Dentofacial characteristics in orthodontic patients with centric relation–maximum intercuspation discrepancy

Abstract

To investigate dentofacial characteristics of orthodontic patients with centric relation (CR)-maximum intercuspation (MI) discrepancy and to analyze changes in dentofacial characteristics between CR and MI positions in these patients using lateral cephalograms. Adult female patients were classified into two groups: large CR-MI discrepancy (greater than 2.0 mm horizontal or vertical mandibular incisor movements during CR to MI change, n = 20) and small CR-MI discrepancy (less than 1.0 mm horizontal and vertical mandibular incisor movements during CR to MI change, n = 22). All subjects underwent temporomandibular joint (TMJ) magnetic resonance imaging prior to treatment. Gnathological stabilizing splints were used to find a reliable CR position in patients with large CR-MI discrepancy. Sixteen variables from lateral cephalograms were analyzed to identify differences in cephalometric variables between CR and MI positions in patients with large discrepancy. Differences in dentofacial cephalometric variables at MI positions between patients with large and small CR-MI discrepancies were also analyzed. Patients with large CR-MI discrepancy had backward positioning and rotation of the mandible at the MI position compared to the norm. In addition, the mandible moved more posteriorly and rotated more in a clockwise direction during MI to CR change. Interestingly, all patients with large CR-MI discrepancy had TMJ disk displacement. There were no significant differences in the cephalometric variables of the MI positions between patients with small and large CR-MI discrepancies. This study suggests that adult patients with backward positioning and rotation of the mandible should be carefully evaluated as a result of the potential CR-MI discrepancy.