正中关系的临床决策

Clinical decision of centric relation

正中关系(CR)最初应用于无牙颌的全口义齿修复,后来逐渐应用于有牙颌的临床诊疗。关于CR在有牙颌中的应用,一方面对其合理性有不少质疑,如在颞下颌关节紊乱病治疗中,CR是否应作为诊疗核心?咬合重建修复治疗中,CR是否应作为建颌位?正畸治疗中,CR是否应作为目标颌位?但另一方面,CR的各种临床运用却是客观存在的。根据现有认知,本文汇总整理了争议不大的几种主要临床场景的适用条件,初步提出了CR临床应用时的决策树,供临床参考。

Centric relation(CR) was used in the complete dentures for edentulous jaws firstly.Then,CR was gradually applied in the clinical diagnosis and treatment of dentate jaws.Regarding the application of CR in dentate jaws,there are many doubts about its rationality.For instance,should CR be the core of diagnosis and treatment of temporomandibular disorders? Should CR be used as the jaw position of establishing occlusion in occlusal reconstruction? Should CR serve as the target jaw position in orthodontic treatment? Meanwhile,varieties of CR clinical applications are objective.According to the existing evidence,this paper summarizes the applicable conditions of several main clinical situations with little controversy.We preliminarily put forward the decision tree for the clinical application of CR,which can be used as a reference in clinical practice.