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Abstract
== Abstract == The masticatory system, which includes teeth, occlusion, muscles, joints, and the central and peripheral nervous system, is increasingly understood as a complex system rather than a simple biomechanical mechanism. This shift in perspective aligns with Thomas Kuhn's stages of paradigm changes, where anomalies in traditional models trigger the search for new paradigms. In the context of Masticationpedia, a new interdisciplinary approach to the diagnosis and treatment of malocclusion emerges, focusing on "Occlusal Dysmorphisms" rather than "Malocclusions." Recent advances in electrophysiological tests, such as motor evoked potentials and mandibular reflexes, reveal functional symmetry in the masticatory system, even in patients with occlusal discrepancies. This discovery challenges the traditional understanding of malocclusion, suggesting that neuromuscular dynamics play a crucial role in maintaining masticatory function. Consequently, interdisciplinary diagnoses that consider both occlusal and neuromuscular factors are necessary for accurate diagnosis and effective treatment. This paradigm shift has implications for current rehabilitative therapies, including orthodontics and prosthetics, which have traditionally focused on achieving occlusal stability. However, considering the masticatory system as a complex system requires an integrative approach that incorporates both aesthetic and neurophysiological factors to prevent relapses and achieve long-term functional stability. The emerging field of OrthoNeuroGnathodontic treatments exemplifies this interdisciplinary approach, offering innovative strategies to address masticatory disorders. Viewing the masticatory system through the lens of complexity science, the field of dentistry can expand its understanding of occlusal stability and dysfunction, ultimately leading to new treatment paradigms that improve patient outcomes. This new model does not replace traditional treatments but seeks to enrich them with a broader interdisciplinary perspective, in line with the evolution of masticatory rehabilitation science.
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==Ab ovo [1][1]
Latin for 'from the beginning'==
Before delving into the analysis of Masticationpedia, we must first introduce some preliminary considerations, particularly regarding two fundamental dimensions—social and scientific-clinical—that characterize both the current era and the one immediately preceding it.
The Phases of Paradigm Change According to Thomas Kuhn
In the last hundred years, technological and methodological innovations [2][2]
🧪 Cross-sectional study analyzing dental innovations over the past 30 years, identifying those that practicing dentists believe have most influenced patient care. 🧬 Thirty experts from the International Association for Dental Research selected the most relevant innovations, which were then surveyed among U.S. dentists who graduated before 1995 and were clinically active for over 50% of the time. 🧩 The most cited innovations were adhesive materials (74.5%), dental implants (71.9%), direct bonding (71.2%), magnifying lenses (54.7%), universal infection control precautions (48.6%), and digital imaging (46.0%), with differences between generalists and specialists: oral surgeons and periodontists (OMSPER) also favored CBCT (74%) and regenerative techniques (68%). The general consensus highlights the importance of implants, imaging, lenses, and universal precautions; generalists value adhesive materials and bonding, while specialists cite CBCT and tissue engineering. 📌 The study concludes that innovations with direct clinical impact are perceived as the most decisive, suggesting that future research should also consider cost-effectiveness and patient perception. have exponentially increased, even in dentistry. These developments have had a significant impact on clinical decision-making, schools of thought, and the fundamental principles of the discipline, with the explicit goal of improving quality of life. A notable example is the vision proposed in "Exposure Science in the 21st Century"[3][3]
The document Exposure Science in the 21st Century: A Vision and a Strategy (2012) by the National Academy of Sciences proposes a renewed vision of exposure science, aiming to address emerging challenges for human and environmental health. 🧠 What is exposure science? Exposure science studies the contact between humans or other organisms and environmental agents (chemical, physical, or biological), analyzing the duration, intensity, and effects of such exposures. This discipline is crucial for understanding how environmental stressors affect health and for developing prevention and mitigation strategies. 🌐 The proposed vision: the “eco-exposome” The concept of “eco-exposome” extends exposure science from the point of contact between stressor and receptor within the organism to the surrounding environment, including the ecosphere. 🔬 Technological innovations and strategic collaborations: The document highlights technological advancements, such as advanced environmental sensors, analytical methods, molecular technologies, and computational tools, which offer new opportunities to collect more accurate and comprehensive data on exposures. 🛠️ Implementing the vision: To realize this vision, it is necessary to: Develop standardized and non-targeted methods to collect information on exposures. 🎯 Long-term goals: The ultimate goal is to use exposure science to: Quickly assess and mitigate exposures to emerging threats. 📌 In summary, the document proposes a transformation of exposure science, moving from an approach focused on individual stressors to an integrated and holistic vision, to address the environmental and health challenges of the 21st century.
However, this accelerated growth is not without conceptual side effects. Some of these effects may be ambiguous, if not outright contrary to apparent progress, generating clinical and scientific paradoxes.[4][4]
Monoclonal antibodies (MAbs) have ushered in a new era of targeted therapies, particularly in the fields of immunotherapy and oncology. MAbs have evolved from murine antibodies to fully human antibodies, with significant improvements in immunogenicity and safety. However, the safety of these agents is of particular concern, with reports of side effects associated with their use. These side effects have shaken the confidence of many researchers in MAbs. 🧠 This review comprehensively summarizes the side effects of MAbs in clinical use, highlighting the prevention and management of adverse reactions. Although many MAbs are well tolerated, and new MAbs are continuously being developed, it is difficult to guarantee that every new formulation is completely safe. The clinical use of MAbs will face increasing challenges in the future. Physicians should be vigilant about potentially lethal side effects and treat them as soon as possible.
Such ambiguities, instead of weakening the entire epistemological structure, are a symptom of a mature system capable of recognizing its own limits and seeking a paradigm evolution, as described by Thomas Kuhn in his famous theory on the development of science.
Kuhn's Phases in Dentistry
Thomas Kuhn identifies five distinct phases in the evolution of a scientific paradigm. In Masticationpedia, we will focus on the three most relevant ones, which best fit the evolution of masticatory rehabilitation science.
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Bibliography
- ↑ Latin for 'from the beginning'
- ↑ Heft MW, Fox CH, Duncan RP, «Assessing the Translation of Research and Innovation into Dental Practice», in JDR Clin Trans Res, 2019».
DOI:10.1177/2380084419879391 - ↑ «Exposure Science in the 21st Century. A Vision and a Strategy», National Research Council, Division on Earth and Life Studies, 2012».
ISBN: 0-309-26468-5 - ↑ Liu L, Li Y, «The unexpected side effects and safety of therapeutic monoclonal antibodies», in Drugs Today, 2014, Barcelona».
DOI:10.1358/dot.2014.50.1.2076506