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{{DISPLAYTITLE: Malocclusion Rethought — Occlusal Dysmorphisms}}
 
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  <h1 style="margin:.2rem 0; font-size:2.2rem; line-height:1.2;">Malocclusion Rethought</h1>
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    From “Malocclusion” to a broader paradigm: <b>Occlusal Dysmorphisms</b>.
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    [https://www.masticationpedia.org/index.php/Introduction 👉 Read the full chapter]
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== Malocclusion Rethought ==
== Malocclusion Rethought ==
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From "bad bite" to a broader paradigm: Occlusal Dysmorphisms
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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.
'''In brief:''' many so-called "malocclusions" show functional symmetry at neurophysiological tests (MEP, jaw-jerk).
 
Purely occlusal targets risk ''relapse'' if neuromuscular factors are ignored.  
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
An interdisciplinary model improves long-term stability.
| autore = Smaglyuk LV
| 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.


=== Why this matters ===
Electrophysiological testing revealed functional symmetry in the masticatory system despite occlusal discrepancies. Findings included:
* Electrophysiology can reveal balanced trigeminal dynamics even with occlusal issues.
<gallery mode="slideshow">
* A mechanistic-only view may miss neural drivers of orofacial dysfunction.
File:Occlusal Centric view in open and cross bite patient.jpg|'''Figure 1a:''' Malocclusion with open bite and right posterior crossbite.
* Integrating occlusion + neurophysiology reduces relapses and improves outcomes.
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 you’ll learn ===
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.
* How complexity science reframes occlusal stability. 
* Why “malocclusion” is often an insufficient label.
* The clinical role of Occlusal Dysmorphisms in rehabilitation.


=== Evidence & further reading ===
<blockquote>''Occlusal Dysmorphisms, not simply Malocclusion — an entirely different paradigm.''</blockquote>
* [https://www.masticationpedia.org/wiki/Dental_Malocclusion Dental Malocclusion (classical view)] 
* [https://www.masticationpedia.org/wiki/Philosophy_and_paradigm_shifts Epistemology and paradigm shifts (Kuhn)] 
* [https://www.masticationpedia.org/wiki/Complex_systems Complex systems and emergent behavior] 
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{{Bib}}
'''→ [[Introduction|Read the full chapter]]'''
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    [https://www.masticationpedia.org/index.php/Introduction#Dental_Malocclusion 👉 Explore the full section in the Introduction]
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