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   <h1 style="margin:.2rem 0; font-size:2.2rem; line-height:1.2;">Malocclusion Rethought</h1>
   <h1 style="margin:.2rem 0; font-size:2.2rem; line-height:1.2;">Malocclusion Rethought</h1>
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     From “bad bite” to a broader paradigm: <b>Occlusal Dysmorphisms</b>
     From “Malocclusion” to a broader paradigm: <b>Occlusal Dysmorphisms</b>.
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   </p>
   <span class="colour-button">[[Introduction|👉 Read the full chapter]]</span>
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   <span class="colour-button">[[Dental Malocclusion|Compare with classical view]]</span>
    [https://www.masticationpedia.org/index.php/Introduction 👉 Read the full chapter]
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  <h2 style="margin-top:0;">⚡ Why this matters</h2>
  <ul>
    <li>Electrophysiology reveals <b>balanced trigeminal dynamics</b> even with occlusal issues.</li>
    <li>Mechanical-only approaches risk <b>relapse</b>.</li>
    <li>An <b>interdisciplinary</b> model improves long-term stability.</li>
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== Malocclusion Rethought ==
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  <h2 style="margin-top:0;">📘 What you’ll learn</h2>
The term "Malocclusion," derived from the Latin ''malum'' ("bad"), was first introduced by Edward Angle to define an improper “closure” of teeth.<ref>Attributed to [[:wpen:Edward Angle|Edward Angle]], the father of modern orthodontics.</ref> Yet, the notion of "bad closure" remains ambiguous in medical contexts.
  <ul>
 
    <li>How <b>complexity science</b> reframes occlusal stability.</li>
A PubMed search for "Malocclusion" yields over 33,000 articles,<ref>Pubmed, ''[https://www.ncbi.nlm.nih.gov/pubmed/?term=%22malocclusion%22 Malocclusion]''</ref> but without clear consensus on its definition. Smaglyuk et al. stress the importance of an interdisciplinary approach in diagnostics,<ref>{{cita libro
    <li>Why “malocclusion” is an <b>insufficient label</b>.</li>
| autore = Smaglyuk LV
    <li>The role of <b>Occlusal Dysmorphisms</b> in clinical practice.</li>
| autore2 = Voronkova HV
  </ul>
| autore3 = Karasiunok AY
</div>
| autore4 = Liakhovska AV
| autore5 = Solovei KO
| titolo = Interdisciplinary approach to diagnostics of malocclusions (review)
| url = https://www.ncbi.nlm.nih.gov/pubmed/31175796
| opera = Wiad Lek
| anno = 2019
}} 72(5 cz 1):918-922.</ref> yet a query for "interdisciplinary diagnostics of malocclusions" returns only four articles,<ref>Pubmed, ''[https://www.ncbi.nlm.nih.gov/pubmed/?term=interdisciplinary+diagnostics+of+malocclusions Interdisciplinary diagnostics of malocclusions]''</ref> underscoring a major gap in the literature. This suggests a paradigmatic shift may be underway, as described in Kuhn’s phase 4 model.
 
{{q2|Diagnosis, treatment strategies, and prevention of anomalies and dento-facial deformities should consider the organism as a whole, particularly in children whose structures are still developing.}}
 
A clinical case illustrates this complexity: a patient presented with a unilateral posterior crossbite and anterior open bite. Literature suggests orthodontic appliances and sometimes orthognathic surgery are indicated.<ref>{{cita libro
| autore = Reichert I
| autore2 = Figel P
| autore3 = Winchester L
| titolo = Orthodontic treatment of anterior open bite: a review article--is surgery always necessary?
| url = https://www.ncbi.nlm.nih.gov/pubmed/23949448
| opera = Oral Maxillofac Surg
| anno = 2014
}} Sep;18(3):271-7.</ref> Crossbite correction is equally important due to its functional link with open bite.<ref>{{cita libro
| autore = Miamoto CB
| autore2 = Silva Marques L
| autore3 = Abreu LG
| autore4 = Paiva SM
| titolo = Impact of two early treatment protocols for anterior dental crossbite on children’s quality of life
| url = https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5962250/pdf/2176-9451-dpjo-23-01-00071.pdf
| opera = Dental Press J Orthod
| anno = 2018
}} Jan-Feb; 23(1) 71–78.</ref> In this case, however, the patient refused treatment, claiming function was unaffected.
 
Electrophysiological testing revealed functional symmetry in the masticatory system despite occlusal discrepancies. Findings included:
<gallery mode="slideshow">
File:Occlusal Centric view in open and cross bite patient.jpg|'''Figure 1a:''' Malocclusion with open bite and right posterior crossbite.
File:Bilateral Electric Transcranial Stimulation.jpg|'''Figure 1b:''' Motor-evoked potential symmetry in masseter muscles.
File:Jaw Jerk .jpg|'''Figure 1c:''' Jaw reflex test confirming functional balance.
File:Mechanic Silent Period.jpg|'''Figure 1d:''' Mechanical silent period indicating neuromuscular coherence.
</gallery>
 
These results challenge the reductionist view of malocclusion, showing that **neuromuscular balance may coexist with occlusal asymmetries**. Hence, diagnostic strategies must integrate occlusion with neurophysiology to avoid oversimplification.


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<blockquote>''Occlusal Dysmorphisms, not simply Malocclusion — an entirely different paradigm.''</blockquote>
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  [[File:Duck-Rabbit illusion.jpg|350px|center|alt=Paradigm shift illustration]]
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    Paradigm shifts: science can change perspective overnight.
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  <h3>Evidence & further reading</h3>
  <ul>
    <li>[[Dental Malocclusion|Dental Malocclusion (classical view)]]</li>
    <li>[[Introduction#Epistemology|Epistemology and paradigm shifts (Kuhn)]]</li>
    <li>[[Introduction#Conclusion|Complex systems and emergent behavior]]</li>
  </ul>
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   <span class="colour-button">[[Introduction|Read the full chapter →]]</span>
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    [https://www.masticationpedia.org/index.php/Introduction#Dental_Malocclusion 👉 Explore the full section in the Introduction]
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Latest revision as of 19:24, 19 September 2025


Malocclusion Rethought

From “Malocclusion” to a broader paradigm: Occlusal Dysmorphisms. 

 
   👉 Read the full chapter


Malocclusion Rethought

The term "Malocclusion," derived from the Latin malum ("bad"), was first introduced by Edward Angle to define an improper “closure” of teeth.[1] Yet, the notion of "bad closure" remains ambiguous in medical contexts.

A PubMed search for "Malocclusion" yields over 33,000 articles,[2] but without clear consensus on its definition. Smaglyuk et al. stress the importance of an interdisciplinary approach in diagnostics,[3] yet a query for "interdisciplinary diagnostics of malocclusions" returns only four articles,[4] underscoring a major gap in the literature. This suggests a paradigmatic shift may be underway, as described in Kuhn’s phase 4 model.

«Diagnosis, treatment strategies, and prevention of anomalies and dento-facial deformities should consider the organism as a whole, particularly in children whose structures are still developing.»

A clinical case illustrates this complexity: a patient presented with a unilateral posterior crossbite and anterior open bite. Literature suggests orthodontic appliances and sometimes orthognathic surgery are indicated.[5] Crossbite correction is equally important due to its functional link with open bite.[6] In this case, however, the patient refused treatment, claiming function was unaffected.

Electrophysiological testing revealed functional symmetry in the masticatory system despite occlusal discrepancies. Findings included:

  • Figure 1a: Malocclusion with open bite and right posterior crossbite.

  • Figure 1b: Motor-evoked potential symmetry in masseter muscles.

  • Figure 1c: Jaw reflex test confirming functional balance.

  • Figure 1d: Mechanical silent period indicating neuromuscular coherence.

These results challenge the reductionist view of malocclusion, showing that **neuromuscular balance may coexist with occlusal asymmetries**. Hence, diagnostic strategies must integrate occlusion with neurophysiology to avoid oversimplification.

Occlusal Dysmorphisms, not simply Malocclusion — an entirely different paradigm.

Bibliography & references
  1. ↑ Attributed to Edward Angle, the father of modern orthodontics.
  2. ↑ Pubmed, Malocclusion
  3. ↑ Smaglyuk LV, Voronkova HV, Karasiunok AY, Liakhovska AV, Solovei KO, «Interdisciplinary approach to diagnostics of malocclusions (review)», in Wiad Lek, 2019».  72(5 cz 1):918-922.
  4. ↑ Pubmed, Interdisciplinary diagnostics of malocclusions
  5. ↑ Reichert I, Figel P, Winchester L, «Orthodontic treatment of anterior open bite: a review article--is surgery always necessary?», in Oral Maxillofac Surg, 2014».  Sep;18(3):271-7.
  6. ↑ Miamoto CB, Silva Marques L, Abreu LG, Paiva SM, «Impact of two early treatment protocols for anterior dental crossbite on children’s quality of life», in Dental Press J Orthod, 2018».  Jan-Feb; 23(1) 71–78.
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