Changes

[[File:Segmentazione Trigeminale.jpg|left|thumb|500px|'''Figure 2:''' Segmentation of Trigeminal Nervousus System]]

[[File:Segmentazione Trigeminale.jpg|left|thumb|500px|'''Figure 2:''' Segmentation of Trigeminal Nervousus System]]

The brainstem district is a relay area that connects the upper centres of the brain, the cerebellum, and the spinal cord, and provides the main sensory and motor innervation of the face, head, and neck through the cranial nerves.  

The brainstem district is a relay area that connects the upper centres of the brain, the cerebellum, and the spinal cord, and provides the main sensory and motor innervation of the face, head, and neck through the cranial nerves.  

This plays a determining role in regulation of respiration, locomotion, posture, balance, excitement (including intestinal control, bladder, blood pressure, and heart rate). It is responsible for regulating numerous reflexes, including swallowing, coughing, and vomiting. The brainstem is controlled by higher Cerebral Centers from cortical and subcortical regions, including the Basal Ganglia Nuclei and Diencephal, as well as feedback loops from the cerebellum and spinal cord. Neuromodulation can be achieved by the ‘classical’ mode of glutammatergic neurotransmitters and GABA (gamma-amino butyric acid) through a primary excitation and inhibition of the ‘anatomical network’, but can also be achieved through the use of transmitters acting on G-proteins. These neuromodulators include the monoamine (serotonine, noradrenaline, and dopamine) acetylcholine, as also glutamate and GABA. In addition, not only do neuropeptides and purines act as neuromodulators, so do other chemical mediators like Growth Factors which, too can have similar actions..<ref>{{Cite book  

This plays a determining role in regulation of respiration, locomotion, posture, balance, excitement (including intestinal control, bladder, blood pressure, and heart rate). It is responsible for regulating numerous reflexes, including swallowing, coughing, and vomiting. The brainstem is controlled by higher Cerebral Centers from cortical and subcortical regions, including the Basal Ganglia Nuclei and Diencephal, as well as feedback loops from the cerebellum and spinal cord. Neuromodulation can be achieved by the ‘classical’ mode of glutammatergic neurotransmitters and GABA (gamma-amino butyric acid) through a primary excitation and inhibition of the ‘anatomical network’, but can also be achieved through the use of transmitters acting on G-proteins. These neuromodulators include the monoamine (serotonine, noradrenaline, and dopamine) acetylcholine, as also glutamate and GABA. In addition, not only do neuropeptides and purines act as neuromodulators, so do other chemical mediators like Growth Factors which, too can have similar actions..<ref>{{Cite book  

  | autore = Mascaro MB

  | autore = Mascaro MB

  | OCLC =  

  | OCLC =  

  }}</ref>

  }}</ref>

==Conclusive Consideration==

==Conclusive Consideration==

The paradigm of gnathological descriptive tests faced a crisis years ago and, 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, it has not yet come to accept this paradigm for 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 paradigm of gnathological descriptive tests faced a crisis years ago and, 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, it has not yet come to accept this paradigm for 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.  

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 <ref>Dworkin, S.F., et al., ''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.'' J Orofac Pain, 2002. 16(1): p. 48-63. https://www.ncbi.nlm.nih.gov/pubmed/?term=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.</ref> were the main investigators.  

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 <ref>{{Cite book

| autore = Dworkin SF

| 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 =  

| oaf = <!-- qualsiasi valore -->

}}</ref> were the main investigators.  

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>Farrar, W.B., ''Differentiation of temporomandibular joint dysfunction to simplify treatment.'' J Prosthet Dent, 1972. 28(6): p. 629-36. https://www.ncbi.nlm.nih.gov/pubmed/?term=Differentiation+of+temporomandibular+joint+dysfunction+to+simplify+treatment.+J+Prosthet+Dent%2C+1972</ref><ref>Farrar, W.B., ''Controversial syndrome.'' J Am Dent Assoc, 1972. 85(1): p. 30.https://www.ncbi.nlm.nih.gov/pubmed/?term=Controversial+syndrome.+J+Am+Dent+Assoc%2C+1972</ref>  Eversole e Machado (1985)<ref>Eversole, L.R. and L. Machado, ''Temporomandibular joint internal derangements and associated neuromuscular disorders.'' J Am Dent Assoc, 1985. 110(1): p. 69-79. https://www.ncbi.nlm.nih.gov/pubmed/?term=Temporomandibular+joint+internal+derangements+and+associated+neuromuscular+disorders.+J+Am+Dent+Assoc%2C+1985</ref>, Bell (1986) <ref>Storum KA, Bell WH.., The effect of physical rehabilitation on mandibular function after ramus osteotomies. J Oral Maxillofac Surg. 1986 Feb;44(2):94-9. https://www.ncbi.nlm.nih.gov/pubmed/?term=Temporomandibular+joint+bell+1986

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>Farrar, W.B., ''Differentiation of temporomandibular joint dysfunction to simplify treatment.'' J Prosthet Dent, 1972. 28(6): p. 629-36. https://www.ncbi.nlm.nih.gov/pubmed/?term=Differentiation+of+temporomandibular+joint+dysfunction+to+simplify+treatment.+J+Prosthet+Dent%2C+1972</ref><ref>Farrar, W.B., ''Controversial syndrome.'' J Am Dent Assoc, 1972. 85(1): p. 30.https://www.ncbi.nlm.nih.gov/pubmed/?term=Controversial+syndrome.+J+Am+Dent+Assoc%2C+1972</ref>  Eversole e Machado (1985)<ref>Eversole, L.R. and L. Machado, ''Temporomandibular joint internal derangements and associated neuromuscular disorders.'' J Am Dent Assoc, 1985. 110(1): p. 69-79. https://www.ncbi.nlm.nih.gov/pubmed/?term=Temporomandibular+joint+internal+derangements+and+associated+neuromuscular+disorders.+J+Am+Dent+Assoc%2C+1985</ref>, Bell (1986) <ref>Storum KA, Bell WH.., The effect of physical rehabilitation on mandibular function after ramus osteotomies. J Oral Maxillofac Surg. 1986 Feb;44(2):94-9. https://www.ncbi.nlm.nih.gov/pubmed/?term=Temporomandibular+joint+bell+1986

</ref> [27], Fricton (1989)<ref>Schiffman E1, Anderson G, Fricton J, Burton K, Schellhas K., Diagnostic criteria for intraarticular T.M. disorders. Community Dent Oral Epidemiol. 1989 Oct;17(5):252-7. https://www.ncbi.nlm.nih.gov/pubmed/2791516

</ref> [27], Fricton (1989)<ref>Schiffman E1, Anderson G, Fricton J, Burton K, Schellhas K., Diagnostic criteria for intraarticular T.M. disorders. Community Dent Oral Epidemiol. 1989 Oct;17(5):252-7. https://www.ncbi.nlm.nih.gov/pubmed/2791516