How I find CR…
I remember finding CR was something I was not comfortable with in dental school. After graduate school and finally practicing for a few years, I developed a way to find CR that embraces the concepts of graphic tracings. Although I don’t do much pantographic tracing or use these fancy instruments for my routine dentistry, I do use the concepts to help me locate centric relation.
For me, I don’t ever manipulate the patient’s mandible to find CR. I don’t ask the patient to curl the tongue back to the palate or the throat in an attempt to bring the jaw back. I simply ask the patient to move the lower jaw to the extreme right, the extreme left and the extreme forward. If the patient has trouble understanding what that means, before the days of N95 mask, I simply demonstrate to them what I mean by moving my own jaw in front of them.
Then I ask the patient to swallow. The simple act of swallowing usually brings the jaw back to a position very close to CR if not already there. I educate and practice with the patient a few times how this is the position I want to see and record….I practice until I get a repeatable position.
Repeatable positions in an edentulous patient would mean the midlines and the overjet and overbite in the occlusal rims would be meeting the same way every time. Or if the patient has teeth, the way the lower teeth land on an anterior deprogrammer will be exactly the same position. The repeatability confirms that I have located this centric relation position.
The fact that I took the time to locate the border mandibular movement also helps me to confirm what I don’t want to see…or this is how I know the patient’s jaw may have deviated from the centric position.
This is how I find CR most of the time, with teeth or with no teeth. I find that it works well for me and patients seem to be able to follow my instructions easily. I hope you find this information helpful. Thanks for reading.