We thank Drs Tian and Han for their interest in our study.
Most importantly, our study was designed to assess the validity of 3 bite registrations. If there was a difference among these registrations, this would have been detected even if the differences were small. The differences we found, however, were highly variable and unpredictable. Whether the patients had TMD or not, if these registrations were effective in positioning the condyles, we would have detected this consistently regardless of the magnitude. However, we did not.
Drs Tian and Han appear to have contradicted themselves when they initially acknowledged that there is a “range for centric relation” but later rationalized that the “practice of positioning condyles is clinically conducted in patients with abnormal condylar positions to alleviate or prevent TMD.” So which is it? What constitutes an abnormal condylar position? If there is a range, where in this so-called range do Drs Tian and Han suggest that these “abnormal” condyles be placed in patients with TMD? Interestingly, gnathologists believe that condylar positioning should be carried out routinely even in patients without TMD.
Unlike anecdotal reports, hearsay, and clinical opinions and beliefs, the bottom line, based on our study and the other evidence-based literature, is that the routine clinical practice of condylar positioning with various bite registrations to prevent or treat TMD is invalid and unjustified.