Abstract: The retruded contact position (RCP) is an important maxillomandibular relation in restorative dentistry. This review will describe RCP and consider its importance and use in the restorative dental treatment of the dentate and edentulous subject. A comparative account of the various mandibular guidance methods used to obtain a RCP record will be presented, followed by recommendations for fixed and removable clinical prosthodontic practice.

Abstract: The stability of mandibular complete dentures may be improved by reducing the transverse forces on the denture base through linear (noninterceptive) occlusion, selecting an occlusal plane that reduces horizontal vectors of force at occlusal contact, and utilizing a central bearing intraoral gothic arch tracing to record jaw relations. This article is intended to acquaint the reader with one technique for providing stable complete denture prostheses using the aforementioned materials, devices, and procedures.

Abstract: It is not difficult to observe and record patient occlusal characteristics before starting simple or complex occlusal rehabilitations. If this is done, and if the subsequently placed crowns and fixed prostheses are constructed in observation of similar characteristics, clinical success usually is the result. Deviations from the suggestion to duplicate the "normal" occlusion should be made when the original natural occlusion had caused overt pathosis, or when all teeth or one arch of the teeth is being restored at one time. If this is the case, centric relation occlusion is more reproducible and easier to develop than occlusion with a shift from centric relation to centric occlusion. Peculiar requests of patients relative to occlusal positioning, or routine dependence on various devices to predetermine occlusal characteristics for rehabilitation (as is currently popular in some groups), should be considered, but they should be tempered with careful observation of preoperative occlusal characteristics.

Abstract: The knowledge of forces that influence implants and suprastructure is important for the restorative dentist to realize the surface areas and vertical dimension of fixed restorations. The purpose of the concepts of occlusion is to respect the protection of implants that receive stress transmission and being aware of destructive forces. In cases in which the edentulous maxilla and mandible are provided with large monoblock implant bridges, the author recommends a bilateral balanced group guidance. If biomechanical principles are not respected, implant loss and restoration failure will result. For the first adjustment of occlusion and articulation patterns immediately after implantation, fixed temporaries are placed on the implants. Another 40 to 60 days later, the temporaries are exchanged for definitive implant bridgework.

Abstract: Restoring the edentulous patient with an implant-supported fixed complete denture prosthesis is a challenging procedure. The patient's occlusal vertical dimension, centric relation position, esthetics, and phonetics should be maintained throughout the restorative process, while the patient is traditionally wearing a removable prosthesis. This article presents an alternative treatment philosophy that addresses these concerns and guides the restorative process using a fixed provisional restoration made from the patient's removable complete dentures.

Abstract: Although reproducibility of centric relation position, determined with an anterior deprogramming device, a leaf gauge, is widely accepted among clinicians, data confirming statistical evidence are lacking in the current literature. The objective of this study was to prove clinical reliability of a measuring-procedure to locate the centric relation position, determined with the leaf gauge. A sample of 15 subjects (6 men, 9 women, age 22 to 46), assessed with the Research Diagnostic Criteria to rule out any TMD-signs, was selected. Three observers each took three sequential interocclusal records with the leaf gauge, to mount a set of casts into the centric relation position in an articulator. Out of 15 subjects, 12 (5 men, 7 women) fitted criteria of precision--three out of three interocclusal records for each of the three observers--in a split-cast procedure. The applied statistical method is an analysis of variance model (ANOVA) with two factors for 3 observers and 12 subjects. The variance components estimation procedure is MIVQUE (0). The a was set at 0.05. No significant difference between observers for the measured variables sagittally (XL, XR), transversally (YL, YR), and vertically (ZL, ZR) could be found. MIVQUE variance components estimates for observers is < 0, varies for subjects from 0.04 to 0.20 and varies for error from 0.12 to 0.25 mm. Reliability of a measuring-procedure to locate a muscle-determined centric relation position could be established satisfactory.

Abstract: Proper treatment sequencing is critical when a patient requires multiple fixed restorations in conjunction with a removable partial and complete denture. The vertical dimension, centric relation, and horizontal occlusal plane must be determined first, followed by a diagnostic wax-up that incorporates linear occlusal concepts to prevent anterior hyperfunction. A more predictable treatment outcome is possible when individual components are defined clearly.

Abstract: Dentists use arbitrary methods in determining the vertical dimension of occlusion, and arranging the maxillary anterior teeth. Some dentists have difficulty in making maxillomandibular records for completely edentulous patients. Therefore the use of pre-extraction records has been recommended. This article reviews the pre-extraction records proposed for determining the vertical dimension of occlusion, recording centric relation, and arranging the maxillary anterior teeth. A MEDLINE search, from 1966-2002, for the key words "pre-extraction records" was supplemented with a hand search to identify relevant peer-reviewed English articles published in dental journals. On the basis of the review, it appeared that pre-extraction records proposed for determining the original vertical dimension of occlusion and arranging the maxillary anterior teeth for a completely edentulous patient were useful and preferred to arbitrary methods, whereas pre-extraction records proposed for recording centric relation may not be necessary.

Abstract: Dentures were fabricated for a 73-year-old woman using porcelain 20-degree maxillary posterior teeth and acrylic resin flat planes in the mandibular posterior region. A digital gothic arch tracing device was used to observe the horizontal mandibular positions before insertion and to evaluate the therapeutic effect of the diagnostic dentures at 1 and 3 months after insertion.

Abstract: Disagreement exists regarding the relationship between occlusal interferences and temporomandibular joint dysfunction (TMD). This study sought to determine how a balanced occlusion, providing uniform contact in centric relation, would affect signs and symptoms of TMD. A randomly chosen group of 60 patients with occlusal interferences and signs and symptoms of TMD used a mandibular orthotic to balance their occlusions at centric relation (CR). When the occlusions of symptomatic patients were balanced in CR, there was a significant reduction or elimination of TMD complaints, suggesting a relationship between balancing occlusion in CR and optimum management of TMD.