Maxillomandibular relationship philosophies for prosthodontic treatment: A survey of dental educators

A variety of treatment philosophies persist concerning the need for coincidence of centric occlusion (CO) and maximum intercuspation (MI) in prosthodontic restoration; however, no consensus exists. The purpose of this study was to determine the philosophies of dental educators throughout the United States at both the predoctoral and postdoctoral levels and to compare their attitudes toward desirable maxillomandibular relationships in defined clinical situations. A survey was constructed with 5 clinical scenarios presented describing patients with a difference between maximum intercuspation and centric occlusion. The survey was mailed to 171 dentists involved in either predoctoral or postdoctoral dental programs in the United States; including 56 dental schools; the Army, Navy, and Air Force postdoctoral programs; 8 Department of Veterans Affairs postdoctoral programs; and 7 hospital-based programs. Descriptive statistics of the responses were provided. Chi-squared (α=.05) and Fisher's exact test analyses (α=.05) comparing predoctoral and postdoctoral program responses for each question were performed. Forty-three predoctoral dental school program responses were received. Forty-one postdoctoral program directors, including the dental school-based programs, 3 armed service branches, 2 Veterans Administration programs, and 1 hospital-based program responded to the survey. Fifteen respondents indicated that they represented both predoctoral and postdoctoral programs, and these data were deleted from the sample. Summarized results for each question reflect on whether the clinicians philosophically believed patients were better off with the elimination of an existing occlusal interference between MI and CO or not. There was no statistically significant difference seen between the predoctoral and postdoctoral responses. The controversy regarding the preferred mandibular position for treatment of dentulous and partially edentulous patients continues among dental educators at both the predoctoral and postdoctoral levels in the United States.