The Relationship Between Centric Occlusion and The Maximal Intercuspal Position and Their Use as Treatment Positions for Complete Mouth Rehabilitation: Best Evidence Consensus Statement

Abstract

Purpose: The purpose of this Best Evidence Consensus Statement was to evaluate the existing literature relative to two focus questions: How often does centric occlusion coincide with maximal intercuspal position in dentate and partially dentate populations?; and should centric occlusion or maximal intercuspal positions be equivalent for dentate and partially dentate patients undergoing complete mouth rehabilitation?

Materials and methods: Keywords used in the initial search were: intercuspal position, centric occlusion, centric relation, maximal intercuspal position, prosthodontic rehabilitation, and occlusion. The search was then limited to Systematic Reviews, Randomized Controlled Studies, Meta-analyses and Clinical Trials.

Results: The initial search strategy related to the selected search terms resulted in more than 15,000 articles. When the subsequent search was limited to Systematic Reviews, Randomized Controlled Studies, and Meta-Analysis and Clinical Trials, 313 articles were selected for further analysis.

Conclusions: Review of the literature reveals that most dentate and partially dentate patients do not have coincident centric occlusion and maximal intercuspal position. There is support for coincidence between centric occlusion and maximal intercuspal position as the preferred occlusal relationship in complete mouth rehabilitations. The literature does not report conclusive evidence of adverse prosthodontic outcomes with complete rehabilitations in centric occlusion or maximal intercuspal position in a healthy population. However, there is support for an association between centric occlusion-maximal intercuspal position discrepancies and occlusal instability as well as temporomandibular joint disorders. Hence, it is concluded that partially and completely dentate patients requiring complete mouth rehabilitation should be restored in centric occlusion.

Keywords: Intercuspal position; centric relation; maximal intercuspal position; occlusion; prosthodontic rehabilitation.