Prosthetic rehabilitation for a patient with CO-MI discrepancy

비생리적인 최대교두감합위의 교합재구성을 통한 수정

  • Received : 2015.06.29
  • Accepted : 2015.07.14
  • Published : 2015.09.30


Centric occlusion-maximum intercuspation (CO-MI) discrepancy is one of main causes of evoking premature contact and resultant mandibular shift. These non-physiological conditions can induce temporomandibular disease, periodontitis, and non-carious cervical lesion. Therefore, if CO-MI discrepancy exists in patients who need extensive prosthetic rehabilitation, it must be corrected and then physiological occlusion must be restored. This report describes the treatment procedure of removing CO-MI discrepancy and prosthetic rehabilitation in a patient with 3.5 mm discrepancy, multiple caries and periodontitis. Proper mandibular position and modified opening & closing movement were confirmed by ARCUSdigma II and transcranial radiograph.


centric relation;maximum intercuspal position;centric slide;prosthetic rehabilitation


  1. The glossary of prosthodontic terms. J Prosthet Dent 2005;94:10-92.
  2. Pullinger AG, Seligman DA, Gornbein JA. A multiple logistic regression analysis of the risk and relative odds of temporomandibular disorders as a function of common occlusal features. J Dent Res 1993;72:968-79.
  3. Landi N, Manfredini D, Tognini F, Romagnoli M, Bosco M. Quantification of the relative risk of multiple occlusal variables for muscle disorders of the stomatognathic system. J Prosthet Dent 2004;92:190-5.
  4. Branschofsky M, Beikler T, Schäfer R, Flemming TF, Lang H. Secondary trauma from occlusion and periodontitis. Quintessence Int 2011;42:515-22.
  5. Harrel SK, Nunn ME. The association of occlusal contacts with the presence of increased periodontal probing depth. J Clin Periodontol 2009;36:1035-42
  6. Brandini DA, Trevisan CL, Panzarini SR, Pedrini D. Clinical evaluation of the association between noncarious cervical lesions and occlusal forces. J Prosthet Dent 2012;108:298-303.
  7. Troeltzsch M, Troeltzsch M, Cronin RJ, Brodine AH, Frankenberger R, Messlinger K. Prevalence and association of headaches, temporomandibular joint disorders, and occlusal interferences. J Prosthet Dent 2011;105:410-7.
  8. Dawson PE. Functional occlusion: from TMJ to smile design. St. Louis; CV Mosby; 2007. p. 4-9.
  9. Ehrlich J, Hochman N, Yaffe A. The masticatory pattern as an adjunct for diagnosis and treatment. J Oral Rehabil 1992;19:393-8.
  10. Yoshida E, Fueki K, Igarashi Y. Association between food mixing ability and mandibular movements during chewing of a wax cube. J Oral Rehabil 2007;34:791-9.
  11. Park JM, Kim HJ, Park EJ, Kim MR, Kim SJ. Three dimensional finite element analysis of the stress distribution around the mandibular posterior implant during non-working movement according to the amount of cantilever. J Adv Prosthodont 2014;6:361-71.
  12. Aglietta M, Siciliano VI, Zwahlen M, Brägger U, Pjetursson BE, Lang NP, Salvi GE. A systematic review of the survival and complication rates of implant supported fixed dental prostheses with cantilever extensions after an observation period of at least 5 years. Clin Oral Implants Res 2009;20:441-51.
  13. Zurdo J, Romao C, Wennstrom JL. Survival and complication rates of implant-supported fixed partial dentures with cantilevers: a systematic review. Clin Oral Implants Res 2009;20 Suppl 4:59-66.
  14. Salama MA, Salama H, Garber DA. Guidelines for aesthetic restorative options and implant site enhancement: the utilization of orthodontic extrusion. Pract Proced Aesthet Dent 2002;14:125-130.
  15. Hellsing G. Occlusal adjustment and occlusal stability. J Prosthet Dent 1988;59:696-702.
  16. Kirveskari P. Assessment of occlusal stability by measuring contact time and centric slide. J Oral Rehabil 1999;26:763-6.