Using the term “centric”

William E. Avant, D.D.S., M.S.

Columbia, S. C.

C riticism of the term “centric” occurs for at least two reasons. One is that often
the noun that “centric” modifies is omitted, and confusion results. The other is that
some definitions of “centric relation” leave much to be desired.

ELLIPSES
Ellipses are shortened forms of words and may cause confusion. It is a common
practice to use “perio” for periodontics, “pedo” for pedodontics, “endo” for
endodontics, and “ortho’ for orthodontics. Some orthodontists even refer to cephalo-
metric radiographs as “cephs,” Such elliptical forms may not cause confusion; How-
ever, they are slang and should be avoided.
Not only do we omit parts of words, but also we omit entire words. Elliptical
statements are the result. Some elliptical statements cause no problems. Others
cause grammatical errors and confusion. For example, is it correct to say “two and
two is four” or “two and two are four. 3” Some consider “two and two” to be a
compound subject which requires the plural verb form “are.” However, I prefer to
use the singular verb form “is,” because the real subject, “sum,” is omitted. That
is, “the sum of two and two is four”; or even better, “the sum of two plus two is
four.” Moreover, grammatical errors, such as, “I try harder than him,” are made.
Little knowledge of grammar is needed to recognize and to correct the error to read,
“I try harder than he.” If the complete statement, “I try harder than he tries,”
were used, the error would not be made.
It seems obvious, then, that elliptical constructions can cause problems. Further-
more, the word “centric” is a victim of ellipses.

“CENTRIC” DEFENDED
The word “centric” is an adjective, not a noun. However, the use of “centric”
elliptically, that is, omitting the noun that “centric” modifies, makes it function as a
noun. This causes confusion, because there are at least two adjectival uses for
“centric” in dental terminology. These are centric relation and centric occlusion.
The confusion is bad enough. However, to make it worse, “centric” has been indicted,
but not convicted, as the culprit that causes the confusion’* 2 when, in reality, the
slovenly use of the word is a big factor.8
12
 Using the term “centric” 13

Recently, the terms “long centric” and “freedom in centric” have made their
appearances. Again, “centric” is being made to function as a noun. Sooner or later
someone is sure to criticize “centric,” rather than the person who uses it, as being an
improper term.
It has been suggested that “centric” be removed from our dental vocabulary.ll *
If “centric” is unacceptable, should one speak of eccentric movements of the
mandible? Furthermore, has anyone suggested that words such as “he” and “him”
or “is” and “are” be deleted from our vocabulary because they are used incorrectly?
Indeed not! We are expected to use them correctly. The same reasoning should apply
to the word “centric.”

DEFINITIONS
Seven definitions of “centric relation” appear in the Glossary of Prosthodontic
Terms (ed. 2, 1960) edited by the Nomenclature Committee of The Academy of
Denture Prosthetics, This is regrettable. Some of these definitions have provoked
criticism of the terms “centric” and “centric relation.”
Centric relation is a patient-established position of the mandible. The apex of a
needlepoint tracing or the terminal hinge position of the mandible can indicate that
the mandible is in centric relation with the maxillae. Also, the mandible can be
placed in centric relation by instructing the patient to pull back the lower jaw as
far as possible. Thus, in essence, centric relation is the most retracted position of
the lower jaw in relation to the upper jaw. However, since centric relation can exist
at more than one vertical relation of the jaws, a complete definition should include
the vertical component of the relationship. Therefore, the following definition seems
to be acceptable: “Centric relation is the most posterior relation of the mandible
to the maxillae at the established vertical relation.“4
Centric occlusion is defined as the relationship of opposing occlusal surfaces that
provides the maximum planned contact and/or intercuspation of the teeth.5

CENTRIC RELATION VERSUS CENTRIC OCCLUSION

If centric occlusion coincides with centric relation, they appear to be the same.
However, they are never the same. Centric relation is always a bone-to-bone rela-
tion while centric occlusion is a tooth-to-tooth relation (Fig. 1). Centric occlusion
does not coincide with centric relation in most people with natural teeth (Fig. 2).
One study showed that centric occlusion placed the mandible an average of 1.2
mm. anterior to its position in centric relation .6 The concensus of most prostho-
dontists, many periodontists, and probably all gnathologists is that centric occlusion
should coincide with centric relation (Fig. 3). Centric relation occlusion is being
used by some to indicate that centric occlusion coincides with centric relation.* De-
fined as such, the term is descriptive.
When no occlusion of teeth (natural and/or artificial) is involved, then both
centric relation and centric occlusion lose their significance. However, except in
relatively few situations, dentists are concerned with the occlusion of teeth and need
a reproducible reference position to describe the relation of the jaws to each other

“App, George R.: Personal Communication, May, 1966.

 J. Prosth. Dent.
January. 1971

Fig. 1. Centric relation is a bone-to-bone (mandible to maxillae) relation. Centric occlusion

is a tooth-to-tooth (mandibular teeth to maxillary teeth) relation.

\ 0
I 0
t 0 2”
l I-
Fig. 2. The border movements of the mandible are represented in the midsagittal plane as
indicated by the envelope of motion traced by the incisal edge of a mandibular central incisor.
Centric occlusion (A) is depicted as being anterior to centric relation (B). Note that the
mandible must be retracted to reach centric relation at point B. (A) Centric occlusion; (B,J
centric relation; (C) the point at which the mandible can no longer open on the terminal
hinge axis (translation occurs as the condyles move downtiard and forward); (0) the wide-
open position of the mandible; (E) the most protracted position of the mandible with the
teeth in contact; (A-B) the path of the incisor from centric occlusion to centric relation with
the teeth in contact; (B-C-D) the most retracted path of the incisor from centric relation to
the wide-open position of the mandible; (B-C) terminal hinge opening; (C-D) translation;
(D-E) the most protracted path of the incisor from the wide-open position to the point at
which the teeth make contact; (E-A) the path of the incisor, with the teeth in contact, from
the most protracted position to centric occlusion.
Volume 25 Using the term “centridJ 15
Number 1

Fig. 3. Centric occlusion (A) coincides with centric relation, (B) on the tracing of the
envelope of motion as seen in the sagittal plane. The labeling follows that seen in Fig. 2.

irrespective of the teeth. Whether precisely reproducible or not, centric relation is

the only usable position that exists.

SUMMARY
“Centric” is an old term that would be almost impossible to eliminate from
dental terminology. It seems prudent, then, that the term be used correctly and that
simple, usable definitions of centric relation and centric occlusion be employed. The
word “centric” is an adjective that should not be made to function as a noun.
Centric relation is a bone-to-bone (mandible to maxillae) relation. Centric occlusion
is a tooth-to-tooth relation (mandibular teeth to maxillary teeth). Therefore, centric
relation and centric occlusion are not the same by definition; however, often they
both can exist at the same time.

References
1. Gottsegen, R.: Centric Relation: The Periodontist’s Viewpoint, J. PROSTH. DENT. 16:
1034-1038, 1966.
2. Dyer, E. H.: Dental Articulation and Occlusion, J. PROSTH. DENT. 17: 238-246, 1967.
3. Boucher, C. 0.: Through the Eyes of the Editor, J. PROSTH. DENT. 17: 208, 1967.
4. Boucher, C. 0.: Swenson’s Complete Dentures, ed. 5, St. Louis, 1964, The C. V. Mosby
Company, p. 176.
5. Boucher, C. 0.: Current Clinical Dental Terminology, St. Louis, 1963, The C. V. Mosby
Company.
6. Posselt, U.: Studies in the Mobility of the Human Mandible, Acta Odont. Stand. 10:
19-160 (Suppf. lo), 1952.

2827 MILLWOOD AVE.

COLUMBIA, S. C. 29205