The Role of Maxillofacial Structure and Malocclusion on Condylar Displacement in Maximum Intercuspation and Centric Relation in Patients Seeking Orthodontic Treatment-A Scoping Review

BACKGROUND

Available knowledge about malocclusion and cephalometric variables and their connection with an increased risk of condylar displacement (CD) is scarce. This article aims to present current information on the relationship between centric relation-maximum intercuspal position discrepancies and maxillofacial morphology and malocclusion in patients seeking orthodontic treatment as well as to identify those who require expanded diagnostic evaluation for this disorder.

METHODS

This review analyzed the PubMed, Cochrane Library, Web of Science, and Scopus electronic databases up to February 2022. Keywords and additional manual searches were performed. Literature selection was based the PRISMA-ScR checklist. The JBI Critical Appraisal Tool assessed the methodological quality of included studies.

RESULTS

The databases search provided 2321 studies. A total of 10 studies were included in this review after eligibility criteria and JBI assessment. This review was separated into five parts that evaluated CD correlations depending on the following: maxillofacial structure in different vertical and sagittal skeletal patterns, vertical, horizontal, and transverse malocclusions.

CONCLUSIONS

A hyperdivergent facial skeletal structure is a risk factor for increased CD, particularly in the vertical dimension. The condylar processes are usually displaced in a posteroinferior direction. Further studies are warranted to elucidate the relationship among remaining skeletal and dental malocclusions and the occurrence of CD.

Effects of CO-CR discrepancy in daily orthodontic treatment planning

Background and aims

Nowadays centric relation is defined as a musculoskeletal stable position, with the condyles forward, as far upward as possible, centered transversely and with the articular disc properly interposed. On the other hand, centric occlusion or maximum intercuspidation is a dental determined position. The purpose of this pilot study is to evaluate the direction, frequency and magnitude of the discrepancy between centric occlusion and centric relation in all three axial directions, in a muscular non-deprogrammed population, before the beginning of orthodontic treatment.

Methods

The study group was represented by 40 symptomatic and asymptomatic patients seeking orthodontic treatment in a private dental office in Cluj-Napoca, Romania between 2014 and 2015. All patients had full records and articulator mounted models. All measurements were analyzed three-dimensionally.

Results

85% of the patients had vertical and 87.5% had horizontal CO-CR discrepancy for both condyles. 87.5% of the cases have had a significant condylar displacement in at least one of the three planes.

Conclusions

We should be aware of the dental occlusion determined by the dental contacts and the occlusion dictated by the musculoskeletal stable position of the condyles. The bigger the discrepancy between these two positions at the level of the condyles, the greater the chances to have either a patient who will develop a form of TMD before/during or after the orthodontic or prosthetic treatment, or a patient suffering already, but poorly diagnosed.