Ramos Montiel, Ronald Roossevelt¹

Language: English/Spanish [Versión en español]
References: 3
Page: 180-182
PDF size: 69.85 Kb.

Since the beginning of knowledge, man has tried to get closer to reality in search of knowing, understanding, controlling and / or predicting the environment that surrounds him; In such an event, knowledge can be acquired in a vulgar (doxa) or empirical opinion as personal experiences, scientifically transcending the facts of reality or in a philosophical way with the essence and purposes of the world. In such a context, the philosophical analysis of the nature of knowledge related to the racial and morphological characteristics of populations is a highly debated topic since time immemorial, as well,

The knowledge written and / or described to date in all areas of health is based on basic components of histology, physiology and the causal variability of the "Growth and Development" process of all hard and soft tissues, which promote the correct genetic function and adaptation of man to the environment habitually exposed in conjunction with the normal conditions for it.¹ Now, this theoretical-epistemic and ontological assumption is a key point that allows the recognition of a disease through the use of differential diagnosis, in which it is possible to separate and distinguish the present disease from various similar diseases but with different aspects to the semiology of the patient; In this regard and for the sake of exemplifying the evaluation and planning of a maxillofacial cranio-cervico treatment, I could mention the temporomandibular joint, since its constitution and structure respond to the genetic component and the environmental influence to which it is subjected; In addition, it develops according to the biological and functional mechanisms that stimulate maxillofacial skull growth.

In the context of the synthesis of temporomandibular disorders and in consideration of the evident and diverse presentations of the mandibular condyle in the glenoid cavity, more questions are generated than answers; that, when seeking solutions, could generate more errors than successes. Therefore, it is necessary to use theory in a critical way and address atheoretical referents not as an epistemological obstacle, but as a mechanism for the perception of new forms and contents of real processes not considered by the theory until that moment. The question then arises, does the form make the function or does the function make the form? Although this is one of the great paradigms without answers to date due to the subjectivity of the human being, it also becomes the answer to the different cognotations of the various views in all fields of knowledge. For example, if from the health field it is possible to mention that, "health is a state of perfect (complete) physical, mental and social well-being, and not only the absence of disease", could an individual be considered healthy? This response is no longer objective and becomes subjective, because a condition could produce physical alterations; and at the same time, show sensory, psychological and / or emotional repercussions, in addition to the fact that to apply a treatment it depends on the idiosyncratic interpretation of a professional with modifiable knowledge and feelings. "Health is a state of perfect (complete) physical, mental and social well-being, and not just the absence of disease" Could an individual be considered healthy? This response is no longer objective and becomes subjective, because a condition could produce physical alterations; and at the same time, show sensory, psychological and / or emotional repercussions, in addition to the fact that to apply a treatment it depends on the idiosyncratic interpretation of a professional with modifiable knowledge and feelings. "Health is a state of perfect (complete) physical, mental and social well-being, and not just the absence of disease" Could an individual be considered healthy? This response is no longer objective and becomes subjective, because a condition could produce physical alterations; and at the same time, show sensory, psychological and / or emotional repercussions, in addition to the fact that to apply a treatment it depends on the idiosyncratic interpretation of a professional with modifiable knowledge and feelings.

It is reasonable then to think, specifically in the treatment of the temporomandibular joint, that the responsibility for complex thinking should be assumed, based on the fact that, in the disorder of the semiology of the disease there is a certain degree of compensatory order, and before seeking to place, categorize or classify somatic aspects, we should couple ourselves to the interactions, actions, feedback and traits to achieve the intelligibility of the health process in the temporomandibular joint, in addition to the evidence that bone structure and muscle load / strength are directly proportional to the function and form.² Therefore, I allow myself to assert that the majority of asymmetries or alterations of hard and / or soft cranio-cervico maxillo-facial tissues of a physiological or pathological type are related to compensations for adaptive modifications.

Specifically, health professionals have a set of knowledge and resources for the adequate analysis, diagnosis, planning, application and execution of a treatment that solves various scenarios of disease and / or alterations in the histo / physiology of the human being; From my experience and vision as an Orthodontic Specialist, it is clear to me that the key to comprehensive improvement of any cranio-cervico-maxillary pathology or alteration should focus on the balance of the soft tissues and the correct permeability, which will later be indicated to us the proper positioning of hard tissues.³ The same thing happens and to mention it as an example in the simplest and most visible things in our environment, what would happen if only a riverbed were blocked to build a road? In the short, medium or long term and with each drop of water the river will open its way again and that resistant concrete road will inevitably fall.

In conclusion, the overwhelming diversity of knowledge in the diagnosis and planning of cranio-cervico maxillo-facial alterations focused on hard tissues and the achievement of average standards in favor of pigeonhole or classify who is well or who is not is evident. These terms allow to visualize the opposite purpose to save or heal, therefore I call and propose that the lines of research be directed and focused on the balance of soft tissues and a correct permeability, having as a collateral effect the correct balance of hard tissues called "Orthopedic Balance". That awakens the epistemic style and critical thinking of researchers,

REFERENCES

1. Duterloo HS. El legado científico de Donald H. Enlow (1927-2014). Rev Esp Ortod. 2015; 45: 181-182.

2. Zonnenberg AJJ, Türp JC, Greene CS. Centric relation critically revisited-What are the clinical implications? J Oral Rehabil [Internet]. 2021; 48 (9): 1050-1055.

3. Li P, Ning XH, Lin H, Zhang N, Gao YF, Ping F. Continuous positive airway pressure versus mandibular advancement device in the treatment of obstructive sleep apnea: a systematic review and meta-analysis. Sleep Med. 2020; 72: 5-11.

AFFILIATIONS

¹ Docente de Grado de la Carrera de Odontología Unidad Académica de Salud y Bienestar Coordinador de Especialización en Ortodoncia matriz Cuenca. Universidad Católica de Cuenca.

CORRESPONDENCE

Ronald Roossevelt Ramos Montiel, PhD PD^©. E-mail: ronald_mtz@hotmail.com