Establishing centric relation and checking functional movements

It is important to evaluate orthodontic cases in centric relation at the beginning of treatment. If not, major diagnostic errors can be made. This position needs to be monitored throughoiU treatment and it is essential to reevaluate mandibular position as the finishing stage of treatment commences (Fig. 10.16B). It may be that additional correction is needed, for example with inter-maxillary elastics, prior to finishing of the case. Patients with occlusion in a Class I position and with the condyles in centric relation, can then be checked for interference during protrusive and lateral excursions. During protrusive movement, it is important that the lower eight most anterior teeth make contact with the upper six most anterior teeth, with no posterior contact. During lateral excursions, the patient should experience cuspid rise with slight anterior contact and disclusion of the posterior teeth on both the working and the balancing sides.2

Fig. 10.16B Mounted models may be used to re-evaluate mandibular position and check functional movements as the finishing stage commences.

Fig. 10.16A Cases which show narrowing in the maxilla can be expanded using rapid palatal expansion in the mixed dentition. This expansion can be maintained with a palatal bar, and it assists in achieving adequate buccal root torque in the upper posterior segments.

Fig. 10.16B Mounted models may be used to re-evaluate mandibular position and check functional movements as the finishing stage commences.

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