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Introduction to Masticationpedia

 

Masticationpedia
Article by  Gianni Frisardi

 


Occlusal Centric view in open and cross bite patient.jpg

The introduction of Masticationpedia offers a deep and complex analysis on themes that span the evolution of science, with a particular focus on medicine and dentistry. It begins by examining the epistemological transformation of science through the lens of Kuhn's paradigms, emphasizing the importance of paradigmatic changes that science, including dentistry, has experienced and continues to experience. The document outlines the stages of paradigmatic change proposed by Kuhn, applying them to the field of dentistry, where it highlights a paradigmatic crisis that calls for an evolution towards new paradigms, especially in masticatory rehabilitation. The discussion extends to epistemology, considering how science acquires knowledge and addresses the issue of the verifiability of scientific theories. A critical emphasis is placed on the use and interpretation of the P value in scientific statistics, highlighting the ongoing debate about its reliability as an indicator.

The text strongly emphasizes the crucial role of interdisciplinary research, proposing the use of "metacognitive scaffolds" to overcome communicative difficulties between different disciplines. It proposes a holistic and interdisciplinary approach to understanding masticatory disorders, particularly malocclusion, which is explored not only from the traditional orthodontic perspective but also through a broader lens that considers the masticatory system as a whole.

Through the examination of a clinical case study, the traditional interpretation of malocclusion is questioned, suggesting that understanding malocclusion requires a view that considers the complexity of the masticatory system and its interaction with the nervous system. The introduction concludes by highlighting the importance of paradigmatic innovations that go beyond incremental improvements, to embrace a change in thinking that profoundly influences masticatory science.

This approach represents an invitation to overcome the limits of traditional dental conventions, proposing a model of understanding and treatment of masticatory disorders that is truly interdisciplinary, based on principles of open and inclusive science, oriented towards the acceptance of uncertainty, and the holistic evaluation of the patient.

In particular, the following topics are covered in the chapter:

Ab ovo

This section introduces "Masticationpedia" by setting a historical and philosophical context based on Thomas Kuhn's theory of paradigm shifts within science, specifically his ideas on how scientific progress is punctuated by periods of revolutionary change[1][2]. It details how recent technological and methodological "Innovations"[3], particularly in the field of dentistry, have prompted significant changes in scientific thought and practice, sometimes leading to challenges in established scientific certainties due to overlooked conceptual ambiguities[4][5]. Kuhn's framework is employed to discuss how science evolves through a series of discontinuous paradigm shifts rather than continuous progression[1], highlighting the cyclical nature of scientific advancements and setbacks as they pertain to masticatory science. The discussion elaborates on three critical phases of paradigm change—Normal Science, Crisis of the Paradigm, and Scientific Revolution—as they apply to the field of dentistry[6], underscoring the transformative impact of new paradigms on scientific inquiry and medical practice. This narrative sets the stage for understanding the complex interactions between scientific theories and the practical realities they aim to model, particularly in the dynamic field of masticatory rehabilitation.

Epistemology is the branch of philosophy that studies the conditions and methods for acquiring scientific knowledge[7]. It addresses questions about the nature, scope, and validity of knowledge and is often used synonymously with 'theory of knowledge'.

Central to epistemology is the concept of verifiability, a principle that has evolved from the time of philosopher David Hume to modern discussions in science and medicine[8]. This includes challenges to traditional approaches like the use of P-values in statistical inference, highlighted by recent critiques in significant scientific journals[9].

Epistemology also encompasses issues highlighted by Hempel's paradox about the logic of scientific inference[10], and debates over the falsifiability criterion proposed by philosopher Karl Popper, emphasizing that no hypothesis can be completely verified.

Recent debates extend into the realm of interdisciplinarity in research, suggesting that modern science increasingly requires a blend of philosophical, practical, and technological knowledge to solve complex problems[11].

In essence, epistemology seeks to clarify what it means to know something and how we can be sure of what we know.

Anomaly vs. Interdisciplinarity

The exploration of epistemic evolution in science reveals a perceived conflict between the traditional "Physics Paradigm of Science" and the emerging "Engineering Paradigm of Science." The former focuses on individual disciplines and anomalies within those fields, while the latter promotes an interdisciplinary approach and uses metacognitive scaffolds to enhance understanding across disciplines. Contrary to initial appearances, these paradigms are not in opposition but are complementary, both contributing to what is termed "Paradigmatic Innovation"[12].

This synthesis becomes evident through the ongoing advancements in dentistry, influenced by both biological and digital revolutions, such as nanotechnologies and virtual reality simulations, which are redefining educational and clinical practices[13]. These technological and methodological innovations underscore the shift from mere incremental improvements to profound paradigmatic innovations that reshape our understanding and approach to scientific challenges.

Further, this section discusses the broader implications of such paradigmatic innovations, which transcend typical scientific boundaries to affect societal and theoretical perspectives globally. It aligns with Kuhn’s philosophy that scientific progress is not linear but occurs via paradigm shifts that reflect deeper conceptual revolutions within the scientific community and society at large.

Ultimately, this discourse advocates for a holistic view where interdisciplinary strategies are crucial for true scientific advancement, urging a move beyond old paradigms to embrace new, more integrative approaches.

Malocclusion

"Malocclusion" refers to improper teeth alignment and comes from Latin "malum," meaning "bad" or "wrong". This term encompasses various types of misalignments affecting dental and jaw positioning [14].

The complexity of diagnosing malocclusion involves understanding the full spectrum of individual dental positioning as it relates to overall masticatory function. This condition does not only affect aesthetics but can also impact physical health and quality of life, leading to problems in eating, speaking, and even breathing.

A profound exploration in 2019 identified a vast range of literature on the subject, with over 33,309 articles listed on PubMed alone[15], yet there was a significant variance in the diagnostic approaches and definitions used across the studies. This disparity points to a lack of consensus on what exactly constitutes malocclusion, highlighting the need for interdisciplinary research and standardized diagnostic criteria.

Interdisciplinary approaches are particularly sparse, with only four documented instances of such research in 2019, suggesting that while malocclusion is frequently discussed, it is often treated within narrow scientific confines rather than through collaborative efforts that encompass broader medical, psychological, and social perspectives[16].

«The understanding of malocclusion requires not just dental analysis but a holistic view of patients' health, emphasizing the interconnectedness of body systems.»

Conclusion

In the final analysis of the masticatory system within Masticationpedia, it is emphasized that this system should not be viewed merely as a set of mechanical components but rather as a "Complex System"[17]. This perspective acknowledges the intricate interactions among various subsystems like teeth, muscles, and the nervous system, which lead to emergent behaviors beyond the capabilities of any single component.

The masticatory system’s complexity suggests that issues such as malocclusion should be approached with a broader lens, considering all related subsystems for a holistic diagnosis and treatment strategy. This is supported by the advanced analytical philosophy provided by Kazem Sadegh-Zadeh in his "Handbook of Analytic Philosophy of Medicine"[18], which promotes a comprehensive and integrated view of medical conditions.

The concept of "Occlusal Dysmorphisms" is introduced as a more accurate term than malocclusion, reflecting the nuanced nature of dental irregularities that are not merely mechanical but are influenced by the entire masticatory and central nervous systems.

«The integration of interdisciplinary methods in diagnosing and treating these conditions is crucial. This approach helps move beyond traditional methods that might focus too narrowly on isolated symptoms rather than underlying systems.»

Innovative treatments, such as the OrthoNeuroGnathodontic methodology, illustrate how combining aesthetic considerations with neurophysiological analysis can lead to better outcomes in terms of occlusal stability and overall patient satisfaction[19].

Ultimately, this holistic and integrated approach not only improves clinical outcomes but also enriches the scientific understanding of the masticatory system, advocating for a shift towards "Extraordinary Science" that challenges existing paradigms and encourages innovative thinking across disciplines.

Bibliography & references
  1. 1.0 1.1 Kuhn, Thomas S. "The Structure of Scientific Revolutions." Univ. of Chicago Press, 2012. [1]
  2. Treccani, "Kuhn, Thomas Samuel". Or Wikipedia, Thomas Kuhn.
  3. Heft MW, Fox CH, Duncan RP. "Assessing the Translation of Research and Innovation into Dental Practice." JDR Clin Trans Res. 2019. [2]
  4. "Exposure Science in the 21st Century. A Vision and a Strategy." Committee on Human and Environmental Exposure Science in the 21st Century; Board on Environmental Studies and Toxicology; Division on Earth and Life Studies; National Research Council. [3]
  5. Liu L, Li Y. "The unexpected side effects and safety of therapeutic monoclonal antibodies." Drugs Today. 2014;50(1):33-50. [4]
  6. Image Source: "The phases of paradigm change according to Thomas Kuhn." [File:The phases of paradigm change according to Thomas Kuhn.jpg]
  7. The term "epistemology" was likely coined by Scottish philosopher James Frederick Ferrier, as documented in his work Institutes of Metaphysic (1854). For more, see: Internet Encyclopedia of Philosophy article on James Frederick Ferrier.
  8. Discussion on verifiability can be found in the works of Srivastava S, "Verifiability is a core principle of science," Behavioral and Brain Sciences, 2018. DOI: 10.1017/S0140525X18000869
  9. See Amrhein V and others, "Scientists rise up against statistical significance," Nature, 2019. DOI: 10.1038/d41586-019-00857-9
  10. Carl Gustav Hempel's "Raven paradox" explores these themes, detailed further in his philosophical discussions. Raven Paradox on Wikipedia
  11. Interdisciplinary research challenges and paradigms are discussed by Boon M in "Epistemology for interdisciplinary research - shifting philosophical paradigms of science," European Journal of Philosophy of Science, 2019. [5]
  12. Discussion on the interaction between these paradigms can be found in the context of various scientific innovations and their impact on the field of dentistry, as detailed in Guven Y's "Scientific basis of dentistry," J Istanb Univ Fac Den, 2017. [6]
  13. Zhao XF et al. "Diagnosis of biphenotypic acute leukemia: a paradigmatic approach," Int J Clin Exp Pathol, 2010. [7]
  14. The term "Malocclusion" was introduced by Edward Angle, known as the father of modern orthodontics. See more in Gruenbaum T, "Famous Figures in Dentistry", Mouth – JASDA, 2010, 30(1):18.
  15. Malocclusion articles on PubMed
  16. Interdisciplinary diagnostics of malocclusions on PubMed
  17. Complex Systems - Wikipedia
  18. «[8]»». 
  19. See detailed studies by Essam Ahmed Al-Moraissi and colleagues, and J Hoffmannová and team for more on the effectiveness of these treatments:






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