When and Why CR

What you will learn

The participant will learn when to use CR and when it is ok to treat in MI. Major literature on posterior exclusion and anterior guidance is sited. Why Anterior Guidance is both inside out and outside in, as first documented by Dawson in 1974, is explained. How to recognize the “red joint” patient, and why an unstable joint will always lead to unstable occlusions.

Meeting Goals/Objectives

  • To be able to defend exactly why you believe in Centric Relation.
  • Understand when to use CR and when MI is acceptable.
  • Recognize that the TMJ Occlusal exam is the vehicle for making the determination for using CR or MI.
  • Identify the 3 goals of occlusal treatment.
  • Why starting in Centric Relation is ALWAYS the starting point.

Pre-Meeting Prep

1. Review Chapter 7 – Centric Relation – in Dr. Dawson’s text, “Functional Occlusion From TMJ to Smile Design”.
2. Review Chapter 29 – Requirements for Occlusal Stability – in “Functional Occlusion From TMJ to Smile Design”.
3. If available read, “Evaluation, Diagnosis and Treatment of Occlusal Problems”, review chapter 16 – Anterior Guidance.
4. Review the blog post from 11/21/16: Identifying Specialty Patients.
5. Participants are to be thinking of cases they successfully restored in CR and cases in which they did not restore in CR and what and why they would do that case differently now.

Meeting Schedule

1. Break into groups of 3 or 4 and answer the following questions:
a.) What are the basic requirements of a stable occlusion?
b.) What is the specific requirement of occlusal stability that will be lacking, if we don’t begin in centric relation?
c.) In one paragraph have you group list the reasons for when and why you would use Centric Relation. Then list the clinical indications when you would use the patient’s MI.
d.) Lastly, when would you use a treatment position?

2. Share the input from each group with the entire membership.

3. Show video segment through 19min 23sec which is theory.

4. Reform the groups and review the answers to the questions discussed prior to viewing the video. Are the any different answers? Share with the entire group.

5. Remaining in the groups, share some success stories with patients you restored in CR and some cases you now wish you had restored in CR.

6. Show remaining video which is patient case examples.

7. Close with final comments from the group-make a list of what they learned, what they will start doing, what they will stop doing.

Discussion Points/Questions

  • What are the basic requirements of a stable occlusion?
  • What is the specific requirement of occlusal stability that will be lacking, if we don’t begin in centric relation?
  • List the reasons for when and why you would use Centric Relation. Then list the clinical indications when you would use the patient’s MI.
  • When would you use a treatment position?

CE Codes Breakdown

  • CE Credits Awarded: 2
  • COURSE SUBJECT CODES & HOURS: #200 (0.5L), #730 (1L, 0.5P)
    (L) Lecture
    (P) Participation/Discussion/Hands-On