Professional Documents
Culture Documents
Linical Ciences: The Anterior Acrylic Resin Platform and Centric Relation Verification: A Clinical Report
Linical Ciences: The Anterior Acrylic Resin Platform and Centric Relation Verification: A Clinical Report
Taylor
Fig. 3. Occlusal record generated with bimanual manipula- Fig. 4. Platform placed on maxillary cast to check for accu-
tion and anterior acrylic resin platform. racy of mounting. Acrylic resin fits precisely on stone model.
platform and the material injected between the occlusal material that can fracture if thin, it must be heated to
surfaces. generate indents that mark mandibular teeth, and it is
After face-bow mounting of the maxillary cast, the not as stable as a broad platform of acrylic resin to
mandibular cast was mounted with the interocclusal transfer to the mounted cast to verify accuracy of
record. The anterior acrylic resin platform was trimmed mounting.
to remove the interproximal septae and any palatal soft For patients with occlusomuscular disharmony caus-
tissue contact, and repositioned on the cast (Fig. 4). ing muscle hypertonicity, mandibular manipulation can
Mandibular incisor contact must be on the intraoral be challenging. The anterior acrylic resin platform acts
mark to rule out distortion in the centric relation as a deprogrammer similar to the leaf gauge and biting
record or plaster mounting. jig, and allows condyles to reposition superiorly as pos-
DISCUSSION terior teeth disengage and neuromuscular feedback
from occluding teeth subsides.1,4,6,8,11 As patients
Accurate centric relation registration requires that protrude and retrude on the appliance to find the start-
only elevator muscles be active during operator assisted ing point for centric relation manipulation, it serves as
arc of closure. Dentists who are learning bimanual an intraoral gothic arch tracing.1,8,10 This definite end-
manipulation become aware of how small forces on the point trains patients to relax, generating a smooth arc
mandible can activate protrusive musculature and of closure before manipulation and load testing.
displace the condyles inferior and anterior to centric The anterior acrylic resin platform allows the dentist
relation.2,3,5 The anterior acrylic resin platform reveals to confirm that no posterior teeth are in contact during
any deviation from centric relation closure objectively, bimanual manipulation by a minimal dimension to
without the dentist relying on obtaining the proper reduce error that earbows incorporate in arc of closure
“feel.” Mandibular incisor contact is on a flat plane and compared with true hinge axis face-bow. The anterior
ensures no distalizing force on the mandible that would acrylic resin platform can be combined with Dawson
result in a posterior-inferior condylar position away bimanual manipulation to improve several aspects of
from centric relation.1,4 occlusal record taking. It is a simple, stable, inexpensive
Leaf gauges do not provide a flat plane contact appliance that is kept in the permanent record of each
against the mandibular anterior teeth and cannot con- patient and enables a single operator to make and
trol this error. This is especially true when mandibular verify occlusal records.
closure is from the patient’s biting force and the den-
tist is not providing external force through the REFERENCES
condyle.6,9 Leaf gauges require sterilization between
1. Dawson PK. Evaluation, diagnosis, and treatment of occlusal problems.
patients, are difficult to mark, and are not secure on
2nd ed. St Louis: CV Mosby; 1989. p. 41-169.
the maxillary teeth. Therefore assistance is needed 2. Tarantola GJ, Becker IM, Gremillion H. The reproducibility of centric rela-
during bimanual manipulation. Modeling compound tion: a clinical approach. J Am Dent Assoc 1997;128:1245-51.
covering a central incisor has been described as a jig or 3. Dawson PK. Temporomandibular joint pain-dysfunction problems can be
solved. J Prosthet Dent 1973;29:100-12.
anterior stop to the arc of mandibular closure when 4. Dawson PK. Optimum TMJ condyle position in clinical practice. Int J Peri-
taking centric relation records.1,6-8,10 It is a brittle odont Restorative Dent 1985;5:11-30.
5. McKee JR. Comparing condylar position repeatability for standardized 11. Golsen LF, Shaw AF. Use of a leaf gauge in occlusal diagnosis and thera-
versus nonstandardized methods of achieving centric relation. J Prosthet py. Quintessence Int 1984;15:611-21.
Dent 1997;77:280-4.
6. Carroll WJ, Woelfel JB, Huffman RW. Simple application of anterior jig or Reprint requests to:
leaf gauge in routine clinical practice. J Prosthet Dent 1988;59:611-7. DR ROGER A. SOLOW
7. Levinson E. Centric relation—the anterior biting jig for recording the 655 REDWOOD HIGHWAY
clenching position. Int J Periodont Restorative Dent 1982;2:8-21. SUITE 251
8. Lucia VO. A technique for recording centric relation. J Prosthet Dent MILL VALLEY, CA 94941
1964;14:492-505.
9. Long JH. Locating centric relation with a leaf gauge. J Prosthet Dent Copyright © 1999 by The Editorial Council of The Journal of Prosthetic
1973;29:608-10. Dentistry.
10. Lundeen HC. Centric relation records: the effect of muscle action. J Pros- 0022-3913/99/$8.00 + 0. 10/1/94938
thet Dent 1974;31:244-53.