Análise comparativa entre três técnicas para obtenção da relação cêntrica

Abstract

Achievement of centric relation (CR) is one of the most important steps in dental clinical procedures. This study evaluated the percentage of discrepancy between Centric Relation and Maximum Intercuspation (MI) positions and compared three methods (frontal technique of manipulation; bilateral technique of manipulation; and swallowing technique) for achievement of maxillomandibular position in CR, according to the reproducibility and accuracy of positioning. The sample was composed of 42 patients with mean age of 32.3 years and complete dentition. The individuals answered a questionnaire to categorize and quantify the subjective analysis of temporomandibular dysfunction symptoms and used an occlusal jig for nearly 5 minutes before achievement of CR by each technique, to allow muscular relaxation. Comparison of the mean values between CR and MI positions achieved by the three techniques was performed by one-way ANOVA for repeated measurements. The Pearson coefficient of correlation was employed to verify the correlation between techniques. All statistical tests were performed at a significance level of 5% (p<0.05). Among the characteristics related to temporomandibular dysfunction, 76.19% of patients presented some type of dysfunction, with predominance of parafunctional habits including eccentric bruxism and onychophagia, demonstrating the possibility to reproduce the Centric Relation in patients with temporomandibular dysfunction. The mean values between CR and MI positions achieved by the three techniques did not reveal any statistically significant difference (p= 0.425). Also, there was a clear correlation between techniques. A total of 2.38% of patients did not present discrepancy between MI and CR mandibular positions; thus, these mandibular positions exhibited different positional relationships in the majority of the population.