Difference between revisions of "Introduction/Landing/Malocclusion Rethought"

 
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   <h1 style="margin:.1rem 0 0; font-size:2rem; line-height:1.15;">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 style="margin:0 0 .3rem;">
    <span class="colour-button">[[Introduction|👉 Read the full chapter]]</span>
    <span class="colour-button">[[Dental Malocclusion|Classical view →]]</span>
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    [https://www.masticationpedia.org/index.php/Introduction 👉 Read the full chapter]
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== Malocclusion Rethought ==
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  <b>In 30 seconds:</b> many “malocclusions” show <b>functional symmetry</b> at neurophysiological tests (MEP, jaw-jerk).
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.
  Purely occlusal targets risk <b>relapse</b> if neuromuscular factors are ignored.
  An <b>interdisciplinary</b> model improves long-term stability.
</div>


== Why this matters ==
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
* Electrophysiology can reveal <b>balanced trigeminal dynamics</b> even with occlusal issues.
| autore = Smaglyuk LV
* A mechanical-only view may miss <b>neural drivers</b> of orofacial dysfunction.
| autore2 = Voronkova HV
* Integrating occlusion + neurophysiology reduces <b>relapses</b> and improves outcomes.
| autore3 = Karasiunok AY
| 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.


== What you’ll learn ==
{{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.}}
* How <b>complexity science</b> reframes occlusal stability.
* When “malocclusion” is an <b>insufficient label</b>.
* The clinical role of <b>Occlusal Dysmorphisms</b> in rehabilitation.


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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
<div style="margin:12px 0 6px; text-align:center;">
| autore = Reichert I
  [[File:Duck-Rabbit illusion.jpg|320px|class=center|alt=Paradigm shift illustration|link=]]
| autore2 = Figel P
  <div style="font-size:.9rem; opacity:.7; margin-top:6px;">
| autore3 = Winchester L
    A paradigm shift: the same data can be seen in a new way.
| titolo = Orthodontic treatment of anterior open bite: a review article--is surgery always necessary?
  </div>
| url = https://www.ncbi.nlm.nih.gov/pubmed/23949448
</div>
| 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.


== Evidence & further reading ==
Electrophysiological testing revealed functional symmetry in the masticatory system despite occlusal discrepancies. Findings included:
* [[Introduction#Epistemology|Epistemology and paradigm shifts (Kuhn)]]
<gallery mode="slideshow">
* [[Introduction#Conclusion|Complex systems and emergent behavior]]
File:Occlusal Centric view in open and cross bite patient.jpg|'''Figure 1a:''' Malocclusion with open bite and right posterior crossbite.
* [[Dental Malocclusion|Dental Malocclusion (classical view)]]
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.
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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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  <span class="colour-button">[[Introduction|Read the full chapter →]]</span>
  <span class="colour-button">[[Masticationpedia:Book index|Browse the Book Index →]]</span>
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<blockquote>''Occlusal Dysmorphisms, not simply Malocclusion — an entirely different paradigm.''</blockquote>
== Quick FAQ ==
; Is this against orthodontics?
: No. It <i>enriches</i> traditional rehab with neuro-physiology and complexity.
; Why “Occlusal Dysmorphisms”?
: Because function may be preserved despite occlusal discrepancies; the label highlights a wider diagnostic frame.


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{{Bib}}
  Masticationpedia — open scientific platform for dentistry and medicine.
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              box-shadow:0 2px 8px rgba(0,0,0,.15); font-weight:600; padding:10px 22px; color:#fff;">
    [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:

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.