微小种植体支抗辅助螺旋扩弓器上颌快速扩弓效果的动物实验研究
|
摘要
在正畸临床工作中,经常会遇到牙弓狭窄,牙列轻、中度拥挤,后牙反牙合等错牙合畸形,需要对上颌扩大牙弓来刺激上颌的发育。
上颌扩弓的应用已有一百多年的历史,扩弓的方法也多种多样。按支抗设计分为以骨为支抗、以牙为支抗和骨牙混合支抗;按扩弓效果分为矫形扩弓(腭中缝扩大)和正畸扩弓(基牙移动)。目前较为常用的方法是上颌快速扩弓(RME),最早由Angle[1]于1860年提出。通常认为,只要腭中缝未完全闭合,都可以进行上颌的快速扩弓。
传统螺旋扩弓器快速扩弓是在两侧第一磨牙和第一双尖牙上粘接个别带环为支抗,将螺旋扩弓器扩弓的力量通过支抗牙传递到上颌骨。这种方法虽然效果确定,但是由于扩弓的力量必须通过支抗牙起作用,不可避免的带来支抗牙的颊向倾斜,基牙的过分倾斜不仅改变了良好的牙弓形态,而且如果是以基牙的过分倾斜为主要成分的扩弓,效果是不稳定的,最终必然导致复发及扩弓的失败[2];支抗牙颊侧受力较大,也会使其颊侧牙根吸收,尤其对于牙周病患者,颊侧牙根的吸收是危险的。怎样在扩弓的时候以腭中缝的扩张占的比例更大,而尽量减少基牙的倾斜是临床医生一直非常关注的问题。
为了观察本设计的扩弓效果,设计实验一。
一、种植体腭骨支抗扩弓疗效的动物实验研究
6个月龄的雄性实验犬8只,体重10kg左右,随机分为两组, 4只实验犬,4只对照犬。实验组用自制不锈钢板与螺旋扩弓器的扩弓臂焊接,制作腭部扩弓器。用长6mm、宽4mm的一段式纯钛微小种植钉固定于犬上颌腭部。对照组在犬的尖牙和第一磨牙上制作个别带环,按传统方法进行螺旋扩弓器的快速扩弓。两组均螺旋扩弓器均两日加力一次,每次旋转1/2圈,连续加力1个月。在实验前后给每只犬都取上颌模型,测量上颌中切牙、尖牙和第一磨牙牙齿间距离和对照组犬支抗牙倾斜角度及实验组犬同名牙倾斜角度。
结果显示对于中切牙实验前后距离,实验和对照两组没有显著区别,p﹥0.05。但是对于尖牙和前磨牙,实验组和对照组之间p﹤0.05,实验组犬实验前后尖牙和第一磨牙间距离变化量小于对照组,两者有差别。可认为实验组和对照组上颌横向宽度均有扩大,利用传统牙为支抗扩弓后,支抗牙之间扩大的距离大于以微小种植体为支抗进行扩弓时同名牙之间分开的距离。看似以牙为支抗的传统快速上颌扩弓方法在牙弓宽度增加量上优于微小种植体支抗辅助螺旋扩弓器上颌快速扩弓上颌牙弓宽度增加量。对照组犬的尖牙、第一前磨牙、第一磨牙颊侧倾斜角度在实验前后均有不同程度的增大,而实验组犬实验前后牙倾斜角度几乎无任何变化,组间p﹤0.05,有明显差异。结果提示实验组没有发生牙齿的颊侧倾斜,虽然显示上颌宽度的增加量是对照组大于实验组,但是其中部分增加量是由于支抗牙的颊侧倾斜所带来的效果,并不是所希望的单纯腭中缝的扩大。支抗牙颊侧倾斜带来的是扩弓效果的不稳定,容易复发,如果是牙齿过分倾斜,还可能导致扩弓的失败。
为了更好的观察扩弓前后腭中缝宽度的增加在整个扩弓量中占的比例,我们设计实验二。
二、种植体腭骨支抗扩弓前后四环素荧光染色片的研究
实验动物及扩弓方法同实验一。实验前后两组在扩弓以前和扩弓结束前的两日内,给予全部犬静脉注射四环素10mg/kg,每日两次。在结束后处死所有犬,在尖牙、前磨牙和第一磨牙水平连线处切片,制备7-10um厚的四环素荧光标记不脱钙骨磨片。在荧光显微镜下观察并且将结果输入计算机分析仪测量腭中缝宽度。
在四环素染色不脱钙磨片中,利用四环素能够和钙离子螯合的特点,在荧光显微镜下能够观察到扩弓前和保持后两条四环素荧光染色带。通过计算机测量两条荧光带之间距离,得出腭中缝真实扩大的量。其量占实验一模型测量得出的支抗牙之间距离扩大量的比例就是两种扩弓方法腭中缝扩大在整个扩弓效应中占的比例。通过结果显示,对照组中,腭中缝扩大量在整个扩弓量占的比例为70%;而在实验组中,腭中缝扩大量在整个扩弓量占95%以上。结果提示实验组模型测量得出支抗牙之间距离扩大的值就完全是由腭中缝宽度的扩大引起;而对照组支抗牙之间距离扩大的值腭中缝宽度的开展只占整个效应的一部分,另外的部分由支抗牙颊侧倾斜效应引起。
我们在上颌扩弓中,不能盲目的追求总的扩弓量的增大,如果是以牙齿的过分倾斜为重要成分的扩弓,这种扩弓是不稳定的,而且是最终会导致失败,我们应该把注意力放在腭中缝的扩大和牙齿的整体移动上。
本课题成功地建立了犬种植体支抗式快速扩弓模型,并与传统牙支持式装置进行了效果对比,证实了其扩弓和保护牙齿支抗的效果,为日后的临床应用提供了实验依据。
Maxillary transverse deficiency, mild crowding and crossbite of posterior teeth are very common in the clinical work. In these situations, a expansion is needed to stimulate the growth of maxilla.
Maxillary expansion treatments have been used for more than a century and can be categorized by different ways. It can be divided into osteo-anchorage, dental-anchorage and dentalosteo-anchorage, or RME and SME, or orthopedic and orthodontic expansion. Among all the methods, RME, which is first come up with by Angle, is the most extensively-used one. It is generally accepted that RME is effective as long as the suture system is still growing.
Traditionally, bilateral first premolars and molars are utilized to supply anchorage. This dental-anchorage method has been proved to be effective, however, some limitations associated with it have been reported, including bite opening, relapse, microtrauma of the temporomandibular joint and the midpalatal suture, root resorption, tissue impingement and pain, excessive tipping of anchorage teeth or even a failure of expansion. So it has been greatly concerned that how to reduce the tipping of teeth and maximize the splitting effect of midpalatal suture.
Experiment 1 to observe the expansion effect of our appliance.
Animal Experiment on palatal implant anchorage applied in expanding narrow dental arch
8 dogs of six months old and about 10kg were matched into two groups randomly, with 4 dogs in each group. In experiment group, we fabricate an expansion appliance with two stainless-steel boards and a screw welding together. Then this appliance is fixed in dog’s palatal area with some titanium mini-screws with a scale of 6mm in length and 4mm in width. In control group, we use the traditional RME method of utilizing bands on bilateral premolars and molars. Both groups load force every two days, 180 every time. Then we set plaster cast for every dog before and after the experiment, and measure the distance between maxillary central insiors, canines and first premolars and the axial angles of maxillary canines、premolars and first molars before and after experiment.
the result showed that the distance of central incisors had no obvious differences in experimental group and control group before and after experiment (p﹥0.05) . However, canines and premolars in experimental group and control group showed p value <0.05. Variance of the distance between dog’s canines and first molars in experimental group before and after experiment was less than in the control group, and there were differences between the two groups. It was considered that the width of the maxilla in lateral direction was all expanded in experimental group and control group. After anchorage was used to expend ordinary tooth’s arch, the expanded distance among anchorage teeth was wider than among homonym teeth when micro-implant was used as anchorage. The traditional rapid maxillary expansion with tooth as anchorage was more advantageous in increasment than that of maxilla arch width using micro-implant anchorage to assist expansion screw’s rapid maxillary expansion. The tilting angles of dog’s canines, first premolars and first molar’s buccal surface showed different extent of increasement. However, while those in experimental group showed almost no change. The difference of the groups was significant (p﹤0.05). The result indicated that there was no labial inclination in experimental group. Although the increasement of control group’s maxillary width was greater than that of experiment group, some increasement was bought by anchorage teeth’s labial inclination instead of the desirable pure expansion of palatal suture. Labial inclination of anchorage teeth had an unstable effect with a high incidence of relapse. The over inclination of teeth could cause the failure of arch expansion. To better observe the proportion of increasement of palatal suture width before and after arch expansion to the total quantity of arch expansion, we designed the second experiment.
2. The research on tetracycline fluorescent staining method before and after palatal implant anchorage was applied in expanding narrow dental arch.
The experimental animal and arch expansion method was the same as in the first experiment. The two groups were given intravenous tetracycline (10mg/kg) twice every day before and after experiment, two days before arch expansion and at the end of arch expansion. After the experiment, the dogs were all killed. We made slices from horizontal line of first molars and made tetracycline fluorescent labeled undecalcified ground bone of 7-10um width. They were observed under the fluoroscope and the result was input into computer analyzer to measure the width of palatal suture.
In tetracydine stained undecalcified ground bones, we explored the tetracydine’s characteristic of chelating with calcium ion and employed the fluorescence microscope to observe two tetracydine fluorescent staining bands before arch expansion and after maintenance. With the help of computer, we measured the distance between two fluorescent striate bands and got the real quantity of expansion of palatal suture. Its proportion of the expanded quantity among anchorage teeth to the first experiment model was just the proportion of palatal suture’s expansion quantity in two arch expansion methods to the whole arch expansion effect. The result showed that, in control group, the proportion of palatal suture’s expansion in total arch expansion was 70%. However, the figure was 95% in the experimental group. The result showed that the expansion quantity among anchorage teeth in the experimental group model was completely caused by the expanded width of palatal suture. For the expansion quantity among anchorage teeth in the control group model, the expanded width of palatal suture was only a part of the complete effect causes. The rest effect was caused by the labial inclination effect of anchorage teeth.
In the process of maxillary expansion, we can’t aimlessly seek the total expansion quantity. The anchorage expansion with over inclination of teeth as its focus is unstable and will lead to failure finally. We shall concentrate on the expansion of palatal suture and integral movement of teeth.
This study establishes the RME model with implant anchorage on dogs. In comparison with the traditionally teeth anchorage RME appliance, the expansion and anchorage-protecting effects are proved.
That will provide some reference for the future clinical application.
上颌扩弓的应用已有一百多年的历史,扩弓的方法也多种多样。按支抗设计分为以骨为支抗、以牙为支抗和骨牙混合支抗;按扩弓效果分为矫形扩弓(腭中缝扩大)和正畸扩弓(基牙移动)。目前较为常用的方法是上颌快速扩弓(RME),最早由Angle[1]于1860年提出。通常认为,只要腭中缝未完全闭合,都可以进行上颌的快速扩弓。
传统螺旋扩弓器快速扩弓是在两侧第一磨牙和第一双尖牙上粘接个别带环为支抗,将螺旋扩弓器扩弓的力量通过支抗牙传递到上颌骨。这种方法虽然效果确定,但是由于扩弓的力量必须通过支抗牙起作用,不可避免的带来支抗牙的颊向倾斜,基牙的过分倾斜不仅改变了良好的牙弓形态,而且如果是以基牙的过分倾斜为主要成分的扩弓,效果是不稳定的,最终必然导致复发及扩弓的失败[2];支抗牙颊侧受力较大,也会使其颊侧牙根吸收,尤其对于牙周病患者,颊侧牙根的吸收是危险的。怎样在扩弓的时候以腭中缝的扩张占的比例更大,而尽量减少基牙的倾斜是临床医生一直非常关注的问题。
为了观察本设计的扩弓效果,设计实验一。
一、种植体腭骨支抗扩弓疗效的动物实验研究
6个月龄的雄性实验犬8只,体重10kg左右,随机分为两组, 4只实验犬,4只对照犬。实验组用自制不锈钢板与螺旋扩弓器的扩弓臂焊接,制作腭部扩弓器。用长6mm、宽4mm的一段式纯钛微小种植钉固定于犬上颌腭部。对照组在犬的尖牙和第一磨牙上制作个别带环,按传统方法进行螺旋扩弓器的快速扩弓。两组均螺旋扩弓器均两日加力一次,每次旋转1/2圈,连续加力1个月。在实验前后给每只犬都取上颌模型,测量上颌中切牙、尖牙和第一磨牙牙齿间距离和对照组犬支抗牙倾斜角度及实验组犬同名牙倾斜角度。
结果显示对于中切牙实验前后距离,实验和对照两组没有显著区别,p﹥0.05。但是对于尖牙和前磨牙,实验组和对照组之间p﹤0.05,实验组犬实验前后尖牙和第一磨牙间距离变化量小于对照组,两者有差别。可认为实验组和对照组上颌横向宽度均有扩大,利用传统牙为支抗扩弓后,支抗牙之间扩大的距离大于以微小种植体为支抗进行扩弓时同名牙之间分开的距离。看似以牙为支抗的传统快速上颌扩弓方法在牙弓宽度增加量上优于微小种植体支抗辅助螺旋扩弓器上颌快速扩弓上颌牙弓宽度增加量。对照组犬的尖牙、第一前磨牙、第一磨牙颊侧倾斜角度在实验前后均有不同程度的增大,而实验组犬实验前后牙倾斜角度几乎无任何变化,组间p﹤0.05,有明显差异。结果提示实验组没有发生牙齿的颊侧倾斜,虽然显示上颌宽度的增加量是对照组大于实验组,但是其中部分增加量是由于支抗牙的颊侧倾斜所带来的效果,并不是所希望的单纯腭中缝的扩大。支抗牙颊侧倾斜带来的是扩弓效果的不稳定,容易复发,如果是牙齿过分倾斜,还可能导致扩弓的失败。
为了更好的观察扩弓前后腭中缝宽度的增加在整个扩弓量中占的比例,我们设计实验二。
二、种植体腭骨支抗扩弓前后四环素荧光染色片的研究
实验动物及扩弓方法同实验一。实验前后两组在扩弓以前和扩弓结束前的两日内,给予全部犬静脉注射四环素10mg/kg,每日两次。在结束后处死所有犬,在尖牙、前磨牙和第一磨牙水平连线处切片,制备7-10um厚的四环素荧光标记不脱钙骨磨片。在荧光显微镜下观察并且将结果输入计算机分析仪测量腭中缝宽度。
在四环素染色不脱钙磨片中,利用四环素能够和钙离子螯合的特点,在荧光显微镜下能够观察到扩弓前和保持后两条四环素荧光染色带。通过计算机测量两条荧光带之间距离,得出腭中缝真实扩大的量。其量占实验一模型测量得出的支抗牙之间距离扩大量的比例就是两种扩弓方法腭中缝扩大在整个扩弓效应中占的比例。通过结果显示,对照组中,腭中缝扩大量在整个扩弓量占的比例为70%;而在实验组中,腭中缝扩大量在整个扩弓量占95%以上。结果提示实验组模型测量得出支抗牙之间距离扩大的值就完全是由腭中缝宽度的扩大引起;而对照组支抗牙之间距离扩大的值腭中缝宽度的开展只占整个效应的一部分,另外的部分由支抗牙颊侧倾斜效应引起。
我们在上颌扩弓中,不能盲目的追求总的扩弓量的增大,如果是以牙齿的过分倾斜为重要成分的扩弓,这种扩弓是不稳定的,而且是最终会导致失败,我们应该把注意力放在腭中缝的扩大和牙齿的整体移动上。
本课题成功地建立了犬种植体支抗式快速扩弓模型,并与传统牙支持式装置进行了效果对比,证实了其扩弓和保护牙齿支抗的效果,为日后的临床应用提供了实验依据。
Maxillary transverse deficiency, mild crowding and crossbite of posterior teeth are very common in the clinical work. In these situations, a expansion is needed to stimulate the growth of maxilla.
Maxillary expansion treatments have been used for more than a century and can be categorized by different ways. It can be divided into osteo-anchorage, dental-anchorage and dentalosteo-anchorage, or RME and SME, or orthopedic and orthodontic expansion. Among all the methods, RME, which is first come up with by Angle, is the most extensively-used one. It is generally accepted that RME is effective as long as the suture system is still growing.
Traditionally, bilateral first premolars and molars are utilized to supply anchorage. This dental-anchorage method has been proved to be effective, however, some limitations associated with it have been reported, including bite opening, relapse, microtrauma of the temporomandibular joint and the midpalatal suture, root resorption, tissue impingement and pain, excessive tipping of anchorage teeth or even a failure of expansion. So it has been greatly concerned that how to reduce the tipping of teeth and maximize the splitting effect of midpalatal suture.
Experiment 1 to observe the expansion effect of our appliance.
Animal Experiment on palatal implant anchorage applied in expanding narrow dental arch
8 dogs of six months old and about 10kg were matched into two groups randomly, with 4 dogs in each group. In experiment group, we fabricate an expansion appliance with two stainless-steel boards and a screw welding together. Then this appliance is fixed in dog’s palatal area with some titanium mini-screws with a scale of 6mm in length and 4mm in width. In control group, we use the traditional RME method of utilizing bands on bilateral premolars and molars. Both groups load force every two days, 180 every time. Then we set plaster cast for every dog before and after the experiment, and measure the distance between maxillary central insiors, canines and first premolars and the axial angles of maxillary canines、premolars and first molars before and after experiment.
the result showed that the distance of central incisors had no obvious differences in experimental group and control group before and after experiment (p﹥0.05) . However, canines and premolars in experimental group and control group showed p value <0.05. Variance of the distance between dog’s canines and first molars in experimental group before and after experiment was less than in the control group, and there were differences between the two groups. It was considered that the width of the maxilla in lateral direction was all expanded in experimental group and control group. After anchorage was used to expend ordinary tooth’s arch, the expanded distance among anchorage teeth was wider than among homonym teeth when micro-implant was used as anchorage. The traditional rapid maxillary expansion with tooth as anchorage was more advantageous in increasment than that of maxilla arch width using micro-implant anchorage to assist expansion screw’s rapid maxillary expansion. The tilting angles of dog’s canines, first premolars and first molar’s buccal surface showed different extent of increasement. However, while those in experimental group showed almost no change. The difference of the groups was significant (p﹤0.05). The result indicated that there was no labial inclination in experimental group. Although the increasement of control group’s maxillary width was greater than that of experiment group, some increasement was bought by anchorage teeth’s labial inclination instead of the desirable pure expansion of palatal suture. Labial inclination of anchorage teeth had an unstable effect with a high incidence of relapse. The over inclination of teeth could cause the failure of arch expansion. To better observe the proportion of increasement of palatal suture width before and after arch expansion to the total quantity of arch expansion, we designed the second experiment.
2. The research on tetracycline fluorescent staining method before and after palatal implant anchorage was applied in expanding narrow dental arch.
The experimental animal and arch expansion method was the same as in the first experiment. The two groups were given intravenous tetracycline (10mg/kg) twice every day before and after experiment, two days before arch expansion and at the end of arch expansion. After the experiment, the dogs were all killed. We made slices from horizontal line of first molars and made tetracycline fluorescent labeled undecalcified ground bone of 7-10um width. They were observed under the fluoroscope and the result was input into computer analyzer to measure the width of palatal suture.
In tetracydine stained undecalcified ground bones, we explored the tetracydine’s characteristic of chelating with calcium ion and employed the fluorescence microscope to observe two tetracydine fluorescent staining bands before arch expansion and after maintenance. With the help of computer, we measured the distance between two fluorescent striate bands and got the real quantity of expansion of palatal suture. Its proportion of the expanded quantity among anchorage teeth to the first experiment model was just the proportion of palatal suture’s expansion quantity in two arch expansion methods to the whole arch expansion effect. The result showed that, in control group, the proportion of palatal suture’s expansion in total arch expansion was 70%. However, the figure was 95% in the experimental group. The result showed that the expansion quantity among anchorage teeth in the experimental group model was completely caused by the expanded width of palatal suture. For the expansion quantity among anchorage teeth in the control group model, the expanded width of palatal suture was only a part of the complete effect causes. The rest effect was caused by the labial inclination effect of anchorage teeth.
In the process of maxillary expansion, we can’t aimlessly seek the total expansion quantity. The anchorage expansion with over inclination of teeth as its focus is unstable and will lead to failure finally. We shall concentrate on the expansion of palatal suture and integral movement of teeth.
This study establishes the RME model with implant anchorage on dogs. In comparison with the traditionally teeth anchorage RME appliance, the expansion and anchorage-protecting effects are proved.
That will provide some reference for the future clinical application.
引文
1﹑Angell E.Treatment of irregularities of the permanent teeth or adult teeth.Dent Cosmos,1860;1:540-544
2﹑陈莉莉,段银钟等.快速上颌扩弓保持与复发的动物实验研究.实用口腔医学杂志.2004;20(2):214-217
3﹑Meffert RM.Endosseous dent implantology from the periodontitis viewpoint.J Periodontal,1986;57(9):531-536
4 ﹑ Gainsforth BL,Higley LB.A study of orthodontic anchorage possibilities in basal bone[J].Am J Orthod Oral Surg,1945;31: 406-411
5﹑Branemark PI,Adell R,Breine U,et al.Intra-ossenous anchorage of dental prostheses.I. Experimental studies [J].Scand J Plast Recomstr Surg,1963;3:18-23
6 ﹑ Linkow Li.The endosseous blade implants and its use in orthodontics.Int J Orthod 1969;17:149-154
7﹑Robert WE.Smith RK.Zilberman Y.Mozsary PG,Smith RS.Osseous adaptation to continuous loading of rigid endossous implants.Am J Orthod.1984;86(2): 95-111
8﹑Block M,H offm an DR.A new device for absolute anchorage for orthodontics Am J Orthod Dentofacial Orthod, 1995;107(3): 251-258
9、Smalley WM,Shapiro PA,Hohl TH.Osseointegrated titanium implants for maxillofacial protraction in monkeys.Am J Orthod Dentofac Orthop,1988;94(4):285-295
10 、曾祥龙 . 正畸种植体支抗的发展、类型和应用 . 口腔正畸学.2005;12(1):44-48
11、Sugawara.ICO Interviews:Dr.Junji Sugawara on the skeletal anchorsge system[J].J Clin Orthod,1999;33:689-694
12、Daimaruya T.Nagasaka H.Umemori M.Sugawara J.The influences of molar intrusion on the inferior alveolar neurovascular bundle and root using the skeletal anchorage system in dofs.Angle Orthod 2001;71:60-70
13、Chung KR,Kim YS,Lee YJ,The miniplate with tube for skeletal anchorage.J Clin Orthod.2002;36:407-412
14、Block MS,Hoffman DR.A new device for absolute anchorage for orthodontics.Am J Orthod Dentofacial Orthop 1995;107:251-258
15、Bondemark L,Feldmann I,Feldmann F.Distal molar movement with an intra-arch device provided with the onplant system for absolute anchorage.World J Orthod 2002;3:117-124
16、Celenza F,Hochman MN.Absomute anchorage in orthodontics direct and indirect implant-assisted modalities[J].J Clin Orthod, 2000, 34:397
17、Kanomi R Mini—implant for orthodontic anchorage.J Clin 0rthod,1997;31:763～767
18、石咏梅,王翔,王虎中等. 不同受力条件下微螺钉支抗种植体稳定性的动物实验研究. 临床口腔医学杂志,2005;21. 6:323～324
19、Odman J, Lekholm V, Jemt T. Osseointegrated implants as orthodontic anchorage in the treatment of partially edentulous adults patients..Eur J Orthod,1994;16(3):187-201
20、刘鑫,段银钟等.微小种植体支抗与传统支抗在成人双颌前突尖牙远移中的比较.实用口腔医学杂志,2004;20(2):143-146
21、Goodacre CJ,Brown DT,Roberts WE.Prosthodontic considerations when using implants for orthodontic anchorage[J].J prosbert Dent, 1997;77:162-170
22、张肇森译.微植体齿颌矫正治疗.台湾:日毅企业有限公司,2003:7-12
23、Fritz V,Diedrich P,Kinzinger G,et.Am J Orofac Orthop, 2003;64(4): 293- 304
24、Costa A,Raffaini M,Melsen B.Miniscrew as orthodontic anchorage: A preliminary report[J].Int Adult 0rthod Orthp Surg,1998;13(3): 201 -209
25、Yamaura T, Abe S, Tamatsu Y, et al. Anatomical study of the maxillary tubersity in Japanese men [J]. Bull Tokyo Dent Coll, 1998; 39(4): 287-292
26、Tosun T,Keles A,Erverdi N.Method for the placement of palatal implants[J].Int J Oral Maxillafac Implants 2002; 17(1): 95-100
27、Wehrbein H,Feifel H,Diedrich P.Palatal implant anchorage reinforcement of posterior teeth:A prospective study[J].Am J Orthod Dentofacial Orthop,1999;116(6): 678-866
28 、 Debbane EF Experiment study of maxillary expansion in dento-facial orthopedics.Am J Orthod.1958;44:187-199
29、张漫.快速扩弓研究进展.国外医学口腔医学分册.1999;26 (4):211-223
30、潘晓岗,房兵,钱玉芬等. 成人上颌横向发育不足的矫治进展.上海口腔医学.2003;12(5):370-373
31、Scott JH.The growth of the cranio-facial skeleton.Ir J Med Sci.1962; 438:276-286
32、Latham RA.The development,structure and growth pattern of the human mid-palatal suture.J Anat.1971 Jan,108(1):31-41
33、Kurol J, Berglund L. Longitudinal study and cost-benefit analysis of the effect of early treatment of posterior cross-bite in the primary dentition[J].Eur J Orthod,1992;14(3):173-179
34、Melsen B.Palatal growth studied on human autopsy material. A histologic microradiographic study.Am J Orthod. 1975;68(1): 42-54
35、Baik HS. Clinical results of the maxillary protraction in Korean children[J]. Am J Orthod, 1995, 108(6): 583-592
36、Gray LP.Results of 310 cases of rapid maxillary expansion selected medical reasons.J Laryngol Otol, 1975;89 (6):601-614
37、Capelozza Filho L,Cardoso Neto J,da Silva Filho OG,et al. Non-surgically assisted rapid maxillary expansion in adults[J]. Int J Adult Orthodon Orthogonath Surg,1996;11(1): 57-66
38、吴晶,王邦康等.快速上颌扩大术的研究概况.北京口腔医学.2004; 12(3):178-181
39、Revelo B,Fishman LS.Maturational evaluation of ossification of the midpalatal suture.Am J Orthod Dentofacial Orthop,1994; 105(3):288-291
40、Kondo E, Aoba TJ.Nonsurgical and nonextraction treatment of skeletal class Ⅲ open bite:its long-term. 2001;117 (3): 267 -287
41、Memikoglu TU,Iseri H.Effects of a bonded rapid maxillary expansion appliance during orthodontic treatment.AngleOrthod.1999;69(3):251-256
42、Stuart DA,Wiltshire WA.Rapid palatal expansion in the young adult: time for a paradigm shift?J Can Dent Assoc. 2003; 69(6): 374-377
43、张巧余,陈华.固定矫治器快速上颌扩弓的实验和临床观察.中华口腔医学杂志,1990;25:70-72
44、Mcdonald JP.Airway problems in children-can the orthodontist help.Ann-Acad-Med-Singapore.1995;24(1):158-162
45、Akkaya S,Lorenzon S,Ucom TT.A comparison of sagittal and vertical effects between bonded rapid and slow maxillary expansion procedures.Eur J Orthod.1999;21(2):175-180
46、Landford SR,Sims MR.Root surface resorption,repair,and periodontal attachment following rapid maxillary expansion in man.Am J Orthod,1982,81(2):108-115
47、Majourau A,Nanda R.Biomechanical basis of vertical dimension control during rapid palatal expansion therapy.Am J Orthod Dentofacial Orthop,1994,106(3):322-328
48、Erverdi N,Okar I.A Comprasion of two different rapid palatal expansion techniques from the point of root resorption. Am J Orthod Dentofacial Orthop 1994,106:47-51
49、Glassman AS, Nahigian SJ, Medway JM, Aronowitz HI. Conservative surgical orthodontic adult rapid palatal expansion: sixteen cases. Am J Orthod 1984, 86:206-213
50、Haas AJ.The treatment of maxillary deficiency by opening the midpalatal suture.Angle Orthod 1965,3:201-217
51 、 Kraut RA.Surgically assisted rapid maxillary expansion byopening the midpalatal suture.J Oral Maxillofac Surg 1984,42: 651-655
52 、 Wertz RA.Skeletal and dental changes accompanying rapid midpalatal suture pening.Am J Orthod 1970,58:41-66
53、Isaacson RJ, Ingram AH.Force produced by rapid maxillary expansion.Ⅱ .Force present during treatment Angle Orthod.1964, 34:256 - 270
54、Christian Zahl,Klaus Louis Gerlach.Transversal Palatail Expansion Using a Palatal Distractor.J Orofac Orthop 2003; 64: 443～449
55、Lars Hansen,Eve Tausche.Skeletally-anchored Rapid Maxillary Expansion using the Dresden Distractor. J Orofac Orthop 2007;68:148-158
56、Vardimon AD,Brosh T,Spiegler A.Rapid palatal expansion.Part
2:Dentoskeletal changes in cats with patent versus synostosed midpalatal sulure.Am J Orthod Dentofacial Orthop 1998,113(5):488-497
57、Langford SR.Root resorption to movement of the bone[J]Am J Orthod,1973;64(3):229-247
58、郭军,段银钟等.种植体与口外弓作支抗推上颌磨牙远移的比较研究.中国美容医学.2005;14(3):335-337
59、贺红,韩光丽等.On plant 种植体支抗的研究——前方牵引上颌骨矫治骨性反牙合. .口腔正畸学.2004;S1:45
60、贺红.腭部骨膜下支抗种植体的研究现状及临床应用.继续医学教育.2006.20(22):27-30
2﹑陈莉莉,段银钟等.快速上颌扩弓保持与复发的动物实验研究.实用口腔医学杂志.2004;20(2):214-217
3﹑Meffert RM.Endosseous dent implantology from the periodontitis viewpoint.J Periodontal,1986;57(9):531-536
4 ﹑ Gainsforth BL,Higley LB.A study of orthodontic anchorage possibilities in basal bone[J].Am J Orthod Oral Surg,1945;31: 406-411
5﹑Branemark PI,Adell R,Breine U,et al.Intra-ossenous anchorage of dental prostheses.I. Experimental studies [J].Scand J Plast Recomstr Surg,1963;3:18-23
6 ﹑ Linkow Li.The endosseous blade implants and its use in orthodontics.Int J Orthod 1969;17:149-154
7﹑Robert WE.Smith RK.Zilberman Y.Mozsary PG,Smith RS.Osseous adaptation to continuous loading of rigid endossous implants.Am J Orthod.1984;86(2): 95-111
8﹑Block M,H offm an DR.A new device for absolute anchorage for orthodontics Am J Orthod Dentofacial Orthod, 1995;107(3): 251-258
9、Smalley WM,Shapiro PA,Hohl TH.Osseointegrated titanium implants for maxillofacial protraction in monkeys.Am J Orthod Dentofac Orthop,1988;94(4):285-295
10 、曾祥龙 . 正畸种植体支抗的发展、类型和应用 . 口腔正畸学.2005;12(1):44-48
11、Sugawara.ICO Interviews:Dr.Junji Sugawara on the skeletal anchorsge system[J].J Clin Orthod,1999;33:689-694
12、Daimaruya T.Nagasaka H.Umemori M.Sugawara J.The influences of molar intrusion on the inferior alveolar neurovascular bundle and root using the skeletal anchorage system in dofs.Angle Orthod 2001;71:60-70
13、Chung KR,Kim YS,Lee YJ,The miniplate with tube for skeletal anchorage.J Clin Orthod.2002;36:407-412
14、Block MS,Hoffman DR.A new device for absolute anchorage for orthodontics.Am J Orthod Dentofacial Orthop 1995;107:251-258
15、Bondemark L,Feldmann I,Feldmann F.Distal molar movement with an intra-arch device provided with the onplant system for absolute anchorage.World J Orthod 2002;3:117-124
16、Celenza F,Hochman MN.Absomute anchorage in orthodontics direct and indirect implant-assisted modalities[J].J Clin Orthod, 2000, 34:397
17、Kanomi R Mini—implant for orthodontic anchorage.J Clin 0rthod,1997;31:763～767
18、石咏梅,王翔,王虎中等. 不同受力条件下微螺钉支抗种植体稳定性的动物实验研究. 临床口腔医学杂志,2005;21. 6:323～324
19、Odman J, Lekholm V, Jemt T. Osseointegrated implants as orthodontic anchorage in the treatment of partially edentulous adults patients..Eur J Orthod,1994;16(3):187-201
20、刘鑫,段银钟等.微小种植体支抗与传统支抗在成人双颌前突尖牙远移中的比较.实用口腔医学杂志,2004;20(2):143-146
21、Goodacre CJ,Brown DT,Roberts WE.Prosthodontic considerations when using implants for orthodontic anchorage[J].J prosbert Dent, 1997;77:162-170
22、张肇森译.微植体齿颌矫正治疗.台湾:日毅企业有限公司,2003:7-12
23、Fritz V,Diedrich P,Kinzinger G,et.Am J Orofac Orthop, 2003;64(4): 293- 304
24、Costa A,Raffaini M,Melsen B.Miniscrew as orthodontic anchorage: A preliminary report[J].Int Adult 0rthod Orthp Surg,1998;13(3): 201 -209
25、Yamaura T, Abe S, Tamatsu Y, et al. Anatomical study of the maxillary tubersity in Japanese men [J]. Bull Tokyo Dent Coll, 1998; 39(4): 287-292
26、Tosun T,Keles A,Erverdi N.Method for the placement of palatal implants[J].Int J Oral Maxillafac Implants 2002; 17(1): 95-100
27、Wehrbein H,Feifel H,Diedrich P.Palatal implant anchorage reinforcement of posterior teeth:A prospective study[J].Am J Orthod Dentofacial Orthop,1999;116(6): 678-866
28 、 Debbane EF Experiment study of maxillary expansion in dento-facial orthopedics.Am J Orthod.1958;44:187-199
29、张漫.快速扩弓研究进展.国外医学口腔医学分册.1999;26 (4):211-223
30、潘晓岗,房兵,钱玉芬等. 成人上颌横向发育不足的矫治进展.上海口腔医学.2003;12(5):370-373
31、Scott JH.The growth of the cranio-facial skeleton.Ir J Med Sci.1962; 438:276-286
32、Latham RA.The development,structure and growth pattern of the human mid-palatal suture.J Anat.1971 Jan,108(1):31-41
33、Kurol J, Berglund L. Longitudinal study and cost-benefit analysis of the effect of early treatment of posterior cross-bite in the primary dentition[J].Eur J Orthod,1992;14(3):173-179
34、Melsen B.Palatal growth studied on human autopsy material. A histologic microradiographic study.Am J Orthod. 1975;68(1): 42-54
35、Baik HS. Clinical results of the maxillary protraction in Korean children[J]. Am J Orthod, 1995, 108(6): 583-592
36、Gray LP.Results of 310 cases of rapid maxillary expansion selected medical reasons.J Laryngol Otol, 1975;89 (6):601-614
37、Capelozza Filho L,Cardoso Neto J,da Silva Filho OG,et al. Non-surgically assisted rapid maxillary expansion in adults[J]. Int J Adult Orthodon Orthogonath Surg,1996;11(1): 57-66
38、吴晶,王邦康等.快速上颌扩大术的研究概况.北京口腔医学.2004; 12(3):178-181
39、Revelo B,Fishman LS.Maturational evaluation of ossification of the midpalatal suture.Am J Orthod Dentofacial Orthop,1994; 105(3):288-291
40、Kondo E, Aoba TJ.Nonsurgical and nonextraction treatment of skeletal class Ⅲ open bite:its long-term. 2001;117 (3): 267 -287
41、Memikoglu TU,Iseri H.Effects of a bonded rapid maxillary expansion appliance during orthodontic treatment.AngleOrthod.1999;69(3):251-256
42、Stuart DA,Wiltshire WA.Rapid palatal expansion in the young adult: time for a paradigm shift?J Can Dent Assoc. 2003; 69(6): 374-377
43、张巧余,陈华.固定矫治器快速上颌扩弓的实验和临床观察.中华口腔医学杂志,1990;25:70-72
44、Mcdonald JP.Airway problems in children-can the orthodontist help.Ann-Acad-Med-Singapore.1995;24(1):158-162
45、Akkaya S,Lorenzon S,Ucom TT.A comparison of sagittal and vertical effects between bonded rapid and slow maxillary expansion procedures.Eur J Orthod.1999;21(2):175-180
46、Landford SR,Sims MR.Root surface resorption,repair,and periodontal attachment following rapid maxillary expansion in man.Am J Orthod,1982,81(2):108-115
47、Majourau A,Nanda R.Biomechanical basis of vertical dimension control during rapid palatal expansion therapy.Am J Orthod Dentofacial Orthop,1994,106(3):322-328
48、Erverdi N,Okar I.A Comprasion of two different rapid palatal expansion techniques from the point of root resorption. Am J Orthod Dentofacial Orthop 1994,106:47-51
49、Glassman AS, Nahigian SJ, Medway JM, Aronowitz HI. Conservative surgical orthodontic adult rapid palatal expansion: sixteen cases. Am J Orthod 1984, 86:206-213
50、Haas AJ.The treatment of maxillary deficiency by opening the midpalatal suture.Angle Orthod 1965,3:201-217
51 、 Kraut RA.Surgically assisted rapid maxillary expansion byopening the midpalatal suture.J Oral Maxillofac Surg 1984,42: 651-655
52 、 Wertz RA.Skeletal and dental changes accompanying rapid midpalatal suture pening.Am J Orthod 1970,58:41-66
53、Isaacson RJ, Ingram AH.Force produced by rapid maxillary expansion.Ⅱ .Force present during treatment Angle Orthod.1964, 34:256 - 270
54、Christian Zahl,Klaus Louis Gerlach.Transversal Palatail Expansion Using a Palatal Distractor.J Orofac Orthop 2003; 64: 443～449
55、Lars Hansen,Eve Tausche.Skeletally-anchored Rapid Maxillary Expansion using the Dresden Distractor. J Orofac Orthop 2007;68:148-158
56、Vardimon AD,Brosh T,Spiegler A.Rapid palatal expansion.Part
2:Dentoskeletal changes in cats with patent versus synostosed midpalatal sulure.Am J Orthod Dentofacial Orthop 1998,113(5):488-497
57、Langford SR.Root resorption to movement of the bone[J]Am J Orthod,1973;64(3):229-247
58、郭军,段银钟等.种植体与口外弓作支抗推上颌磨牙远移的比较研究.中国美容医学.2005;14(3):335-337
59、贺红,韩光丽等.On plant 种植体支抗的研究——前方牵引上颌骨矫治骨性反牙合. .口腔正畸学.2004;S1:45
60、贺红.腭部骨膜下支抗种植体的研究现状及临床应用.继续医学教育.2006.20(22):27-30