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Revision as of 11:45, 5 May 2024

'Introduction'

Abstract

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.

 

Masticationpedia
Article by  Gianni Frisardi

 

Ab ovo[1]

Before diving into the analysis of Masticationpedia, it is necessary to introduce some preliminary considerations. These concern, in particular, two fundamental dimensions - social, scientific, and clinical - that are characteristic of both the current era and the one immediately preceding it.

The phases of paradigm change according to Thomas Kuhn

In the course of the last century, there has been an exponential increase in technological and methodological "Innovations",[2] especially in the field of dentistry. These advancements have significantly influenced decision-making strategies, opinions, schools of thought, and axioms, aiming explicitly at improving the quality of life, as highlighted in the "Science of Exposure in the 21st Century".[3] However, this exponential growth implicitly hides conceptual ambiguities - or, in practical terms, "side effects" - which, although sometimes underestimated, have the power to challenge some scientific certainties, making them less rigid and more subject to probability.[4] The sensitive aspects of the current social, scientific, and clinical reality, which may seem contrasting, will be revealed to be complementary by the end of this reading; this is the "Progress of science" according to Kuhn's interpretation and "Epistemology".

In analyzing the progress of science, Thomas Kuhn, in his most famous work, argues that science develops through distinct cycles, reflecting its operational dynamics.[5][6] Kuhn advances the idea that science is structured around paradigms and establishes a clear demarcation between science and pseudoscience, based on the presence of a shared paradigm. For him, the evolution of scientific progress is seen as a continuous curve, yet interrupted by discontinuities represented by paradigm shifts.

Taking on the role of a skilled problem solver, the scientist is engaged in resolving these anomalies. These moments of discontinuity, or scientific revolutions, occur when the existing paradigm can no longer adequately interpret new anomalies, thereby pushing the scientific community towards the exploration and eventual adoption of new paradigms that better align with emerging observations.

Kuhn's phases in Dentistry

Thomas Kuhn identifies in the evolution of a scientific paradigm five distinct phases, a process that holds crucial importance for Masticationpedia. To stay in line with the project's objectives, we will focus on the description of the three most significant phases, as outlined in the book's index.

The phases of paradigm change according to Thomas Kuhn

Thomas Kuhn in his most famous work states that science cyclically passes through some phases indicative of its operation. According to Kuhn, science is paradigmatic, and the demarcation between science and pseudoscience can be traced back to the existence of a paradigm. The evolution of scientific progress is assimilated to a continuous curve which undergoes discontinuity in paradigm changes.

Kuhn's phases in Dentistry

Kuhn, on the other hand, divides the evolution of a paradigm into five phases; this is a fundamental process for Masticationpedia, but to stay tuned with the project we will limit ourselves to describing the three most significant phases shared in the project and indicated in the index of the book:

  • Phase 2, or the Normal Science
    For instance, in the second phase of Kuhn's paradigms, called "Normal Science," scientists are considered problem solvers engaged in strengthening the correspondence between the paradigm and natural reality. This phase is based on a set of fundamental principles established by the paradigm itself, which are not subject to dispute but are instead used to define the guidelines for future research projects. During this phase, the development of the necessary measurement tools to conduct experiments takes place, and the majority of the scientific literature is produced. The results obtained in this phase contribute significantly to the advancement of scientific knowledge. In normal science, both successes and failures occur; the latter are identified by Kuhn as "anomalies," i.e., events that contradict the prevailing paradigm.
 
  • Phase 4, or the Crisis of the Paradigm
    In response to the crisis, there will be the formation of several new paradigms during this period. These emerging paradigms, therefore, will not originate from the successes of the previous theory, but rather from the rejection of the established models of the dominant paradigm. Continuing along this line, Masticationpedia will dedicate attention to the crisis of the masticatory rehabilitative paradigm, through the review of theories, theorems, axioms, currents of thought, and diagnostic research criteria. Subsequently, the focus will shift to the fifth phase.
 
  • Phase 5, or the Scientific Revolution
    Phase 5 is characterized by the scientific revolution. During the period of extraordinary scientific activities, a debate will develop within the scientific community on which new paradigm to adopt. However, the prevailing paradigm will not necessarily be the "truest" or most efficient one, but rather the one that manages to arouse the interest of a sufficient number of scientists and earn the trust of the community. According to Kuhn, competing paradigms have nothing in common, not even the foundations, making them "incommensurable." The choice of paradigm, as mentioned, occurs on socio-psychological or biological bases, with younger scientists replacing the older ones. This battle between paradigms will resolve the crisis, the new paradigm will be named, and science will return to Phase 1. Following the same principle of Phase 4, Masticationpedia will introduce, in the chapter named "Extraordinary Sciences," a new paradigmatic model in the field of Masticatory System rehabilitation, examining its principles, motivations, scientific clinical experiences, and particularly, a radical change in the field of medical diagnostics. This change is fundamentally based on "System Inference," rather than symptom-based inference, assigning primary importance to the objectivity of data.

It's almost taken for granted that Kuhn's scientific philosophy gives priority to discipline, since an anomaly within the genetic paradigm will be more easily recognized by a geneticist rather than a neurophysiologist. This concept, however, seems to contradict the epistemological evolution of Science, thereby making a detailed analysis of this apparent discrepancy appropriate.

Epistemology

The black swan symbolizes one of the historical problems of epistemology: if all the swans we have seen so far are white, can we decide that all the swans are white?
Really?
Black Swan (Cygnus atratus) RWD.jpg
 
Duck-Rabbit illusion.jpg
 Kuhn used optical illusion to demonstrate how a paradigm shift can cause a person to see the same information in a completely different way: which animal is the one here aside?
Sure?


Epistemology (from the Greek ἐπιστήμη, epistēmē, meaning "certain knowledge" or "science", and λόγος, logos, "discourse") represents that branch of philosophy dedicated to the study of the necessary conditions for acquiring scientific knowledge and the methods through which such knowledge can be achieved.[7] This term specifically refers to that section of gnoseology that investigates the foundations, the validity, and the limits of scientific knowledge. In English-speaking countries, the concept of epistemology is commonly employed almost as a synonym for gnoseology or theory of knowledge, that is, the discipline that examines the study of knowledge in general.

It is important to emphasize that the central problem of epistemology, today as in the times of Hume, is the issue of verifiability.[8][9]

The Hempel's paradox asserts that the observation of every white swan provides support to the statement that all ravens are black;[10] in other words, every example that does not contradict the theory confirms a part of it. According to this paradox:

According to the criterion of falsifiability, no theory can be considered definitively true, as although there is only a finite number of experiments that can confirm it, theoretically there is an infinite number of experiments that could refute it.[11]

But it’s not all so obvious...

...because the very concept of epistemology meets continuous implementations, like in medicine:

  • : In medicine, for example, to confirm an experiment or validate a series of data collected through laboratory instruments or surveys, reliance is placed on "Statistical Inference," and in particular on a well-known value called "significance test" (P-value). However, even this concept, now rooted in the practice of researchers, is being questioned. A recent study has focused attention on a campaign conducted in the journal "Nature" against the use of the "significance test."[12] With over 800 signatories, including eminent scientists, this campaign can be seen as an important turning point and a "Silent Revolution" in the field of statistics, touching logical and epistemological aspects.[13][14][15] The critique is aimed at overly simplified statistical analyses, still present in numerous publications. This has stimulated a debate, sponsored by the American Statistical Association, which led to the creation of a special issue of "The American Statistician Association" titled "Statistical Inference in the 21st Century: A World Beyond p < 0.05", containing 43 articles by statisticians looking towards the future[16]. This special issue proposes new ways to communicate the significance of research findings beyond the arbitrary threshold of a P-value and offers guidelines for research that accepts uncertainty, is reflective, open, and modest in claims.[16] The future will reveal whether these attempts to provide more solid statistical support to science, beyond traditional significance tests, will find resonance in future publications.[17] This evolution aligns with Kuhn's concept of scientific progress, reflecting a reworking of some descriptive statistical content within the discipline.
  • Interdisciplinarity:
    In the field of science policy, it is universally recognized that solving science-based problems requires an interdisciplinary research approach (IDR), as highlighted by the European Union's Horizon 2020 project.[18] Recent studies have explored the reasons for the cognitive and epistemic difficulties that researchers encounter in conducting IDR. One identified cause is the decline of philosophical interest towards the epistemology of IDR, attributed to the dominant "Physical Paradigm of Science." This paradigm limits the recognition of significant developments in IDR, both in the context of the philosophy of science and in the practice of research itself. In response, an alternative philosophical paradigm has been proposed, called the "Engineering Paradigm of Science," which offers alternative philosophical perspectives on fundamental aspects such as the purpose of science, the nature of knowledge, the epistemic and pragmatic criteria for the acceptance of knowledge, and the role of technological tools. Consequently, it highlights the need for researchers to make use of metacognitive support structures, called metacognitive scaffolds, to facilitate the analysis and reconstruction of the processes by which knowledge is constructed across different disciplines. In the context of IDR, such metacognitive scaffolds are essential for promoting effective communication between disciplines, allowing scholars to analyze and articulate how each discipline contributes to the construction of knowledge.[19][20]

Anomaly vs. Interdisciplinarity

A superficial view might suggest that the epistemic evolution of science is marked by an apparent opposition between the aspects of disciplinarity, highlighted by the "Physics Paradigm of Science" (which sheds light on anomalies), and those of interdisciplinarity, represented by the "Engineering Paradigm of Science" (and the related concept of metacognitive scaffold). However, as will be explored in this chapter, these two perspectives are not actually in conflict; on the contrary, they prove to be complementary, as both contribute to the generation of a "Paradigmatic Innovation" without any form of conflict.

It could then be argued that "Innovations" themselves represent "Progresses of Science," as illustrated in the article "Scientific Bases of Dentistry" by Yegane Guven. This work explores the impact of biological and digital revolutions on education and daily clinical practice in dentistry, covering topics such as personalized regenerative dentistry, nanotechnologies, virtual reality simulations, genomic information, and stem cell research.[21] Although the innovations mentioned are technological and methodological in nature, it is crucial to recognize that true scientific progress does not occur exclusively through "Incremental Innovations" or "Radical Innovations," but is fundamentally achieved through "Paradigmatic Innovations."

In the strictest sense of the term, "Paradigmatic Innovations" are a change in thinking and awareness that spreads throughout all of humanity, affecting different social layers, from the Copernican revolution to the recent trend of approaching biological phenomena with a stochastic method.[22]

This epistemological context, which includes initiatives such as the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD), Evidence-Based Medicine, and others, is further explored in the Masticationpedia project. The latter aims to highlight the dynamics and dialectics of progress in the science of masticatory rehabilitations, emphasizing the anomalies that stimulate a change in thought and, consequently, a "Paradigmatic Innovation."

Before proceeding, it might be appropriate to observe a very concrete and significant case.

Malocclusion

"Malocclusion" derives from the Latin "malum," meaning "bad" or "wrong," and literally refers to an improper closure of the teeth.[23] The notion of "closure" may seem intuitive; however, the adjective "bad" requires careful consideration, as its application in the medical context is less obvious than it may appear.

To approach an understanding of the term, this introduction poses a seemingly simple yet profoundly complex question, which in turn raises a series of related inquiries in the field of masticatory rehabilitation and, more specifically, in orthodontic disciplines: what exactly is meant by "Malocclusion"? It's interesting to note that, in 2019, a search for the term "Malocclusion" on PubMed yielded a whopping 33,309 articles,[24] indicating a lack of uniform terminological consensus on the subject. Among these articles, some may provide conclusions of significant relevance, as strikingly demonstrated by the work of Smaglyuk and colleagues. This particularly significant study explores the interdisciplinary approach in diagnosing malocclusions:[25]...........................

Read the full chapter
Question 2.jpg

Strategic dental topics for authors to subscribe an article

Scientific Paradigms in Dentistry, Thomas Kuhn Paradigm Shift, Epistemology in Dentistry, Masticatory Rehabilitation, Interdisciplinary Dental Research, Malocclusion Treatment, Complex System Theory in Dentistry, Dental Science Innovations, Metacognitive Scaffolds in Science, Holistic Dental Care, Dental Anomalies and Solutions, Scientific Progress in Dentistry, Dental Paradigm Shifts, Dentistry and Epistemological Shifts

Wiki.png
Masticationpedia is a charity, a not-for-profit organization operating in dentistry medical research,
particularly focusing on the field of the neurophysiology of the masticatory system
 

 


Wiki.png
Masticationpedia is a charity, a not-for-profit organization operating in dentistry medical research,
particularly focusing on the field of the neurophysiology of the masticatory system
 

 
  1. ↑ Latin for 'since the very beginning'
  2. ↑ 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      Oct 7:2380084419879391
  3. ↑ «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.».
    ISBN: 0-309-26468-5 
  4. ↑ Liu L, Li Y, «The unexpected side effects and safety of therapeutic monoclonal antibodies», in Drugs Today, 2014, Barcellona».
    DOI:10.1358/dot.2014.50.1.2076506      Jan;50(1):33-50
  5. ↑ Thomas Samuel Kuhn (Cincinnati, 18 luglio 1922 – Cambridge, 17 giugno 1996) was an American philosopher of science.
    See Treccani, Kuhn, Thomas Samuel. Or Wikipedia, Thomas Kuhn.
  6. ↑ Kuhn Thomas S, «The Structure of Scientific Revolutions», Univ. of Chicago Press, 2012, Chicago».
    ISBN: 9780226458113 
  7. ↑ The term is believed to have been coined by the Scottish philosopher James Frederick Ferrier, in his Institutes of Metaphysic (p.46), of 1854; see Internet Encyclopedia of Philosophy, James Frederick Ferrier (1808—1864).
  8. ↑ David Hume (Edimburgo, 7 maggio 1711[1] – Edimburgo, 25 agosto 1776) was a Scottish philosopher. He is considered the third and perhaps the most radical of the British Empiricists, after the Englishman John Locke and the Anglo-Irish George Berkeley.
  9. ↑ Srivastava S, «Verifiability is a core principle of science», in Behav Brain Sci, Cambridge University Press, 2018, Cambridge».
    DOI:10.1017/S0140525X18000869      Jan;41:e150.
  10. ↑ Here we obviously refer to the well-known paradox called "of the crows", or "of the black crows", formulated by the philosopher and mathematician Carl Gustav Hempel, better explained in Wikipedia's article Raven paradox:
    See Good IJ, «The Paradox of Confirmation», in Br J Philos Sci, 1960 – in «Vol. 11». 
  11. ↑ Evans M, «Measuring statistical evidence using relative belief», in Comput Struct Biotechnol J, 2016».
    DOI:10.1016/j.csbj.2015.12.001      Jan 7;14:91-6.
  12. ↑ Amrhein V, Greenland S, McShane B, «Scientists rise up against statistical significance», in Nature, 2019».
    DOI:10.1038/d41586-019-00857-9      Mar;567(7748):305-307.
  13. ↑ Rodgers JL, «The epistemology of mathematical and statistical modeling: a quiet methodological revolution», in Am Psychol, 2010».
    DOI:10.1037/a0018326      Jan;65(1):1-12.
  14. ↑ Meehl P, «The problem is epistemology, not statistics: replace significance tests by confidence intervals and quantify accuracy of risky numerical predictions», 1997». , in eds Harlow L. L., Mulaik S. A., Steiger J. H., What If There Were No Significance Tests? - editors. (Mahwah: Erlbaum, 393–425. [Google Scholar]
  15. ↑ Sprenger J, Hartmann S, «Bayesian Philosophy of Science. Variations on a Theme by the Reverend Thomas Bayes», Oxford University Press, 2019, Oxford». 
  16. ↑ Wasserstein RL, Schirm AL, Lazar NA, «Moving to a World Beyond p < 0.05», in Am Stat, 2019».
    DOI:10.1080/00031305.2019.1583913      73, 1–19.
  17. ↑ Dettweiler Ulrich, «The Rationality of Science and the Inevitability of Defining Prior Beliefs in Empirical Research», in Front Psychol, 2019».
    DOI:10.3389/fpsyg.2019.01866      Aug 13;10:1866.
  18. ↑ European Union, Horizon 2020
  19. ↑ Boon M, Van Baalen S, «Epistemology for interdisciplinary research - shifting philosophical paradigms of science», in Eur J Philos Sci, 2019».
    DOI:10.1007/s13194-018-0242-4      9(1):16.
  20. ↑ Boon M, «An engineering paradigm in the biomedical sciences: Knowledge as epistemic tool», in Prog Biophys Mol Biol, 2017».
    DOI:10.1016/j.pbiomolbio.2017.04.001      Oct;129:25-39.
  21. ↑ Guven Y, «Scientific basis of dentistry», in J Istanb Univ Fac Den, 2017».
    DOI:10.17096/jiufd.04646      51(3): 64–71. Published online 2017 Oct 2. PMCID: PMC5624148 - PMID: 29114433
  22. ↑ Zhao XF, Gojo I, York T, Ning Y, Baer MR, «Diagnosis of biphenotypic acute leukemia: a paradigmatic approach», in Int J Clin Exp Pathol, 2010».  Prepublished online 2009 Oct 10. PMCID: PMC2776262 - PMID: 19918331. 3(1): 75–86.
  23. ↑ The creation of the term is generally attributed to Edward Angle, considered the father of modern orthodontics, who coined it as a specification of occlusion to signal the incorrect opposition in closing of the lower teeth and upper, especially the first molar; see Gruenbaum T, «Famous Figures in Dentistry», in Mouth – JASDA, 2010». , 30(1):18.
  24. ↑ Pubmed, Malocclusion
  25. ↑ Smaglyuk LV, Voronkova HV, Karasiunok AY, Liakhovska AV, Solovei KO, «Interdisciplinary approach to diagnostics of malocclusions (review)», in Wiad Lek, 2019».  72(5 cz 1):918-922.
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