Intercuspation position (ICP) constitutes the occlusal reference position of the mandible while centric relation (CR) represents the articular reference position. The concept of CR depicts a key component in routine dental clinical practice due to the need for a mandibular position determined not to be dental. But a consensus on this particular topic has still not been achieved even after nearly a century of discussions with scientific and clinical arguments. A remarkable number of dental schools, restrained in their own certainty are struggling with the concept of a non-dental determined reference position, even now after many generations and decades of scientific stress. Unproductive quarrels dominate the development and consequently, a lack of reciprocal expansion of knowledge can be observed. In addition, misunderstandings bring up walls of virtual disagreements. Without pretending to have a universal knowledge, a reconnecting concept on this particular subject can be formulated, based on elementary logic and simple principles of anatomy, physiology and biomechanics. The objective of this tutorial paper is to compose and present such a concept on the basis of the scientific literature and as a synthesis of research data. The practitioner controls the homogeneity of the simple rotational character by digital perception. The absence of muscle tension (vertical oscillations) and of translation (sagittal oscillations) is an indicator for homogeneity. The patient himself gently activates his own closing movement and by doing so the correct coaptation of the condyle and disc along the articular tubercle is established. The occipital support, the light mandibular stabilization by chin control, the information of the patient before and during the procedure, the repetition of the exercise and the peripheral information through the engrammation of the localization of premature contact are parameters which facilitate the achievement of CR.
Prof. Jean-Daniel Orthlieb, G. Hernandez, L. Darmouni, J. P. Ré, A. Girardeau, G. Slavicek, springermedizin.at