Condylar repositioning in mandibular retrusion

Abstract

Statement of problem. There has been debate about which anteroposterior maxillomandibular relationship should be used in fixed and removable prosthodontics for patients without a definite maximal intercuspation. The choice has important implications for complete denture fabrication in which any guidance to the previous dentulous maximal intercuspal position is missing. Purpose. This study was designed to estimate the posterior displacement that takes place at the mandibular condyles and occlusal surfaces when the mandible is moved from maximal intercuspal position to the most retruded mandibular position. Material and methods. Articulated occlusal models of 18 subjects with a natural dentition and well-defined maximal intercuspation were studied. Models were rearticulated in retruded contact position, and the original vertical dimension of occlusion was restored by eliminating all interfering occlusal contacts on the retruded path of closure. Measurement of change in condylar position was estimated using a SAM2 articulator with condylar position indicator. Posterior displacement at the occlusal surfaces was measured with a traveling microscope. Results. Condylar analog retrusion in the horizontal plane at the initial retruded contact position varied from 0.6 to 2.4 mm (mean 1.0 ± 0.4 mm); however, after occlusal adjustment to restore the original vertical dimension of occlusion, retrusion was reduced to a range of 0 to 0.4 mm (mean 0.2 ± 0.1 mm). Retrusion at the occlusal surfaces was found to vary from 0.4 to 1.5 mm (mean 0.7 ± 0.3 mm) at retruded contact position; however, after occlusal adjustment, retrusion was reduced to a range of 0 to 0.5 mm (mean 0.2 ± 0.1 mm). Conclusion. Posterior displacement at both the occlusal surfaces and the condyles was small when interfering occlusal contacts on the retruded path of closure were removed. (J Prosthet Dent 2000;84:612-6.)