) between B and C.</p><p><b>CONCLUSIONS</b>Given the limitations of this experimental design, in edentulous individuals the maxillomandibular horizontal relationship recorded at 1 mm anterior to the tracing apex with the gothic arch can improve the function of masticatory muscles and strengthen masticatory performance.</p>

El aporte de la bioestética / The contribution of bioesthetic to orthodontics

La bioestética es un excelente complemento para la obtención de estética dental, facial y oclusión funcional en diferentes casos ortodóncicos. La importancia de diagnosticar y planear su utilización, antes, durante o al final del tratamiento ortodóncico, obliga al ortodoncista a tener una conducta en su diagnóstico y un plan de tratamiento para que se realice en su máximo potencial y, sobre todo, se logre estabilidad de resultados.

Bioesthetic is an excellent complement to achieve dental and facial aesthetics and functional occlusion in different orthodontic cases. The importance of its diagnosis and treatment planning, before, during or at the end of orthodontic treatment obliges the orthodontist to have a behavior in his diagnosis and a treatment planning for reaching its realization in its maximum potential and mostly to achieve stability in results.

Influencia de la guía incisiva en personas con trastornos temporomandibulares Área Norte de Sancti Spíritus / Influence of incisive guide in temporalmandible problems Northern Area Sancti Spiritus

Fundamento: Los trastornos temporomandibulares constituyen un problema de salud mundial, su origen es multifactorial, estos pueden ser influenciados por factores como la guía incisiva, que puede determinar de una forma u otra el grado de severidad de estos trastornos. Objetivo: Describir la influencia de la guía incisiva en la aparición de los trastornos temporomandibulares. Metodología: Se realizó un estudio transversal con un diseño no experimental, a los pacientes de 15 a 59 años del área Norte de Sancti Spíritus que acudieron al servicio de Prótesis dental en la Clínica Estomatológica Docente Provincial en el período comprendido de enero 2012 a enero 2013. Se utilizaron métodos empíricos de análisis de documentos, observación, entrevista y medición; métodos estadísticos, test de Chi-cuadrado y matemáticos, análisis porcentual. Resultados: El sexo femenino fue el más afectado en 68,3 %, el rango de edad con mayor cantidad de pacientes afectados fue entre 24-32 años con un 36,6 %. Los niveles de disfunción moderado y leve fueron los de mayor frecuencia con un 43,9 % y 36,6 % respectivamente, el síntoma que predominó fue el ruido articular (78,0 %), seguido del dolor muscular (73,2 %). En los pacientes donde no hay resalte o lo tienen aumentado fue donde predominó la disfunción, al igual que los que tienen sobrepase aumentado. Conclusiones: Existe relación significativa entre la guía incisiva y los grados de trastornos temporomandibulares.

Background: Temporalmandible problems constitute a world health problem, they have multifactorial etiologies that can be influenced by factors such as incisive guide that can determine the degree of severity of these problems Objective: To describe the influence of incisive guide in the appearance of temporalmandible problems. Methodology: A transversal non experimental study was done with patients from 15 to 59 years, belonging to the northern area in Sancti Spiritus that went to the dental prostheses service in the Dental provincial Clinic form January 2012 to January 2013. Empirical methods: observation, surveys and measures, statistical methods: Chi square test and mathematical methods: perceptual analysis was used. Results: females were more affected, representing 68,3 %, the most affected range was from 24 to 32 years with 36,6 %. Moderate and slight levels of dysfunction were the most frequent with 43,9 % and 36,6 %, respectively, the most predominant symptom was articular noise with 78,0 %, followed by muscular pain with 73,2 %. Dysfunction was predominant in patients with non resaltation or increase as well as in patients with increased overpass. Conclusion: There is significant relationship between incisive guide and the degrees of temporalmandible problems.

Early Treatment Protocol for Skeletal Class III Malocclusion

Skeletal Class III malocclusion, with its unpredictable and unfavorable nature, has been characterized by a growth pattern with doubtful prognosis regarding orthodontic mechanics, even when performed early. For a long time, Class III malocclusion was regarded as a synonym of mandibular prognathism, regardless of the affected skeletal structures. Mandibular growth, essentially determined by genetic factors, could barely be controlled by early orthodontic interventions. Therefore, the treatment choice was to wait for the patient to grow, and then make an orthodontic intervention associated with an orthognathic surgery. Maxillary involvement in the etiology of Class III malocclusion was conclusive to change orthodontic therapeutics. Maxillary intramembranous growth has a better response to orthopedic treatment, based on growth control and redirection, thus contributing for early intervention success. In several cases, excellent results have been achieved with rapid maxillary expansion and protraction. The aim of this study was to describe and discuss the treatment of a patient with Class III malocclusion, whose treatment planning comprised two phases: interceptive (mechanical orthopedic appliances) and comprehensive (fixed orthodontic appliance). The results of this case showed that Class III malocclusion should be intercepted as early as possible to permit growth redirection, mainly when the maxilla is the primary etiologic factor or dental and/or functional factors are involved. Diagnosis, treatment planning and prognosis depend on patient age, growth potential and severity of malocclusion. Early intervention, adequate indication of appliances, and patient compliance are key factors for good outcomes.

Resumo A má oclusão de Classe III esquelética, com sua imprevisibilidade e natureza potencialmente desfavoráveis, caracteriza um padrão de crescimento com duvidoso prognóstico à mecânica ortodôntica, ainda que esta seja realizada precocemente. Durante muito tempo, a Classe III foi considerada sinônimo de prognatismo mandibular, independente das estruturas esqueléticas comprometidas. O crescimento mandibular, determinado essencialmente por fatores genéticos, dificilmente seria controlado pela intervenção ortodôntica precoce. Assim, optava-se por aguardar o crescimento e então realizar a intervenção ortodôntica associada à cirurgia ortognática. A constatação de envolvimento da maxila como etiologia primária na má oclusão de Classe III foi decisiva para a mudança da terapêutica. O crescimento maxilar, de origem intramembranoso, responderia melhor ao tratamento por meio do controle e direcionamento do crescimento, contribuindo para o sucesso da intervenção precoce. Em muitos casos, excelentes resultados são obtidos com a expansão rápida e protração da maxila. O presente trabalho objetiva descrever e discutir o tratamento de uma paciente com má oclusão de Classe III, cujo plano de tratamento consistiu de duas fases: interceptora, realizada com aparelhos ortopédicos mecânicos e corretiva, com aparelho ortodôntico fixo. Os resultados deste caso clínico demonstraram que a má oclusão de Classe III deve ser interceptada o mais precoce possível, com vistas a redirecionar o crescimento. Esta abordagem deve acontecer, especialmente, quando a maxila é o fator etiológico primário ou quando fatores dentários e/ou funcionais estiverem envolvidos na determinação desta má oclusão. O diagnóstico, ...

Avaliação pré e transoperatória de diferentes registros oclusais em indivíduos com deformidade dentofacial / Pre and transoperative evaluation of different occlusal registrations in subjects with dentofacial deformity

A cirurgia ortognática é uma modalidade terapêutica que vem se tornando cada vez mais comum ao cotidiano de cirurgiões bucomaxilofaciais e ortodontistas. Os dados presentes na literatura quanto a variabilidade do posicionamento mandibular em indivíduos com discrepâncias maxilomandibulares são escassos, fruto de poucas pesquisas ou somente refletem opinião de autores. O presente estudo objetivou a avaliação da variabilidade no posicionamento mandibular entre diferentes registros oclusais e o entendimento da influência das variáveis faixa etária, gênero, tipo de deformidade ou tipo de cirurgia aos resultados. Utilizando amostra composta por 30 indivíduos com deformidade dentofacial a serem submetidos a cirurgia ortognática, estudamos o registro da oclusão dental obtido em três diferentes situações: relação cêntrica, máxima intercuspidação e sob anestesia geral. Tais referências oclusais foram utilizadas para montagem de modelos mandibulares de gesso em articulador semi-ajustável e três pontos dentais (um anterior, um posterior direito e um posterior esquerdo) foram utilizados para determinar possível variação da posição mandibular. Os resultados indicaram tendência geral, com significância estatística, para recuo da mandíbula quando comparamos sua mudança de posição de máxima intercuspidação para relação cêntrica, não havendo significância estatística para a posição mandibular sob anestesia geral quando comparada à posição em relação cêntrica. Faixa etária e tipo de deformidade demonstraram-se como variáveis de influência significante aos resultados.

Orthognathic surgery is a surgical therapeutical modality that has become more common among oral and maxillofacial surgeons and orthodontists. Current data regarding variability of mandibular positioning are scarce, mainly the result of few researches or author`s opinions. The present study aimed the evaluation of the variability of mandibular positioning among different occlusal registrations and the knowledge of whether age, gender, type of deformity or type of proposed surgery would influence results. Through a sample of 30 subjects with dentofacial deformities to be submitted to orthognathic surgery, dental occlusion registrations in three different situations were evaluated: centric relation, maximum intercuspation and under general anesthesia. Such registrations were used to mount cast models on semi-adjustable articulators and three dental points (one anterior, one posterior to the right and one posterior to the left) were used to determine possible variation of the mandibular position. Results indicated overall tendency with statistical significance for mandibular retrusion of the mandible when its position in maximum intercuspation is compared with centric relation, not presenting statistical significance for the mandible position under general anesthesia when compared to centric relation. Age and type of deformity did represent themselves as variables of influence to the results.

Clinical research on curative effect of complete denture with two kinds of occlusion for temporomandibular joint disorders of aged edentulous patients / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To compare curative effect between complete denture with lingualized occlusion and anatomic occlusion on temporomandibular joint disorders (TMD) of aged edentulous patients with severe residual alveolar ridge resorption.</p><p><b>METHODS</b>Seventy aged edentulous patients with severe residual alveolar ridge resorption were recruited in this study and randomly assigned into two groups, thirty-five each. In Group A, patients received complete denture with lingualized occlusion, and in Group B, patients received complete denture with anatomic occlusion. The condition of TMD was examined and recorded by the same TMD specialist at baseline, 3 months and 6 months following denture delivery. The recovery effect of TMD was evaluated according to Fricton Index. Related data were analyzed statistically with t-test and rank sum test.</p><p><b>RESULTS</b>Three months following denture delivery, the craniomandibular index (CMI) decrease value was (0.064 ± 0.022) in group A, and was significantly higher than that in group B (0.043 ± 0.018) (P < 0.01). Six months following denture delivery, the CMI decrease value was (0.084 ± 0.020) in group A, and was significantly higher than that in group B (0.070 ± 0.021) (P = 0.011<0.05).</p><p><b>CONCLUSIONS</b>Complete denture with lingualized occlusion may be more conducive to the remission of TMD for aged edentulous patients with severe residual alveolar ridge resorption.</p>

Occlusion, mandibular position and orthodontic treatment / 华西口腔医学杂志

One of the ultimate goals for orthodontic treatment is to establish an esthetic, healthy, stable and efficient occlusion. Currently, however, most of the criteria are limited to static occlusion, with little attention to dynamic occlusion. During the therapy, the orthodontists may sometimes find the maximum intercuspation (MI) is remarkably inconsistent with the centric relation (CR), or the mandibular positions are different before and after the therapy. These definitely will influence the stability of the treatment, or even the health of temporomandibular joint (TMJ) and stomatognathic system. The functional occlusion theory emphasizes that the displacement of TMJ in the glenoid fossa is the reason for the inharmony between MI and CR, and the relapse. What is more, this theory also gives the orthodontists the ways to evaluate the relationships among the MI, CR and TMJ. In this paper, we will introduce the contents and methods of the functional occlusion theory.

Oclusión dental: ¿doctrina mecanicista o lógica morfofisiológica? / Dental occlusion: mechanistic doctrine or morphophysiological logical?

Las escuelas de oclusión han creado un constructo mecanicista que busca explicar, bajo un modelo reduccionista y determinista, una dinámica cráneo-cervical y estomatognática compleja. Estos modelos de oclusión le dedican más importancia a la morfología dental y sus geometrías interpretativas que a la morfofisiología estomatognática. La configuración musculo-esquelética cráneo-cervical tiene el poder ganado de influir concomitantemente en la ubicación espacial de la mandíbula e implícitamente en las relaciones interoclusales. La visión actual de la oclusión sigue basándose en observaciones empíricas de un siglo de antigüedad que carecen de soporte apropiado en el marco del nivel de evidencia. En la dimensión funcional los modelos de oclusión conservan los mismos vacíos que existían desde su estructuración en el siglo pasado, particularmente en sus representaciones espaciales estáticas, uniáxicas y anti-dinámicas que desestiman la individualidad de cada sujeto. Cada especialidad puede tener tantas razones como puntos de vista diferentes de "maloclusión" así como formas de tratarla.

Occlusion schools have created a mechanistic construct that seeks to explain, under a reductionist and deterministic model, a craneal-cervical and stomatognathic complex dynamic. These occlusion models dedicate more importance to dental morphology and its interpretative geometries than a stomatognathic morphophysiology. Craneocervical musculoskeletal configuration has the gained power to concomitantly influence the jaw location in the space and implicitly in the interocclusal relations. The current vision of the occlusion is based on empirical observations of almost a century that lack support in the level of evidence framework. In the functional dimension occlusion models maintain the same gaps that existed from its origins since the last century, particularly in its static, uniaxic and anti-dynamic spatial representations that dismiss the individuality of each subject. Each specialty can have as many reasons as different points of view about "malocclusion" as well as techniques to treat it.

Métodos de registro de la relación céntrica: ¿Son una necesidad en el diagnóstico y tratamiento de ortodoncia? / Recording methods for centric relation: are they a need in orthodontics

Esta revisión bibliográfica se refiere a los métodos de registro de la Relación Céntrica (RC) con un recorrido de la literatura desde 1921a la actualidad en busca de aclarar su definición. Esta controvertida posición cráneo mandibular lleva a una evolución en las técnicasde su registro.El objetivo es describir los métodos de registro, clasificarlos, aportar conocimiento y demostrar su necesidad en el momento del diagnósticoy el plan de tratamiento de acuerdo a las definiciones más aceptadas de RC.

This literature review analyzes the methods of recording Centric Relation (CR) with a previous revision throughout the years seekingto clarify its definition.This controversial craniomandibular position has gone through many changes in it’s registration techniques. A description of the techniquesis made until arriving to the most recent ones according the current accepted definition. The aim is to describe the methods ofrecording, classify them and provide information in order to choose a method in orthodontics diagnosis and treatment, and demostrateits need according to the most accepted definition of Centric Relation.

An alternative treatment of occlusal wear: Cast metal occlusal surface.

Acrylic resin denture teeth often exhibit rapid occlusal wear, which may lead to decrease in the chewing efficiency, loss of vertical dimension of occlusion, denture instability, temporomandibular joint disturbances, etc. There are various treatment options available like, use of highly cross linked acrylic teeth, amalgam or metal inserts on occlusal surface, use of composite, gold or metal occlusal surface, etc. Several articles have described methods to construct gold and metal occlusal surfaces, however, these methods are time-consuming, expensive and requires many cumbersome steps. These methods also requires the patient to be without the prosthesis for the time during which the laboratory procedures are performed. This article presents a quick, simple and relatively inexpensive procedure for construction of metal occlusal surfaces on complete dentures.

Comparative evaluation of condylar position in symptomatic (TMJ dysfunction) and asymptomatic individuals.

Context: The etiopathogenesis of temporomandibular joint (TMJ) disorders has been attributed to multiple factors and, while the importance of centric relation (CR) has been acknowledged in dental literature, the role of condylar position and CR-CO (CO-centric occlusion) discrepancy in TMJ dysfunction (TMD) has been a source of controversy. Aim: To establish the relationship between condyle position and TMD. Setting and Design: This was a case-control study to evaluate condylar displacement and interarch CR-CO discrepancy in symptomatic subjects (with TMD) and compare them with asymptomatic subjects. Materials and Methods: Forty subjects were screened for TMD based on Helkimo index and grouped into asymptomatic and symptomatic groups. CR was registered using the modified Roth power centric bite registration after neuromuscular deprogramming. Models thus mounted on an Advanced Dental Design (AD2) articulator were evaluated for interarch CR-CO discrepancy. The condylar position discrepancy was recorded on a device MCD (measured condylar deviation). Statistical Analysis: The Student's t test was used to test statistical significance. The paired t test and the unpaired t test were used for comparing results within and between the groups. Pearson correlation coefficient was used to find out the correlation between MCD measurements and dental three-dimensional (3D) model analysis measurements. The Chi-square test was used to evaluate the qualitative data. Results: The average vertical and horizontal condylar displacements were significantly greater in the symptomatic group than in the asymptomatic group. There were significant deviations at the level of the occlusion in both groups. Conclusion: Condyle position may play a significant role in the etiopathogenesis of TMJ disorders.

Desprogramación mandibular: plano de Altura Fija (PAF) / Mandibular desprogramming

Mucho es lo que se propone en materia de desprogramación mandibular, constituyéndose este en un tema controvertido y polémico. La salud de la articulación temporomandibular (ATM) es motivo de preocupación constante, tanto para ortodoncistas como para odontólogos en general... La estabilidad funcional de la oclusión, genera salud articular. Este es uno de los principales objetivos de los tratamientos ortodóncicos. Es así que partiendo de esta premisa, se propone el Plano de Altura Fijo (PAF) como técnica para lograr una correcta desprogramación mandibular, paso fundamental para alcanzar el fin mencionado de otras técnicas

Evaluation of treatment for functional posterior crossbite of the deciduous dentition using Planas' direct tracks.

Background: Functional posterior crossbites are a common finding in children with deciduous teeth and must be treated as soon as they are diagnosed in order to avoid unwanted changes in normal growth and development patterns. Objective: This study objective was to evaluate the changes caused by Planas' direct tracks treatment on the arch dimensions of patients with functional posterior crossbite in first dentition. Materials and Methods: The sample consisted of 20 children, 4 to 6 years old, divided into two groups, paired up according to age and gender. Group test was composed of 10 patients with functional posterior crossbite treated with PDT. Group control consisted of 10 children with normal occlusion. The evaluation criteria were intercanine and intermolar distances and Carrea's analysis (arch perimeter). All data were collected by a pre-calibrated examiner on study casts obtained at baseline and after 4 months of treatment. The statistical analysis of the data was achieved using GraphPad InStat software, version 3.05 for Windows, with the level of significance set at 0.05. For the comparison between intercanine and intermolar distances, the Tukey-Kramer Multiple Comparisons test was used. When Carrea's analysis was considered, the Mann-Whitney test was used. Results: At the beginning of the study, all the evaluated criteria showed lower mean values in patients with posterior crossbites, and significant differences between test and control groups were noticed (P<0.05). After the end of follow-up period, these differences could not be verified (P>0.05). Conclusions: Within the limits of the present study, it is possible to conclude that the treatment with Planas' direct tracks was able to give back the normal dimensions of deciduous arch in patients with unilateral functional posterior crossbites, thus making it possible a better growth pattern.

Evaluation of buccolingual inclination of posterior teeth in different facial patterns using computed tomography.

Background and Objective: Buccolingual inclination of teeth is an essential factor in establishing good occlusion. The objective of this study was to evaluate the buccolingual inclination of molar teeth in different vertical skeletal patterns by using computed tomography scans. Materials and Methods: Coronal section of the jaws obtained from computed tomograms were used to measure the buccolingual inclination of the long axis of the molars relative to their skeletal base. Forty male adult individuals with class I dental occlusion were selected. They were classified as short (Group 1), average (Group II), and long faced (Group III) as per their skeletal patterns measured by GoGn-SN, FH-MP, Y-axis and facial height index in cephalograms. Statistical Analysis: ANOVA and Tukey HSD tests were applied to calculate if there were any significant differences in the mean molar inclination between the groups. Pearson's coefficients of correlation were calculated between the facial parameters and tooth inclination. Results: The differences in the mean molar inclination between the short, average, and long faced groups is significant for mandibular 1 st and 2 nd molars and maxillary 2 nd molars. Conclusion: Variations in mean molar inclination values are observed between short, average, and long faced groups.