March 9, 2021
by Dr. Gavin James, BDS,MDS,FDS (Eng.), Dip. Orthodont.
Biotensegrity is a new word. An explanation of its origins opens the door to a new and unfamiliar world which seems to have nothing to do with orthodontics. Does it merit spending time on it or is just another distraction in an overcrowded schedule? Is it an attempt to sell another piece of equipment? This Editorial is about something harder than that. It is an invitation to change your mind.
Buckminster Fuller is best known for his innovative architecture, but he was not just an architect. He was also an engineer, a designer, a mathematician and a futurist. As a child he displayed many signs of his genius but as a polymath he encountered difficulty in finding ways to make his ideas credible. As an adult he became popular as a speaker, especially with younger adults. At one of his presentations, he met a student, Kenneth Snelson, who grasped what Fuller was trying to demonstrate. Snelson designed a model which employed Fuller’s concepts. Fuller recognized what Snelson had achieved and incorporated Snelson’s work into his own presentations. Unfortunately, Fuller did not give Snelson credit for his contribution and the two men became estranged.
The irony is that Snelson became an artist who had a successful career creating structures which used Fuller’s ideas. Snelson never did see Fuller’s work as having anything more than esthetic value. Fuller himself went on to become one of the most innovative architects of the last century. To describe the principles involved, he coined the term tensegrity from tensional integrity. An excellent example of this is one of Snelson’s best known structures, the Needle Tower in the grounds of the Hirschorn Museum in Washington D. C. This is maintained by a combination of tension (the wires) and compression (the aluminum struts). None of the struts touch each other. Despite its fragile appearance the Needle Tower has both strength and flexibility. There are no joints, just the tension and compression forces maintaining it. The structure is more than 20 metres high but has a minimal base to support it. There are no external guy wires attached (i.e., It is self- supporting despite its height).
Fuller’s buildings can be constructed quickly and are cheaper because they do not need heavy supporting walls and roof. The units can be constructed off- site then transported to the site. This makes them especially suitable for places like weather stations which are exposed to extremes of temperature and wind pressure. Fuller’s buildings are now found throughout the world. Another of their advantages is that they are useful for exhibition sites such as Expo Montreal of 1967.
In the 1970s, Stephen Levin, an orthopedic surgeon in Washington D. C. was sitting near the Washington monument, and idly began to think about its construction. This led him to speculate how animals were supported. Levin spent several months at the Washington Museum of Natural History studying various species. This prompted him to reassess the patients he saw in his own work as a surgeon. He concluded that the adoption of an upright posture by humans is a recent feature, in evolutionary terms. The spine was not created as a vertical support system for the body. The primary function of an intervertebral disc is to supply flexibility between the vertebrae, not act as a cushion bearing the weight of the body but rather as a way of allowing more movement of the spine. Levin began to introduce his ideas about the human body into his work as a surgeon. Donald Ingber and his group at Harvard concentrated on cell biology (Scientific American 1998). As Levin comments, their conclusions from two different approaches to research have far more in common than their differences. Ingber used the petri dish and the electron microscope as a testing ground to study cell behaviour. Levin considered the body as a single entity and added the prefix bio to the name tensegrity.
Levin and Scarr, an osteopath, established a combined research team which has contributed immensely to the scientific literature on biotensegrity. The most comprehensive summary, to my knowledge is Scarr’s 2014 book, now in its second edition. “Nature always does things in the simplest way possible and atoms interact with each other to form simple geometric shapes because they are the most energy- efficient arrangements. “One of the most challenging steps for any dentist is an appreciation of the body as a whole entity, compared to the traditional approach which studies the body as a series of separate parts. The last two chapters of Scarr’s book describes how this new paradigm can be integrated into a holistic approach.
There has to be recognition that other health disciplines may bring knowledge which lies outside the boundaries of traditional orthodontic thinking. Two of these are already familiar to Oral Health readers. One is the role of osteopaths and their contribution in diagnosing and treating what might be seen as dental anomalies. The other discipline is that of myofunctional therapists. As an orthodontist I learned many years ago that there were alternative ways to find solutions to apparent orthodontic problems. Dr Darick Nordstrom has been generous in sharing his experience of working with osteopaths and myofunctional therapists. Dr. James Bronson has followed Dr Nordstrom’s example by using his Advanced Lightwire Functional (ALF) appliances. Like Nordstrom, he works closely with osteopaths and myofunctional therapists. Biotensegrity does not compete with these disciplines. It supplements them, extending the parameters of the ALF appliance. Biotensegrity becomes a concept in which many different health disciplines, sometimes to their surprise, find that what they were doing in isolation resembles what is happening in other fields of health.
What makes biotensegrity so valuable is that it is based on first principles of physics. The problem in applying this in the health field is the current assumption that the introduction of some kind of force into the body follows Newtonian principles (i.e., the more force, the greater the response). This is common sense, everyday thinking. However, when we come to a live organism such as the human body the reaction to a force may be quite contrary to what you might expect. Any such force has to be biocompatible, meaning that it does not suppress or shut down a desirable reaction. Instead, it has to stimulate or enhance the organism’s own reaction which is much more likely to achieve a favourable response. The ALF appliance is designed to do this, but it is most important that biology and biophysics are taken into account. This is why myofunctional therapists and knowledgeable osteopaths are working with ALF dentists.
About the Author
Dr. Gavin James graduated as an orthodontist first in the UK then in Toronto. He has had a particular interest in how orthodontics affects the body as a whole and has worked closely with osteopaths and myofunctional therapists.
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