Modifica di Complex Systems (sezione)

==Conclusive Considerations==
In conclusion, it is clear from the premise, that the Masticatory system should be considered not certainly as a system simply governed by mechanical laws, but as a "Complex System" of indeterministic type, where one can quantify the "Emerging Behavior" only after stimulating it and then analysing the response evoked (Figure 2). The Neuronal System also dialogues with its own encrypted machine language (potential action and ionic currents) and, therefore, it is not possible to interpret the symptoms referred to by the patient through natural language.

This concept deepens knowledge of the state of health of a system because it elicits an answer from inside the network — or, at least, from a large part of it — by allocating normal and/or abnormal components of the various nodes of the network. In scientific terms, it also introduces a new paradigm in the study of the Masticatory System: the "Neuro Gnathology Function", that we will meet in due course in the chapter ‘Extraordinary Science’.

Currently, the interpretation of the Emergent Behavior of the Mastication system in dentistry is performed only by analysing the voluntary valley response, through electromyographic recordings ‘EMG interference pattern’, and radiographic and axographic tests (replicators of mandibular movements). These can only be considered descriptive tests.

The paradigm of gnathological descriptive tests faced a crisis years ago: despite an attempt to reorder the various axioms, schools of thought, and clinical-experimental strictness in the field of Temporomandibular Disorders (through the realization of a protocol called "Research Diagnostic Criteria" RDC/TMDs), this paradigm has not yet come to be accepted because of the scientific-clinical incompleteness of the procedure itself. It deserves, however, a particular reference to the RDC/TMD, at least for the commitment that was carried out by the authors and, at the same time, to scroll the limits.

The RDC/TMD protocol was designed and initialized to avoid the loss of ‘standardized diagnostic criteria’ and evaluate a diagnostic standardization of empirical data at disposition. 
This protocol was supported by the National Institute for Dental Research (NIDR) and conducted at the University of Washington and the Group Health Corporative of Puget Sound, Seattle, Washington. Samuel F. Dworkin, M. Von Korff, and L. LeResche were the main investigators<ref>{{Cite book 
 | autore = Dworkin SF
 | autore2 = Huggins KH
 | autore3 = Wilson L
 | autore4 = Mancl L
 | autore5 = Turner J
 | autore6 = Massoth D
 | autore7 = LeResche L
 | autore8 = Truelove Edmond L
 | titolo = A randomized clinical trial using research diagnostic criteria for temporomandibular disorders-axis II to target clinic cases for a tailored self-care TMD treatment program
 | url = https://pubmed.ncbi.nlm.nih.gov/11889659/
 | volume = 
 | opera = J Orofac Pain
 | anno = 2002
 | editore = 
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 | ISBN = 
 | PMID = 11889659
 | PMCID = 
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 }}</ref>.

To arrive at the formulation of the protocol of the ‘RDC’, a review of the literature of diagnostic methods in rehabilitative dentistry and TMDs, and subjected to validation and reproducibility, has been made. Taxonomic systems were taken into account by Farrar (1972)<ref>{{Cite book 
 | autore = Farrar WB
 | titolo = Differentiation of temporomandibular joint dysfunction to simplify treatment
 | url = https://pubmed.ncbi.nlm.nih.gov/4508486/
 | volume = 
 | opera = J Prosthet Dent
 | anno = 1972
 | editore = 
 | città = 
 | ISBN = 
 | PMID = 4508486 
 | PMCID = 
 | DOI =  10.1016/0022-3913(72)90113-8
 | oaf = <!-- qualsiasi valore -->
 | LCCN = 
 | OCLC = 
 }}</ref><ref>{{Cite book 
 | autore = Farrar WB
 | autore2 = 
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 | titolo = Controversial syndrome
 | url = https://pubmed.ncbi.nlm.nih.gov/4503595/
 | volume = 
 | opera = J Am Dent Assoc
 | anno = 1972
 | editore = Elsevier Inc
 | città = 
 | ISBN = 
 | PMID = 4503595
 | PMCID = 
 | DOI = 10.14219/jada.archive.1972.0286
 | oaf = <!-- qualsiasi valore -->
 | LCCN = 
 | OCLC = 
 }}</ref>, Eversole and Machado (1985)<ref>{{Cite book 
 | autore = Eversole LR
 | autore2 = Machado L
 | titolo = Temporomandibular joint internal derangements and associated neuromuscular disorders
 | url = https://jada.ada.org/article/S0002-8177(85)01024-8/pdf
 | volume = 
 | opera = J Am Dent Assoc
 | anno = 1985
 | editore = 
 | città = 
 | ISBN = 
 | PMID = 3882811
 | PMCID = 
 | DOI = 10.14219/jada.archive.1985.0283
 | oaf = <!-- qualsiasi valore -->
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 }}</ref>, Bell (1986)<ref>{{Cite book 
 | autore = Storum KA
 | autore2 = Bell WH
 | autore3 = 
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 | titolo = The effect of physical rehabilitation on mandibular function after ramus osteotomies
 | url = 
 | volume = 
 | opera = J Oral Maxillofac Surg
 | anno = 1986
 | editore = 
 | città = 
 | ISBN = 
 | PMID = 3456031
 | PMCID = 
 | DOI = 10.1016/0278-2391(86)90188-6
 | oaf = <!-- qualsiasi valore -->
 | LCCN = 
 | OCLC = 
 }}
</ref>, Fricton (1989)<ref>{{Cite book 
 | autore = Schiffman E
 | autore2 = Anderson G
 | autore3 = Fricton J
 | autore4 = Burton K
 | autore5 = Schellhas K
 | titolo = Diagnostic criteria for intraarticular T.M. disorders
 | url = https://www.ncbi.nlm.nih.gov/pubmed/2791516
 | volume = 
 | opera = Community Dent Oral Epidemiol
 | anno = 1989
 | editore = 
 | città = 
 | ISBN = 
 | PMID = 2791516
 | PMCID = 
 | DOI = 10.1111/j.1600-0528.1989.tb00628.x
 | oaf = <!-- qualsiasi valore -->
 | LCCN = 
 | OCLC = 
 }}</ref>, American Academy of Craniomandibular Disorders (AACD) (1990)<ref>{{Cite book 
 | autore = Phillips DJ Jr
 | autore2 = Gelb M
 | autore3 = Brown CR
 | autore4 = Kinderknecht KE
 | autore5 = Neff PA
 | autore6 = Kirk WS Jr
 | autore7 = Schellhas KP
 | autore8 = Biggs JH 3rd
 | autore9 = Williams B
 | autore10 = 
 | autore11 = 
 | autore12 = 
 | titolo = Guide to evaluation of permanent impairment of the temporomandibular joint
 | url = https://www.ncbi.nlm.nih.gov/pubmed/9586521
 | volume = 
 | opera = Cranio
 | anno = 1997
 | editore = American Academy of Head, Neck and Facial Pain; American Academy of Orofacial Pain; American Academy of Pain Management; American College of Prosthodontists; American Equilibration Society and Society of Occlusal Studies; American Society of Maxillofacial Surgeons; American Society of Temporomandibular Joint Surgeons; International College of Cranio-mandibular Orthopedics; Society for Occlusal Studies
 | città = 
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 | PMID = 9586521
 | PMCID = 
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 | oaf = <!-- qualsiasi valore -->
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 }}</ref>, Talley (1990)<ref>{{Cite book 
 | autore = Talley RL
 | autore2 = Murphy GJ
 | autore3 = Smith SD
 | autore4 = Baylin MA
 | autore5 = Haden JL
 | titolo = Standards for the history, examination, diagnosis, and treatment of temporomandibular disorders(TMD): a position paper
 | url = https://www.ncbi.nlm.nih.gov/pubmed/2098190
 | volume = 
 | opera = Cranio
 | anno = 1990
 | editore = American Academy of Head, Neck and Facial Pain
 | città = 
 | ISBN = 
 | PMID = 2098190
 | PMCID = 
 | DOI = 10.1080/08869634.1990.11678302
 | oaf = <!-- qualsiasi valore -->
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 }}</ref>, Bergamini and Prayer-Galletti (1990)<ref>{{Cite book 
 | autore = Prayer Galletti S
 | autore2 = Colonna MT
 | autore3 = Meringolo P
 | titolo = The psychological aspects of craniocervicomandibular pain dysfunction pathology
 | url = https://pubmed.ncbi.nlm.nih.gov/2398856/
 | volume = 
 | opera = Minerva Stomatol
 | anno = 1990
 | editore = 
 | città = 
 | ISBN = 
 | PMID = 2398856
 | PMCID = 
 | DOI = 
 | oaf = <!-- qualsiasi valore -->
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 }}</ref>, Truelove (1992)<ref>{{Cite book 
 | autore = Truelove Edmond L
 | autore2 = Sommers EE
 | autore3 = LeResche L
 | autore4 = Dworkin SF
 | autore5 = Von Korff M
 | titolo = Clinical diagnostic criteria for TMD. New classification permits multiple diagnoses
 | url = https://www.ncbi.nlm.nih.gov/pubmed/1290490
 | volume = 
 | opera = J Am Dent Assoc
 | anno = 1992
 | editore = 
 | città = 
 | ISBN = 
 | PMID = 1290490 
 | PMCID = 
 | DOI = 10.14219/jada.archive.1992.0094
 | oaf = <!-- qualsiasi valore -->
 | LCCN = 
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 }}</ref>, and compared them by granting them to a set of assessment criteria. 
The evaluation criteria were split into two categories that involve methodological considerations and clinical considerations.

The end of the research came to the elimination, due to a lack of scientific and clinical validation, of a series of instrumental diagnostic methodologies like interferential electromyography (EMG Interference Pattern), Pantography, X-ray diagnostics, etc. These will be described in more detail in the next editions of Masticationpedia. This first target was, therefore, the scientific request of an "objective data"' and not generated by opinions, schools of thought or subjective evaluations of the phenomenon’. During the Workshop of the International Association for Dental Research (IADR) of 2008, preliminary results of the RDC/TMDs were presented in the endeavour to validate the project.

The conclusion was that, to achieve a review and simultaneous validation of [RDC/TMD], it is essential that the tests should be able to make a differential diagnosis between TMD patients with pain and subjects without pain, and above all, discriminate against patients with TMD pain from patients with orofacial pain without TMD.<ref>{{Cite book 
 | autore = Lobbezoo F
 | autore2 = Visscher CM
 | autore3 = Naeije M
 | titolo = Some remarks on the RDC/TMD Validation Project: report of an IADR/Toronto-2008 workshop discussion
 | url = https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1365-2842.2010.02091.x
 | volume = 
 | opera = J Oral Rehabil
 | anno = 2010
 | editore = Academic Centre for Dentistry Amsterdam (ACTA)
 | città = Amsterdam, The Netherlands
 | ISBN = 
 | PMID = 20374440
 | PMCID = 
 | DOI = 10.1111/j.1365-2842.2010.02091.x
 | oaf = <!-- qualsiasi valore -->
 | LCCN = 
 | OCLC = 
 }}</ref>

This last article, reconsidering pain as an essential symptom for the clinical interpretation, puts all the neurophysiological phenomenology in the game, not just this. 
To move more easily at ease in this medical branch, a different scientific-clinical approach is required, one that widens the horizons of competence in fields such as bioengineering and neurobiology.

It is, therefore, essential to focus attention on how to take trigeminal electrophysiological signals in response to a series of triggers evoked by an electrophysiological device, treating data and determining an organic-functional value of the trigeminal and masticatory systems as anticipated by Marom Bikson and coll. in their «''[[:File:Electrical stimulation of cranial nerves in cognition and disease.pdf|Electrical stimulation of cranial nerves in cognition and disease]]''».

We should think of a system that unifies the mastication and neurophysiological functions by introducing a new term: "'''Neuro-Gnathological Functions'''"<br>which will be the object of a dedicated chapter.
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