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56]

Review Article

Critical evaluation of various methods of recording centric

jaw relation
Sanjay Bansal, Jayant Palaskar
Department of Prosthodontics, M.M. College of Dental Sciences and Research, Mullana, Ambala, India

For correspondence
Dr. Sanjay Bansal, H. No. 30, Sector 7, HUDA, Karnal, India. E-mail: drsanjaybansal@yahoo.co.in

The rationale of recording Centric Relation records is to establish guidelines as starting point to develop occlusion with artificial
teeth in harmony with the various structures of masticatory apparatus including TMJ. It aids to maintain physiologic as well
as anatomic health of tissues. When maximum intercuspation is coinciding with centric position, it provides stability to the
prosthesis thereby preserving the health of remaining tissues (edentulous foundation, remaining natural teeth, musculature
and TMJ) is accomplished.
Key words: Centric relation, direct recording, functional recording, gothic arch tracing

DOI: 10.4103/0972-4052.49180

CL ASSIFICATION OF THE METHODS OF is essential in the making of an accurate record.

RECORDING CENTRIC RELATION The visual acuity and the sense of touch of the
dentist also enter into the making of a Centric Relation
record using the physiologic method. This phase of
Centric relation record methods - review and the procedure is developed with experience and is
evaluation exceedingly difficult to teach to another individual.
As in the classification of various methods of recording In 1756, Phillip Pfaff,[1] the dentist of Fredrick the Great
Centric Relation records a review and evaluation of of Germany, was the first to describe this technique
these methods is presented: of “taking a bite.” Until the end of nineteenth century
it was the most commonly used method.
Direct checkbite inter-occlusal recordings: • The direct interocculusal record during that
• The direct interocclusal record is the oldest type period, was a non-precision jaw record obtained
of Centric Relation record. by placing a thermoplastic material, usually wax
The interocclusal check record method is referred or compound, between the edentulous ridge and
to as a physiologic method. The normal functioning having the patient close into the material. This
of the patient’s proprioception and the tactile sense was known as the “Mush, “Biscuit”, or “Squash”
Bite.
One early method was to adjust the occlusion
rims to the chosen vertical dimension of occlusion,
DIRECT GRAPHIC FUNCTIONAL CEPHALOMETRICS
RECORDING RECORDING RECORDING

have the patient close in a retruded position,

TEETH AND SUPPORTING MANDIBULOGRAPHING PHONETIC
and attach the rims together for mounting on an
OCCLUSION AS
PREDOMINATING
TISSUES AS
PRED OMINATING
(AFTER SHANAHAN) (AFTER
SILVERMAN)
articulator.
FACTORS FACTORS
RELATOR In 1954, Brown[2] recommended repeated closure
(AFTER HOSPER)
into softened wax rims. Greene[1] had his patients
hold their jaws apart for 10 seconds to fatigue
the muscles and then had them snap the rims
WAX PLASTER WAX PLASTER

COMPOUND COMPOUND
together. He then made lines in the rims to orient
them after removal from the mouth.
EXTRAORAL
GRAPHIC RECORDING
INTERAORAL
GRAPHIC RECORDING
• Gradually, these procedures evolved into
interocclusal records as they are usually done
today. Small amounts of wax, compound, plaster,
EXTRAORAL PLASTER EXTRAORAL GRAPHIC EXTRAORAL GRAPHIC and zinc-oxide eugenol impression paste were
RECORDING RECORDING RECORDING BY INDICATORS
(AFTER STANSBERY) (AFTER GYSI) (AFTER PHILIPS) placed between the occluding rims, and the
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Bansal, et al.: Various methods of recording centric jaw relation

patient closed the jaws into centric relation. These by “REALEFF”.

improvements were an attempt to equalize the Hanau,[1] Block,[7] and others[8] agreed with zero
pressure of vertical contact. pressure philosophy, Schuyler, Payne and Trapozzano,
among others advocated the use of light pressure.
INDICATIONS
Criticisms of interocclusal method of recording
Interocclusal check record is particularly indicated centric relation
in following situations: • There have been many criticisms of “Checkbites”
• Abnormally related jaws. for Centric Relation records. Most of these criticisms
• Supporting tissues that are excessively were from individuals who favored some type of
displaceable. graphic recordings.
• Large awkward tongue. Schuyler[1] in 1932 stated that he did not “consider
• Uncontrollable or abnormal mandibular a record secured on compound or wax occluding
movements. rims sufficiently free from error to compete the
• Check the occlusion of the teeth in existing restorations without additional checks.
dentures. Simpson[1] felt that wax records were unscientific
It is the most practical acceptable method to check and commented that “such methods as holding
teeth that have been arranged as trial dentures. the jaw back on closing the mandible, elevating
the tongue, and having the patient swallow as he
CRITICAL EVALUATION closes the jaw, and the like, are condemned for
the paramount reason that they are unscientific
• There are many opinions regarding the best material and always carry with them the fallacy of
for interocclusal record.
guess”.
Trapozzano [3] in 1955 stated that the wax
Phillips[1] stated that “in the hands of, by for the
“CHECKBITE METHOD” is the technique of
largest majority of operators, it is worse than
preference in recording and checking centric
useless”.
relation.
Gysi [1] tested this method on manikins and
Schuyler[1] in 1932 observed that if the recording
never got the same recording twice with wax or
medium was not of uniform density and viscosity,
compound. He concluded that the uneven cooling
uneven pressures would be transmitted to the
of the material produced distortion.
record bases which would cause a disharmony of
occlusion. He said that modeling compound was Schuyler[1] stated that when records were made
preferable to wax for occlusal records because it using compound, the uneven or premature contact
can be softened more evenly, cools slower, and of areas of occluding surfaces, due to uneven
doesn’t distort as much as wax. thickness or density of occluding rims, may disturb
Payne[4] in 1955 and Hickey[5] in 1964 stated a the relation of the record bases.
preference for dental plaster because less material
had to be placed in the patient’s mouth for the GRAPHIC METHOD
record.
• Wright[1] in 1939 described the four factors he INTRODUCTION
believed affected the accuracy of records:
• Resiliency of tissue. The graphic methods record a tracing of mandibular
• Saliva film. movements in one plane, an arrow point tracing. It
• Fit of bases. indicates the horizontal relation of the mandible to
• Pressure applied. the maxillae. The apex of a properly made tracing
He concluded that the dentist wouldn’t control the presumably indicates the most retruded relation
pressure at which the record was made, so the best of the mandible to the maxillae from which lateral
technique was to record the occlusal record at zero movements can take place. Do not confuse this with
pressure. It could thus be duplicated. other graphic tracings that are made in additional
Hanau[6] in 1923, considered various factors that planes. Pantographic tracings, for example, are made
influenced the recording of Centric Relation and he in three planes.
modified the intra-oral wax method. He pointed out Graphic methods are either intraoral or extraoral,
the “Resiliency And Like Effect” (REALEFF) of the depending upon the placement of the recording devise.
denture supporting tissues. He advocated making The intraoral tracings cannot be observed during the
the registrations of the positional relationships under tracing; therefore the method looses some of the value
zero pressure in order to minimize the error caused of a visible method.
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Bansal, et al.: Various methods of recording centric jaw relation

Techniques attached to the tracing plate with a hole over the

The earliest graphic recordings were based on studies apex of the Gothic Arch. The Centric Relation record
of mandibular movements by Balkwill[9] in 1866. The could then be made without a change of vertical
intersection of the arcs produced by the right and left dimension.
condyles formed the apex of what is known as the Various tracing devices were designed by Hights,
Gothic Arch tracing. Phillips, Terrel, Sears, House, Misserman and
The first known “Needle Point Tracing” was by others.[1,11] The Sears Recording Trivet had an intraoral
Hiesse in 1897, and the technique was improved and central bearing point and two extraoral tracing plates.
popularized by GYSI around 1910. The tracer made The maxillary and mandibular tracing arms were locked
by GYSI was an extraoral incisal tracer. The tracing into Centric Relation with two lumps of plaster.
plate coated with wax, was attached to the mandibular Silverman[12] in 1957, used an intraoral Gothic Arch
rim. A spring-loaded pin or marker was mounted on tracer to locate the “biting point” of a patient. The
the maxillary rim. The rims were made of modeling patient was told to bite hard on the tracing plate.
compound to maintain the vertical dimension of This developed the functional resultant of the closing
occlusion. When a good tracing was recorded, the muscles which would retrude the mandible. The
patient held the rims in the apex of the tracing while indentation made by the patient would be used for
notches were scored in the rims for orientation. the centric record whether or not it corresponded to
Clapp[1] in 1914 described the use of a GYSI tracer the Gothic arch apex.
which was attached directly to the impression Chandrasekharan Nair[13] developed Chandra Tracer.
trays. Nandini et al.[13] conducted - “A Comparative Evaluation
Sears[1] used lubricated rims for easier movement. of Hight Tracer, Chandra Tracer, Intraoral Tracer,
He placed the needle point tracer on the mandibular Functiograph and Checkbite” and they found that
rim and the plate on the maxillary rim. He believed there was no significant difference between Hight
this made the angle of the tracing more acute and tracer, Chandra tracer, Intraoral tracer, Functiograph
more easily discernible. He would then cement the and Checkbite method.
rims together for removal.
Phillips [1] in 1927 recognized that any lateral Important factors in graphic recording
movements of the jaw would cause interference of method:
the rims which could result in a distorted record. He • When any graphic tracing is made, these factors
developed a plate for the upper rim and a tripoded are important:
ball bearing mounted on a jackscrew for the lower 1. Displacement of the record bases may result from
rim. The occlusion rims were removed, and when the pressure if the central bearing point is off center,
patient had produced the proper extraoral tracing, when the mandible moves into eccentric relations
softened compound was inserted between the trial to the maxillae.
bases. This innovation was named the “Central 2. If a central bearing device is not used, the
Bearing Point”. occlusion rims offer more resistance to horizontal
In 1929, Stansbery[1] introduced a technique which movements.
incorporated a curved plate with a 4-inch radius 3. It is difficult to locate the center of the true arches
(corresponding to Monson’s curve) mounted on the to centralize the forces with a central bearing
upper rim. A central bearing screw was attached to device when the jaws are in favorable relation
the lower plate with a 3-inch radius curve (reverse- and far more difficult if the jaws are in excessive
Monson curve). After the extraoral tracing was made, protrusive or retrusive relation.
plaster was injected between the rims to form a 4. It is difficult to stabilize a record base against
biconcave centric registration. horizontal force on residual ridge that have no
Hall[1] in 1929 used Stansbery’s method but substituted vertical height.
compound for Centric Relation record. 5. It is difficult to stabilize a record base against
Later graphic recording methods used the central horizontal forces on tissues that are pendulous
bearing point to produce the Gothic Arch tracing. or otherwise easily displaceable.
Hardy[1] and Pleasure[10] described the use of Coble 6. It is difficult to stabilize a record base or bearing
Balancer, and Hardy later designed a modified intraoral device with patients who have large awkward
tracer similar to the cobles. Hardy and Porter in 1942 tongues.
made a depression with a round bur at the apex of 7. Recording devices are not usually considered
the tracing. The patient would hold the bearing point compatible with normal physiologic simulation
in the depression while plaster was injected for the in mandibular movement.
centric record. 8. The tracing is not acceptable unless a pointed apex
Pleasure[10] in 1955 used a plastic disk which was is developed, a blunt apex usually indicates an
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Bansal, et al.: Various methods of recording centric jaw relation

acquired functional relationship and a sharp apex and playthings”.

usually indicates the position of centric relation. Gysi[1] in 1929 concluded that his tracing technique
9. Double tracings usually indicate lack of coordinated had only a 5-degree error, whereas wax and compound
movements or recordings at a different vertical bites had a 25-degree error.
dimension of jaw separation. In either event, Granger[14] in 1952 insisted that needle point tracing
additional tracings are necessary. is not a reliable means of determining centric relation,
10. A graphic tracing to determine Centric Relation is since it is recorded in horizontal plane only; he believes
made at the predetermined vertical dimension of that Centric Relation should be considered as a vertical
occlusion. This harmonizes Centric Relation with rotational relationship related to the hinge axis.
centric occlusion and the antero-posterior bone- Brill[15] in 1957, claimed that the retruded position
to-bone relation with the tooth-to-tooth contact. of the mandible (stylus at the apex of the tracing)
11. Graphic methods can record eccentric relations of does not coincide with the maximum intercuspation
the mandible to the maxillae. in all persons.
12. Graphic methods are the most accurate visual Trapozzano[3] in 1955, insisted that the retruded
means of making a Centric Relation record with unstrained relation is the only proper position and
mechanical instruments; however, all graphic that the position is constant throughout the life.
tracings are not necessarily accurate. Boos[16] in 1952, claimed that 35 percent of 400 subjects
This record should be checked with an interocclusal had their “best” centric position 1 to 7 mm distal to
check record when the anterior teeth are arranged the apex of the Gothic arch tracing.
and the wax is contoured. Brown[2] believes that the needle point tracing is
unreliable and recommends repeated closures into
Critical analysis of graphic recording wax under close observations.
methods: Moylan in 1953 wrote, “The apex of the Gothic arch
Intra oral v/s extra oral graphic recording methods: is full of vagaries”.
The intraoral tracings cannot be observed during the The National Society of Denture Prosthetics reported
tracing; therefore the method loses some of the value that “the use of the needle point tracing device for
of a visible method. While the extraoral tracings are the purpose of determining and checking centric jaw
visible while the tracing is being made. Hence, the relation is recommended as being both scientific and
patient can be directed and guided more intelligently practical. This society recognizes no other means of
during the mandibular movements. verifying centric jaw relationships.”
Since the intraoral tracings are small, it is difficult to Payne[4] in 1955, described the intraoral tracer as,
find the true apex. The tracer must be definitely seated “difficult to see and does not work as well where
in a hole at the point of the apex to assure accuracy flat ridges or flabby tissue occur. Extraoral tracing
when injecting plaster between the occlusion rims. If provides visibility but retain the other difficulties if
the patient moves the mandible before the occlusion central bearing plates are used. The more equipment
rims are secured, the records shift on their basal seat; we put into the mouth, the more difficult it is for
this destroys the accuracy of the record. While in extra the patient.”
oral tracing, the stylus can be observed in the apex Kingery[17] in 1952 pointed out several drawbacks
of the tracing during the process of injecting plaster in the use of the central bearing point and added
between the occlusion rims. that the “central bearing point allows for no control
The graphic recordings, received much praise and over the amount of closing pressure applied by the
criticism: patient.”
Hanau[1] in 1923 wrote. “The most naive of our Phillips[6] pointed to various errors produced by
genius had intuitions, molded into metal, attached GYSI’s[17] technique and stated that, “if one occlusal
a decorative theory onto their accomplishment and, rim is allowed to touch the other during the lateral
it must be admitted, they found a goodly number extreme positions, undue pressure is bound to be
of fanatical believers and blind followers, whose exerted on the contact side, and on account of resiliency
mental inertial probably did not care to penetrate of the underlying tissues the side not in contact will
even the polish of the nickel-plated instrument under be unseated just enough to cause a false reading for
consideration”. the horizontal inclination of the condylar path”.
In 1927, Hanau[1] conceded that the Gysi tracing Smith in 1941 also pointed out drawbacks in the
was satisfactory to check records, but that universal method where vertical dimension was maintained
usage was not good. by occlusal rims, commenting that, “the contacting
Tech[1] in 1926, stated that the Gysi tracing technique surfaces of the bite rims will not glide easily upon
was the only means that should be used for centric each other, horizontal stresses are set up and the
records, all other methods were “mere deceptions shifting of the bases may easily occur, and under
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these conditions, it is difficult for the patient to make was recorded.

accurate recording. Bilateral manipulation[19] suggested by Peter Dawson
• Criticisms of Gothic arch tracing stated that in 1974 is the method largely used by those who
equalization of pressure did not occur, prognathic adhere to functionally generated path techniques.
or retrognathic patients it could not be used, and They have suggested that the condyles do not always
flabby tissues or large tongues could cause shifting move superiorly, but sometimes, in response to
of bases. posterior guidance from the operators, they move
inferiorly. Because of this clinical observation, they
Functional recordings emphasized the importance of superior placement of
• Functional records were described in dental the condyles in the fossa when attempting to record
literature as early as 1910 and are based on principle centric relation.
that the patient produces a pattern of mandibular Mc Collum[20] and Granger[20] stated that Centric
movements by moving the mandible to protrusion, Relation is that position where the mandible rotates
retrusion, and right and left lateral. around the hinge axis. In securing maxillo-mandibular
Greene1 in 1910, used pumice and plaster mixture records, both investigators recommended the use of
in one of the rims and instructed the patient to grind chin point guidance recommended by Gutchet in 1970
the rims together. The denture teeth were set to the in retruding the mandible. Others who advocated this
generated pattern. technique include Kornfeld,[21] Thompson,[19] Aull,[22]
Needles[1] in 1923, mounted three studs on maxillary and Sloan.[23]
rims which cut arrow tracings into mandibular
compound rims. After removal from the mouth, the Criticism of functional recording method:
rims were reassembled with the functional grooves. • The functional methods of recording Centric
House modified the needles technique and he used Relation requires very stable record bases. Forces
four styli to make the needle point tracings. which can dislodge the record bases occur in any
Patterson[1] in 1923, used wax occlusion rims and method, that requires the mandible to move into
he cut a trough in the upper and lower rims. These eccentric jaw position with the recording medium
were filled with a carborundum and plaster mixture. in contact. The record will not be accurate unless
The patient would move his jaw and grind the rims the bases are stable.
until the proper curvature had been established. This • The displaceable basal seat tissues, the resistance
would ensure equalized pressure and uniform tooth of the recording mediums, and the lack of control
contract in all excursions. of equalized pressure in the eccentric relations
The functional technique developed by Meyer[1] in contribute to inaccuracy in these methods.
1934 used soft wax occlusion rims. Tinfoil was placed • Patients not only must have good neuromuscular
over the wax and lubricated. The patient performed coordination to participate in the functional methods
the functional movements to produce a wax path. of recording centric relations but also must be
A plaster index was made of the wax path and the capable of following instructions if accurate records
teeth were set to the plaster index. are to be obtained.
Boos[1] in 1940, used the Gnathodynamo-Meter to
determine the vertical and horizontal position at Cephalometrics
which a maximum biting force could be produced. The use of cephalometrics to record Centric Relation
His Bimeter was mounted on the lower occlusion was described by Pyott and Schaeffer. Centric Relation
rim with a central bearing point against a plate on and vertical dimension of occlusion were determined
the upper occlusion rim. Plaster registrations were by cephalometric radiographs. This method, however,
made with the Bimeter in the mouth and the patient was somewhat impractical and never gained widespread
exerting pressure. Boos theorized that optimum occlusal usage.
position and the position of maximum biting force
would coincide. He also thought that it was essential Discussion and review of literature:
that all registration be made under biting force so Kantor et al.[19] in 1972 conducted a comparative
that the displacement of soft tissues which occur in investigation on Centric Relation recording techniques
function, would occur during bite registration. by considering the four techniques i.e. swallowing or
Shanahan[18] in 1955, in his Physiologic Technique, free-closure, chin point guidance, chin point guidance
placed cones of soft wax on the mandibular rim with anterior jig and bilateral manipulation and
and had the patient swallow several times. During concluded that:
swallowing, the tongue forced the mandible into • Bilateral manipulation produced the smallest area
its Centric Relation position. The cones of soft wax of displacement of maxillo-mandibular relation
were moved and the physiologic Centric Relation record when compared with the other recording
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techniques tested. by bilateral manipulation is also physiologic.

• The most protrusive positions were recorded with • Unguided closure revealed appreciable lateral
free closure or myo-monitor techniques. displacement, which indicates that muscular
• The most retrusive records were produced with the position is less reproducible laterally, and condylar
technique of chin point guidance with an anterior displacement can be expected.
jig. • Chin-point guidance placed the condyle
• Centric relation can be located by using any one posteriorly, inferiorly, and right-laterally and is
of many techniques. There is variability in the not recommended. Posterior displacement may
result obtained by any techniques. Dentists should result in harmful effect on the bilaminar zone,
evaluate and compare their registrations so that and inferior displacement may cause an occlusal
an objective technique selection can be made. discrepancy.
Kapur et al. [6] in 1957 conducted a study “An Berman MH[25] in 1960 conducted a study - “Accurate
evaluation of Centric Relation records obtained by Inter Occlusal Records” and he tested that the
various techniques” using the three standard methods resistance of various interocclusal recording media
of recording centric relation, i.e. i) the intraoral tracing and concluded that:
procedure (Hardy), ii) the wax registration procedure • Whether dental waxes make accurate interocclusal
(Hanau), and iii) the extraoral tracing procedure records is questioned. Tests with various waxes
(Stansbery) and they came to a conclusion that: indicate that all offer some resistance to closure.
• The intraoral tracing procedure and the extraoral • Zinc oxide eugenol impression paste offers no
tracing procedure were more consistent as compared resistance to closure and possesses many qualities
to the wax registration method. favorable for obtaining
• In patients with flabby ridges, the intraoral tracing Lassila V[26] in 1986, conducted a study “Comparison
procedure and extraoral tracing procedure became Of Five Interocclusal Recording Materials” using
less consistent as compared to the wax registration silicone putty, polyether, zinc, oxide and eugenol
method. impression paste, eugenol free zinc oxide, acrylic
• In patients with flabby ridges, the intraoral and resin and baseplate wax and concluded that:
extra oral tracing procedure became less consistent • The initial resistance of interocclusal recording
as compared to their consistencies in patients with materials to closure changed from 0.5N to 13.8N,
good and flat ridges. and a rapid rise in the working time was seen in
• The wax method seemed less consistent than the all elastomers.
extra and intraoral tracing procedure. It showed • The resistance offered by wax at 60oC was about
the least consistency on flat ridges and highest 7N
consistency in the flabby ridge groups. • The volumetric contraction of elastomers in
• The differences in consistency between the intraoral polymerization was clinically slight.
tracing procedure and the extraoral tracing • The dimensional stability of rigid materials, acrylic
procedure were not statistically significant. resin, and zinc oxide pastes was good.
Hobo[24] in 1985, conducted a study “Reproducibility • Elastomers maintained their reliability for a
Of Mandibular Centricity In Three Dimensions” relatively long time when stored in a tightly sealed
and he used three centric recording techniques: i) plastic bag.
unguided closure, ii) chin-point guidance and iii)
bilateral manipulation and concluded that: CONCLUSION
• Approximately 0.2 to 0.3 mm of the maximum
condylar displacement was recorded by three It is apparent from the dental literature, that there
Centric Relation registration methods. The amount are many opinions and much confusion concerning
of displacement coincided with the freedom reported Centric Relation records. A certain technique might
in the literature. be required for an unusual situation or a problem
• Bilateral manipulation showed the most consistent patient. In the final analysis, the skill of the dentist
reproducibility and is recommended for Centric and the cooperation of the patient are probably the
Relation registration. The minimal condylar most important factors in securing an accurate Centric
displacement by this technique indicated the Relation record.
existence of point centric position.
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