Modifica di Introduction (sezione)

== Conclusion ==
.🔁 Before concluding, it is essential to clarify that the 'masticatory system' cannot be considered merely as a simple biomechanical mechanism without connecting it to a neurophysiological control system that essentially determines a 'Complex System'. {{Tooltip|<sup>[26]</sup>|<ref>https://en.wikipedia.org/wiki/Complex_system</ref>|<small> 📌 A complex system is a dynamic multi-component system, composed of various subsystems that typically interact with each other in an interdependent manner, analytically describable through mathematical models. This type of system is studied within the field of complexity theory. A global approach is typically necessary, as it is not possible to analytically resolve all components with their interactions, while it is useful to rely on complex computer simulations to evaluate/analyze the dynamic behavior of each component as well as their mutual interactions, which can be described in a simple or linear manner or non-linear (see dynamic system). Typical of complex systems are the concepts of self-organization and emergent behavior. The assumption of a complex system thus embraces most real physical systems with many components, compared to systems considered "simple," more typical of classical physics.</small>}}

🧩 This implies that elements such as:

- dental occlusion

- temporomandibular joint

- periodontal receptors

- neuromuscular spindles

- central trigeminal nervous system

do not act in isolation, segmenting the biological system into biomechanical and neurophysiological but in 'synergy', producing an "Emergent Behavior". {{Tooltip||2=The **masseter silent period** (MSP) is a relevant example of emergent behavior in masticatory neurophysiology. This reflex is activated by sudden blows to the chin, leading to a brief cessation of electrical activity in the masseter muscle, and is closely related to the recruitment of motor units. During MSP, there is a specific modulation of motor unit recruitment, regulated by the central nervous system, to respond to external stimuli. In the context of emergent behavior, this reflex is not limited to a single muscle but represents a coordinated response involving synergies between various neuronal centers and antagonist muscles. Mathematically, we can describe the probability <math>P(R)</math> of an emergent response as a function of the input variables <math>x_1, x_2, \ldots, x_n</math> that influence the activation of motor units: <math>P(R) = f(x_1, x_2, \ldots, x_n)</math> where <math>f</math> represents the non-linear interaction between incoming stimuli (such as the type and intensity of the blow to the chin) and the central integration processes of the trigeminal system. This model helps to understand how MSP reflects an integrated and adaptive response that emerges from complex neurophysiological circuits rather than from a single neural pathway.}}

📚 An important conceptual synthesis is represented by the work of 'Kazem Sadegh-Zadeh', "Handbook of Analytic Philosophy of Medicine", which describes medicine as a systemic science.{{Tooltip|<sup>[27]</sup>|<ref>{{cita libro|autore=Sadegh-Zadeh Kazem|titolo=Handbook of Analytic Philosophy of Medicine|url=https: //link.springer.com/book/10.1007/978-94-007-2260-6|anno=2012|editore=Springer|ISBN=978-94-007-2259-0}}</ref>|<small>📌 Medical practice is practiced morality and clinical research belongs to normative ethics. This book clarifies and develops this thesis: 1. analyzing the structure of medical language, knowledge, and theories; 2. investigating the foundations of the clinical encounter; 3. introducing the logic and methodology of clinical decision-making; 4. suggesting comprehensive theories on organism, life, and psyche; on health, disease, and pathology; on etiology, diagnosis, prognosis, prevention, and therapy; and 5. investigating the central moral and metaphysical issues in medical practice and research.</small>}}

🧠 The elements of the masticatory system are consistent with the activity of the central trigeminal nervous system, as evidenced in electrophysiological tests. This reinforces the idea that "Malocclusion" is an 'insufficient heuristic category': the correct term is "Occlusal Dysmorphism".

{{q2|Recognizing the masticatory system as a "Complex System" does not exclude the validity of orthodontic or prosthetic therapies, but enriches them, promoting a functional and neurophysiological perspective.}}

🏁 In this context, 'OrthoNeuroGnathodontic' treatments emerge as paradigmatic: they integrate aesthetics, function, and neurosciences to achieve:

- occlusal stability

- prevention of relapses

- functional resilience

📖 Recent studies confirm the importance of post-therapy stability:{{Tooltip|<sup>[28]</sup>|<ref>Essam Ahmed Al-Moraissi, Larry M Wolford.Is Counterclockwise Rotation of the Maxillomandibular Complex Stable Compared With Clockwise Rotation in the Correction of Dentofacial Deformities? A Systematic Review and Meta-Analysis. J Oral Maxillofac Surg. 2016 Oct;74(10):2066.e1-12. doi:10.1016/j.joms.2016.06.001</ref>|<small><nowiki>📌 Comparing the post-surgical skeletal stability between counterclockwise rotation (CCWR) of the maxillomandibular complex (MMC) and clockwise rotation (CWR) of the MMC for the correction of dentofacial deformities. Materials and methods: To achieve the study's purpose, we designed and implemented a systematic review with meta-analysis based on PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A search strategy was developed and a search was conducted in major databases – PubMed, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) – to find all relevant articles published from the beginning until March 2016. Inclusion criteria were randomized controlled clinical trials, controlled clinical trials, retrospective studies, and case series, with the aim of comparing the post-surgical stability of CCWR and CWR of the MMC. 🧪 The analysis was performed using lateral cephalometric analysis of mean post-operative values and the correlation between surgical and post-operative changes in the occlusal plane angle and linear changes in points A and B. A weighted mean difference analysis was performed using a random-effects model with 95% confidence intervals. Results: A total of 133 patients were enrolled from 3 studies (CCWR, n = 83; CWR, n = 50). 🧪 All included studies had a moderate risk of bias. 🧠 There was a statistically significant difference between CCWR and CWR of the MMC in post-operative changes in the occlusal plane angle (P = 0.034), but no statistically significant difference was found in the correlation between surgical and post-operative changes in the occlusal plane angle in the 2 groups. No statistically significant difference was found between CCWR and CWR of the MMC regarding stability between immediate post-surgical and longest follow-up evaluations, concerning vertical and horizontal positions at points A and B (P > 0.05). Conclusion: CCWR, compared to CWR, for the correction of dentofacial deformities in the absence of pre-existing temporomandibular joint pathologies, is skeletally stable concerning post-surgical changes in the occlusal plane, as well as vertical and horizontal changes in the maxilla and mandible</nowiki></small>|}}{{Tooltip|<sup>[29]</sup>|<ref>J Hoffmannová et al.[https://pubmed.ncbi.nlm.nih.gov/19537679/ Factors influencing the stability of sagittal split ramus osteotomy]. Prague Med Rep. 2008;109(4):286–97.</ref>|<small>📌 The stability of bilateral sagittal split osteotomy (BSSO) is an important goal for every surgeon. The article examines the factors influencing the stability of the surgical outcome. Particular emphasis is given to the different types of fixation of bone fragments. Their advantages and disadvantages in clinical use are discussed. 🧠 Recurrence after BSSO is generally classified as early and long-term. Early recurrence is usually caused by movements at the osteotomy site or failure of the temporomandibular joint and should be defined as surgical dislocation. Long-term recurrence occurs due to progressive condylar resorption of the temporomandibular joint, causing a loss of condylar and mandibular ramus height. Four different types of fixation in orthognathic surgery have been described: rigid intermaxillary fixation, osteosuture, osteosynthesis, and fixation with biodegradable materials.</small>}}


📌 This paradigm 'does not replace' classical models, but 'extends them', creating a bridge between biomechanics, neurosciences, and systemic medicine.<blockquote>{{qnq|What do we mean by “Complex Systems” when we talk about masticatory functions?}}</blockquote>