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    CRANIO®

    The Journal of Craniomandibular & Sleep Practice

    ISSN: (Print) (Online) Journal homepage: https://www.tandfonline.com/loi/ycra20

    «Centric relation»: From red giant to white dwarf

    Jens Christoph Türp

    To cite this article: Jens Christoph Türp (2021) «Centric relation»: From red giant to white dwarf,
    CRANIO®, 39:6, 461-462, DOI: 10.1080/08869634.2021.1980685

    To link to this article: https://doi.org/10.1080/08869634.2021.1980685

    Published online: 13 Oct 2021.

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    https://www.tandfonline.com/action/journalInformation?journalCode=ycra20
    ®
    CRANIO : THE JOURNAL OF CRANIOMANDIBULAR & SLEEP PRACTICE
    2021, VOL. 39, NO. 6, 461–462
    https://doi.org/10.1080/08869634.2021.1980685

    GUEST EDITORIAL

    «Centric relation»: From red giant to white dwarf

    Few terms in dentistry have been as long-lived and, at position must be established as part of dental therapy
    the same time, as controversial as the term “centric (i.e., edentulous individuals or patients requiring com­
    relation” (CR). Wesley C. Salmon [1], one of the greatest plete oral reconstruction). But here, too, the goal is
    American philosophers of science, reminded us that clearly formulated: achieve a reasonable condylar posi­
    giving a definition of something is the same as making tion in relation to the posterior slope of the patient’s
    a suggestion: one can accept it or reject it, but the articular eminence, keeping in mind that this relation­
    proposition itself is neither true nor false. But what to ship is variable in the general population. Once a new
    make of a term – or better, a concept – that has been maximum intercuspation is established, both the new
    redefined at least seven times in its now nearly 100-year tooth and jaw relations are gradually “normalized” by
    history [2], and in such a way that these definitions are cellular remodeling, and occlusal and condylar stability
    not only remarkably different, but in some cases even can be expected in the vast majority of cases.
    diametrically opposed? This is exactly what is true of the In view of these circumstances, the use of terms such
    term “CR,” and this was the reason my fellow authors as “centric” and “centric relation” can no longer be
    and I took a critical look at this topic in a recent pub­ scientifically justified. Since they do not reflect what
    lication [3]. they imply (“centric” = midpoint), ignore biological
    It is certainly undisputed among dentists that after variability [4], and are characterized by changing,
    a major dental or orthodontic treatment involving incompatible content [5], we should agree with
    a change in the maxilla-mandibular relationship, the Kandasamy et al. [7] who state, “CR has been defined
    mandibular condyles should end up being in in so many ways that it has lost credibility today.”
    a position that is reproducible (for patient and practi­ Therefore, the continued use of this term, which reflects
    tioner) and comfortable (for the patient). Many clini­ an ossified vocabulary that has become both limiting
    cians have used terms like “best,” “ideal,” or “optimal” and annoying (to paraphrase American philosopher
    to describe CR as that desired condylar position. Richard Rorty [8]), should be discouraged [9]. Instead
    Surprisingly, the issue of whether there is such of the tradition-bound mechanical view and the termi­
    a condylar position at all was raised very late. nology derived from it, which has so often characterized
    It has long been understood that healthy dentate dentistry in practice and theory and which views the
    individuals show a remarkable variability in the location patient as a “living articulator,” a biologically oriented
    of their condyles when the teeth are in maximum inter­ view of the masticatory system allows for variations of
    cuspal position [4]. Given this biological fact, which “normality” (which a CR-driven concept does not).
    applies to most of the human population, it therefore With such a reorientation, we are approaching con­
    seems somewhat grotesque that there have been more ceptual thinking that is compatible with that of medi­
    than 100 years of heated arguments about the “correct” cine, and this cannot be a bad direction for our
    position of these anatomical structures (the condyles). profession to proceed.
    Hence, the decades-long merry definitional wandering
    of the mandibular condyles – from most retruded to References
    fairly anterior [5] – ultimately reflects a desperate but
    [1] Salmon WC. Logic. 3rd ed. Englewood Cliffs (NJ):
    futile search for a “Holy Grail”. This same opinion was Prentice-Hall; 1984.
    extremely well-stated as long ago as 1990 by the brilliant [2] The Academy of Prosthodontics. The glossary of
    orthodontist Lysle Johnston [6], who wrote, “It could be prosthodontic terms. 8th ed. J Prosthet Dent. 2005;94
    argued that the progressive modifications in the defini­ (1):938–946.
    tion of CR have done more to eliminate centric slides [3] Zonnenberg AJJ, Türp JC, Greene CS. Centric relation
    critically revisited – what are the clinical implications?
    than 20 years of grudging acquiescence of the precepts
    J Oral Rehabil. 2021;48(9):1050–1055.
    of gnathology.” [4] Türp JC, Walter M. The anteroposterior condylar posi­
    Obviously, a special clinical situation exists in patients tion in maximum intercuspation in the dentate adult.
    lacking posterior support, in whom a new mandibular J Craniomandib Funct. 2014;6(1):9–20.

    © 2021 Taylor & Francis Group, LLC


    462 GUEST EDITORIAL

    [5] Rinchuse DJ, Kandasamy S. Centric relation: a historical [9] Türp JC. Unbiological, contradictory, distant
    and contemporary orthodontic perspective. J Am Dent from science: the term “centric”. [Unbiologisch,
    Assoc. 2006;137(4):494–501. widersprüchlich, wissenschaftsfern: der Begriff
    [6] Johnston LE Jr. Fear and loathing in orthodontics: notes «Zentrik»]. Quintessenz Zahntech. 2020;46(9):2–10.
    on the death of theory. In: Carlson DS, Ferrara A,
    editors. Craniofacial growth theory and orthodontic
    treatment. Ann Arbor: Center for Human Growth and Jens Christoph Türp DDS, Dr Med Dent, MSc,
    Development, University of Michigan; 1990. p. 75–91. MA
    [7] Kandasamy S, Rinchuse D. Orthodontics and TMD. In: University Center for Dental Medicine
    Kandasamy S, Cs G, Rinchuse D, et al., editors. TMD Basel UZB, University of Basel, Basel,
    and orthodontics. A clinical guide for the orthodontist.
    New York (NY): Springer; 2015. p. 81–95.
    Switzerland
    [8] Rorty R. Contingency, irony, and solidarity. Cambridge [email protected]
    [UK]: Cambridge University Press; 1989. http://orcid.org/0000-0001-9267-4317

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