Continuing diagnostics and therapy of the temporomandibular and musculoskeletal system (TMS/MSS)

The rest position of the temporomandibular joint (TMJ), the so-called 'centric relation', is discussed controversially. As yet there is no clear definition. According to current understanding, the condyles are bilaterally in the most anterosuperior position over the articular tubercle. The ligaments of the capsule are maximally relaxed. In rest position of the TMJ, the integral of the muscle activity is at the lowest level. The rest position of the joint is a probability and derives from mutual dependencies. Therefore an exact definition is difficult, if not impossible. Finding the rest position, especially in a pathological situation, is difficult. Various procedures are described, but none has proved to be the only true method. The determination of the rest position in a pathological situation can only determine a starting point for reversible therapy by an occlusal splint. This rest position can be defined by palpation of the condyles within the inner ear canal to gain more information of the tissue situation, especially the bilaminar zone, the movement pattern, the symmetry of the right and left sides and the position of the condyles while taking the therapeutic construction bite. The centric bite is easier to take and shows the relation of the mandible in a rest position in healthy joints. Palabras clave: centric bite, construction bite, occlusion, rest position, temporomandibular disorder (TMD), temporomandibular joint (TMJ)