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

 
(32 intermediate revisions by the same user not shown)
Line 2: Line 2:
{{DISPLAYTITLE: Malocclusion Rethought — Occlusal Dysmorphisms}}
{{DISPLAYTITLE: Malocclusion Rethought — Occlusal Dysmorphisms}}


<!-- HERO (1 solo pulsante: Read the full chapter) -->
<!-- HERO -->
<div style="background:#f2f7ff; border-radius:14px; padding:28px; text-align:center; margin-bottom:22px; border:1px solid #e9eef7;">
<div style="background:#f2f7ff; border-radius:14px; padding:28px; text-align:center; margin-bottom:22px;">
   <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>
   <p style="font-size:1.08rem; opacity:.85; margin:.5rem 0 1.2rem;">
   <p style="font-size:1.08rem; opacity:.85; margin:.5rem 0 1.2rem;">
     From “bad bite” to a broader paradigm: <b>Occlusal Dysmorphisms</b>
     From “Malocclusion” to a broader paradigm: <b>Occlusal Dysmorphisms</b>.
   </p>
   </p>
   <div style="margin-top:16px;">
   <span class="mw-ui-button mw-ui-progressive" style="border-radius:9999px; background:linear-gradient(90deg,#5b86ff,#36d1dc); box-shadow:0 2px 8px rgba(0,0,0,.15); font-weight:600; padding:10px 22px;">
     <span class="colour-button">[https://www.masticationpedia.org/index.php/Introduction 👉 Read the full chapter]</span>
     [https://www.masticationpedia.org/index.php/Introduction 👉 Read the full chapter]
   </div>
   </span>
</div>
</div>


<!-- ABSTRACT 30s -->
<div style="background:#f8fbff; border-left:4px solid #4a90e2; padding:12px 18px; margin-bottom:22px; border-radius:6px;">
In <b>30 seconds</b>: many “malocclusions” show <b>functional symmetry</b> at neurophysiological tests (MEP, jaw-jerk). 
Purely occlusal targets risk <b>relapse</b> if neuro-muscular factors are ignored. 
An <b>interdisciplinary model</b> improves long-term stability.
</div>


<!-- WHY -->
== Malocclusion Rethought ==
<div style="background:#f9fcff; border-left:4px solid #2d9ee0; padding:16px 18px; margin-bottom:22px; border-radius:6px;">
 
  <h3>🔹 Why this matters</h3>
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.
  • Electrophysiology can reveal balanced trigeminal dynamics even with occlusal issues. <br/>
 
  • A mechanistic-only view may miss neural drivers of orofacial dysfunction. <br/>
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
  • Integrating occlusion + neurophysiology reduces relapses and improves outcomes.
| autore = Smaglyuk LV
</div>
| autore2 = Voronkova HV
| 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.
 
{{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>


<!-- WHAT -->
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.
<div style="background:#fffaf5; border-left:4px solid #ff9800; padding:16px 18px; margin-bottom:22px; border-radius:6px;">
  <h3>📘 What you’ll learn</h3>
  • How complexity science reframes occlusal stability. <br/>
  • Why “malocclusion” is often an <b>insufficient label</b>. <br/>
  • The clinical role of <b>Occlusal Dysmorphisms</b> in rehabilitation.
</div>


<!-- IMAGE -->
<blockquote>''Occlusal Dysmorphisms, not simply Malocclusion — an entirely different paradigm.''</blockquote>
<div style="text-align:center; margin:22px 0;">
  [[File:Duck-Rabbit illusion.jpg|300px|center|alt=Paradigm shift example|link=]]
  <div style="font-size:.85rem; color:#666; margin-top:6px;">
    Paradigm shifts: science can change perspective overnight.
  </div>
</div>


<!-- FURTHER READING con URL assoluti -->
{{Bib}}
<h3>📑 Evidence & further reading</h3>
* [https://www.masticationpedia.org/index.php/Dental_Malocclusion Dental Malocclusion (classical view)]
* [https://www.masticationpedia.org/index.php/Introduction#Epistemology Epistemology and paradigm shifts (Kuhn)]
* [https://www.masticationpedia.org/index.php/Introduction#Conclusion Complex systems and emergent behavior]


<!-- CTA FINALE (SOLO Book Index) -->
<!-- CTA finale -->
<!-- CTA finale -->
<div style="text-align:center; margin:34px 0 8px;">
<div style="text-align:center; margin:34px 0 8px;">
   <span class="colour-button" style="background:#ccc; color:#333; border:none; opacity:.95;">
   <span class="mw-ui-button mw-ui-progressive"  
     [https://www.masticationpedia.org/index.php/Book_index Browse the Book Index →]
        style="border-radius:9999px; background:linear-gradient(90deg,#5b86ff,#36d1dc);
              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]
   </span>
   </span>
</div>
<div style="text-align:center; margin-top:16px; font-size:13px; opacity:.75;">
  Masticationpedia — open scientific platform for dentistry and medicine.
</div>
</div>

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.