Weinberg L A
J Prosthet Dent. 1975 Aug;34(2):195-207. doi: 10.1016/0022-3913(75)90014-1.
A deflective slide in centric relation to centric occlusion does not necessarily mean anterior condylar displacement. Its diagnosis and treatment depend on the correlation of three factors: the direction and magnitude of the mandibular slide from centric relation to centric occlusion, the change in vertical dimension of occlusion during the slide, and the position of the condyles in the fossae when the teeth are in the maximum occlusion (centric occlusion). When the change in vertical dimension almost equals to amount of slide from the deflective contact in centric relation to maximum intercuspation, very little anterior condylar displacement would be expected. Conversely, with proportionately little change in vertical dimension, more anterior condylar translation is required for a given degree of anterior slide. Examples of each type of anterior slide were related to the TMJ radiographs of the condylar position. If the direction and magnitude of the deflective occlusal contact can be correlated with the TMJ radiographs, the centric relation is ""functional,'' and the clinically retruded mandibular position should be used. When this correlation does not exist, the centric relation is ""dysfunctional'' and the terminal hinge position (retruded mandibular position) should not be used for restorative or corrective procedures. Examples of anterior condylar displacement were given, including deviation, with a comparison of ""before'' and ""after'' TMJ radiographs.
正中关系到正中咬合时的偏斜滑动并不一定意味着髁突向前移位。其诊断和治疗取决于三个因素的相关性：下颌从正中关系到正中咬合的滑动方向和幅度、滑动过程中咬合垂直距离的变化以及牙齿处于最大咬合（正中咬合）时髁突在关节窝中的位置。当垂直距离的变化几乎等于从正中关系中的偏斜接触到最大牙尖交错位的滑动量时，预计髁突向前移位很少。相反，垂直距离变化相对较小时，对于给定程度的向前滑动，需要更多的髁突向前平移。每种类型的向前滑动示例都与髁突位置的颞下颌关节X线片相关。如果偏斜咬合接触的方向和幅度能够与颞下颌关节X线片相关联，则正中关系是“功能性的”，临床上应采用下颌后缩位。当不存在这种关联时，正中关系是“功能失调的”，终末铰链位（下颌后缩位）不应用于修复或矫正程序。给出了髁突向前移位的示例，包括偏差，并比较了颞下颌关节X线片的“术前”和“术后”情况。
