透明保持器对颞下颌关节髁突位置及相关肌肉肌电图的影响
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摘要
第一部分透明保持器对颞肌、咬肌肌电的影响
目的：观察透明保持器对颞肌、咬肌肌电电位的改变情况，从而探讨透明保持器对颞下颌关节(temporomandibular joint，TMJ)的影响。
方法：根据筛选标准选择健康受试者，制作透明保持器。采用神经肌肉电生理仪(Keypoint 2000，VD公司，USA)对受试者进行检测，记录透明保持器戴入前后不同状态下颞肌(temporalis muscle，TM)、咬肌(masseter muscle，MM)的肌电电位值，并进行统计分析。
结果：透明保持器戴入后下颌姿势位时颞肌、咬肌的肌电电位值均较未戴前明显增高(P＜0.05)。受试者发[s]、[z]音时肌电值也较未戴透明保持器前明显增高(P＜0.05)，发[a]音时无显著性差异(P＞0.05)。颞肌、咬肌均得到了相似的结果。
结论：透明保持器的戴用将会对颞肌、咬肌肌电电位造成影响，但该影响是否会导致颞下颌关节疾病的发生，尚需要进一步的观察。
第二部分透明保持器戴入前后髁突位置变化的初步研究
目的：初步研究透明保持器戴入前后髁突位置的变化。
方法：对15名健康受试者拍摄透明保持器戴入前后下颌姿势位(mandible posture position，MPP)时的颞下颌关节侧位体层片，并利用计算机技术对关节间隙进行面积测量及线性测量，并进行统计分析。
结果：透明保持器戴入后髁突向前下方移位，对logE(P／A)值进行统计分析发现，二者存在显著差异(P＜0.01)。面积测量和线性测量得到了相似的结果。
结论：透明保持器戴入前后，髁突位置发生了显著变化，髁突从基本中性位前移到前移位。但戴用不同时间后的改变情况有待进一步的研究。
Part1
The influence of clear thermoplastic retainer on the electromyography of temporalis muscle and masseter muscle
Objective: To investigate the influence of clear thermoplastic retainer on the EMG of TM、MM and to explore the role of clear thermoplastic retainer in the etiology of temporomandibular diseases.
Methods: Choose people according to the standards, fabricate an acceptable clear thermoplastic retainer for everyone. Then decide the situation by preliminary experiment. The EMG of TM、MM was studied before and after clear thermoplastic retainer was wore. Analysis of variance was used to evaluate the differences.
Results: The EMG activity of TM、MM, viewed in mandible posture position(MPP), was higher after clear thermoplastic retainer was wore (P＜0.05). The EMG activity of the muscles increased when the patient said [S] and [Z] after the retainer was wore (P＜0.05). The EMG activity of the muscles didn't change so much when the patient said [a] after the retainer was wore (P＞0.05).
Conclusion: Clear thermoplastics retainer has effect on the EMG of TM、MM, but whether it plays a role in temporomandibular diseases need further observation.
Part 2
A primary study of condylar position change before and after clear thermoplastic retainer was wore
Objective: The study primarily evaluates whether condylar position changed before and after clear thermoplastic retainer was wore.
Method: The temporomandibular joints(TMJs) of 15 healthy people, without TMD, were viewed in MPP with TMJ lateral tomography before and after clear thermoplastic retainer was wore. Computer technique was used to evaluate tomograms: areal and linear changes of the anterior and posterior intra-articular joint spaces were measured. Analysis of variance was used to evaluate the differences.
Results: After the clear thermoplastic retainer was wore, condyle moved forward. LogE (P/A) valuses were analyzed, the differences between them were found significant(p＜0.01). Two methods used to analyze the tomograms produced similar results.
Conclusion: With the limitions of this study ,significant changes in the condylar position occurred after clear thermoplastic retainer was wore. Condyle moved from medial positions to anterior positions, but the changes after clear thermoplastic retainer was used for different times need further observation.
目的：观察透明保持器对颞肌、咬肌肌电电位的改变情况，从而探讨透明保持器对颞下颌关节(temporomandibular joint，TMJ)的影响。
方法：根据筛选标准选择健康受试者，制作透明保持器。采用神经肌肉电生理仪(Keypoint 2000，VD公司，USA)对受试者进行检测，记录透明保持器戴入前后不同状态下颞肌(temporalis muscle，TM)、咬肌(masseter muscle，MM)的肌电电位值，并进行统计分析。
结果：透明保持器戴入后下颌姿势位时颞肌、咬肌的肌电电位值均较未戴前明显增高(P＜0.05)。受试者发[s]、[z]音时肌电值也较未戴透明保持器前明显增高(P＜0.05)，发[a]音时无显著性差异(P＞0.05)。颞肌、咬肌均得到了相似的结果。
结论：透明保持器的戴用将会对颞肌、咬肌肌电电位造成影响，但该影响是否会导致颞下颌关节疾病的发生，尚需要进一步的观察。
第二部分透明保持器戴入前后髁突位置变化的初步研究
目的：初步研究透明保持器戴入前后髁突位置的变化。
方法：对15名健康受试者拍摄透明保持器戴入前后下颌姿势位(mandible posture position，MPP)时的颞下颌关节侧位体层片，并利用计算机技术对关节间隙进行面积测量及线性测量，并进行统计分析。
结果：透明保持器戴入后髁突向前下方移位，对logE(P／A)值进行统计分析发现，二者存在显著差异(P＜0.01)。面积测量和线性测量得到了相似的结果。
结论：透明保持器戴入前后，髁突位置发生了显著变化，髁突从基本中性位前移到前移位。但戴用不同时间后的改变情况有待进一步的研究。
Part1
The influence of clear thermoplastic retainer on the electromyography of temporalis muscle and masseter muscle
Objective: To investigate the influence of clear thermoplastic retainer on the EMG of TM、MM and to explore the role of clear thermoplastic retainer in the etiology of temporomandibular diseases.
Methods: Choose people according to the standards, fabricate an acceptable clear thermoplastic retainer for everyone. Then decide the situation by preliminary experiment. The EMG of TM、MM was studied before and after clear thermoplastic retainer was wore. Analysis of variance was used to evaluate the differences.
Results: The EMG activity of TM、MM, viewed in mandible posture position(MPP), was higher after clear thermoplastic retainer was wore (P＜0.05). The EMG activity of the muscles increased when the patient said [S] and [Z] after the retainer was wore (P＜0.05). The EMG activity of the muscles didn't change so much when the patient said [a] after the retainer was wore (P＞0.05).
Conclusion: Clear thermoplastics retainer has effect on the EMG of TM、MM, but whether it plays a role in temporomandibular diseases need further observation.
Part 2
A primary study of condylar position change before and after clear thermoplastic retainer was wore
Objective: The study primarily evaluates whether condylar position changed before and after clear thermoplastic retainer was wore.
Method: The temporomandibular joints(TMJs) of 15 healthy people, without TMD, were viewed in MPP with TMJ lateral tomography before and after clear thermoplastic retainer was wore. Computer technique was used to evaluate tomograms: areal and linear changes of the anterior and posterior intra-articular joint spaces were measured. Analysis of variance was used to evaluate the differences.
Results: After the clear thermoplastic retainer was wore, condyle moved forward. LogE (P/A) valuses were analyzed, the differences between them were found significant(p＜0.01). Two methods used to analyze the tomograms produced similar results.
Conclusion: With the limitions of this study ,significant changes in the condylar position occurred after clear thermoplastic retainer was wore. Condyle moved from medial positions to anterior positions, but the changes after clear thermoplastic retainer was used for different times need further observation.
引文
[1] Ponitz RJ. Invisible retainers. Am J Orthod 1971; 59: 266-72.
[2] Sheridan J. J.; Gaylord R. E.; Hamula W.; Hickham J. H.; Kokich V. G.; and Tuverson D. L.: JCO Roundtable: Finishing and retention, J. Clin. Orthod. 26: 551-564, 1992.
[3] McNamara JA, Kramer KL, Juenker JP. Invisible retainers. J Clin Orthod 1985; 19: 570-8.
[4] 陈剑飞．压模正畸保持器的制作及临床应用[J]．北京口腔医学2001：9(3)：139-140．
[5] 李荣，赵煜．Hawley保持器与透明膜套保持器的临床应用的比较研究[J]．口腔正畸学2004年第1卷第1期增刊
[6] 张宝茹，王渠蔓．透明压膜保持器与传统可摘保持器对牙周健康的影响[J]．北京口腔医学，2003，11(3)146-147．
[7] Sheridan J. J.; LeDoux W.; and McMinn R.: Essix retainers: Fabrication and supervision for permanent retention. J. Clin. Orthod. 1993; 27: 37-45.
[8] Wang F. A new thermoplastic retainer. J Clin Orthod 1997; 31: 754-7.
[9] Mongini F. Remodeling of the mandibular condyle in the adult and its relationships to the condition of the dental archs. Acta Anat 1972; 82: 437.
[10] Mongini F. Dental abrasion as a factor in remodeling of the mandi bular condyle. Acta Anat 1975; 92: 292.
[11] Weinberg LA. Role of condyle position in TMJ dysfunction-pain syndrome. J Prosthet Dent. 1979; 41: 636.
[12] 赵燕平，马绪臣，邹兆菊，等．髁突位置改变在颞下颌关节结构紊乱中的诊断价值[J]．中华口腔医学杂志，1995，30(4)：235-237．
[13] Ramfjord SP, Ash MM. Occlusion. Philadelphia: Saunders, 1971: 176-193.
[14] Preti G, Bruscagin C, Fva C. Anatomic and statistical study to determine the inclination of the condyle long axis. J prosthet Dent. 1983, 49: 572.
[15] Van Eijden TM, Blanksma NG, Brugman P. Amplitude and timing of EMG activity in the human masseter muscle during selected motortasks. J Dent Res, 1993, 72: 599.
[16] Gianelly AA, Anderson CK. Longitudinal evaluation of condyla position in extraction and nonextraction treatment [J]. Am J Orthod Dentofac Orthop, 1991, 100: 416.
[17] Carlsson GE, Ingervall B, Kocak G. Effect of increasing vertical dimension on the masticatory system in subject with natural teeth[J]. J Prosthet Dent, 1979, 41: 284.
[18] Macaroll RS, Naeije M, Kim YK, etal. The immediate effect of splintinduced changes in jaw positioning on the asymmetry of submaximal masticatory muscle activity[J]. J Oral Rehabil, 1989, 16: 163.
[19] Visser A, Mcarroll RS, Naeije M. Masticatory muscle activity in different jaw relations during submaximal cleching efforts[J]. J Dent Res,1992,71:372.
[20] Owens SE,Lenr RP, Beggs NL. The functional significance of Centric relation as demonstrated by electromyography of the lateral pterygoid muscles[J]. J Prosthet Dent, 1975,33:5.
[21] Morimoto OT,Abekura H,Tokuama H,et al. Alternation in the bite force and EMG activity with changes in vertical dimension of edentulous subjects[J]. J Oral Rehabil, 1996,23(5).336-341.
[22] 黄朝隽,方达峰．健康人咀嚼肌肌电图的研究[J]．中华口腔医学杂志,1988：23(4)：227—230．
[23] John D, Rugh JD, Drago CJ. Vertical dimension: A study of clinical rest position and jaw muscle activity. The Journal of prosthetic Dent, 1981, 45(6): 670-675.
[24] Manns A, Spreng,M. EMG smplitude snd frequence in different muscular elongations under constant masticatory force or EMG activity. Acta Physiol Lat Am 27:259,1977.
[25] Manns A., Mirralles,R. Palazzi.C. EMG bite force and elongation of the masseter muscle under isometric voluntary contractions and varia tions of vertical dimension. J Prosthetic Dent. 42:674,1979.
[26] Garrett, F.A., Angelone,L.,Allen,W. L: The effect of bite opening, bite pressure and malocclusion on the electrical respone of the masseter muscles. Am J Orthod 50: 435, 1964.
[27] 俞凯，李克莉，刊、庚林，等．不同张口度下嚼肌与颞肌肌电变化的研究．Tianjin Med J，Jun 2005, Vol 33，No 6：378．
[28] 樊英显，孔宏晨．颞下颌关节紊乱综合征患者咀嚼肌肌电分析[J]．口腔医学纵横杂志，1994，10(3)：149．
[29] Josell SD. Tooth stabilization for orthodontic retention. Dent Clin North Am 1999; 43: 151-65.
[30] Rosenberg HM, Graczyk RJ. Temporomandibular articulation tomography: A corrected anteroposterior and lateral cephalometric technique[J]. Oral Surg, 1986, 62: 198.
[31] Mongini F. Remodeling of the mandibular condyle in the adult and its relationships to the condition of the dental archs. Acta Anat 1972; 82: 437.
[32] Pullinger A, Hollender L. Variation in condyle-fossa relationships according to different method of evaluation intomograms[J]. Oral Surg, 1986, 62: 719.
[33] Katzberg RW, Keith DA, Teneick WR. Interal derangements of the tempro mandibular joint: An assessment of condyle position in centric occlusion[J]. J Prosthet Dent, 1979, 49: 250.
[34] 张震康，赵福运，孔广熙等．正常人颞颌关节100例X线分析[J]．中华医学杂志，1975，55：130．
[35] Weinberg LA. An evaluation of duplicability of temporo mandibular joint radiography. J Pros Dent, 1970; 24: 512.
[36] Toshio D, Setsudo U, Yoshiko K. Clinical evaluation of temporomandibular joint disorders (TMD) in patients treated with chin cup. Angle Orthodontist, 1998, 68: 91.
[37] Van Sichels J E, Tiner BD, Alder ME. Condylar torque as a possible cause of hypomobility after sagittal split osteotomy: repoth of three cases. J Oral Maxillofac Surg, 1997, 55: 398.
[38] Amett GW. A redefinition of bilateral sagittal osteo tomy (BSO) advancement relapse. Am J Orthod Dentofac Orthop, 1993, 104: 506.
[39] Rebellato J, Lindaner SJ , Sheats RD. Condylar positional changes after mandibular advancement surgery with rigid internal fixation. Am J Orthod Dentofaccial Orthop, 1999, 116: 93.
[40] blaschke DD, Blaschke TJ. A method for quantitative determining TMJ bony relationships. J Dent Res. 1981; 66: 35.
[41] 杨进．髁突位置的定量研究新方法-关节断层的计算机分析．华西医科大学研究生论文，1986．
[1] 许天民．正畸治疗的目标之稳定性概念[J]．口腔正畸学，1997，4(4)：173-174．
[2] Arvystas MG. Maintaining orthodontic success: retention for the adult patient. J Esthet Dent 1996; 8: 279-83.
[3] Joondeph DR, Riedel RA. Retention and relapse. In: Graber TM. Vanaridal RL, eds. Orthodontics: current principles and techniques. St. Louis: Mosby-Year Book, 1994.
[4] Reitan K. Tissue rearrangement during retention of orthodontically rotated teeth. Angle Orthod 1959: 29: 105-13.
[5] White LW. Retention strategies: a pilgrim's progress. J Clin Orthod 1999; 33: 336-8.
[6] 明志强．塑胶成型保持器95例临床效果观察[J]．重庆医学，1999，28(4)：244．
[7] 陈洁，程杰，黄建清．无色透明活动保持器的临床应用[J]．福建医药杂志，2001，23(1)：45-46．
[8] 李炜烽，陈霓．改良式铸造无基托活动保持器的临床应用[J]．口腔正畸学，1999，6(3)：119．
[9] 陈玉梅．乙烯软塑料配合铸造保持器在正畸保持期的临床试验[J]．华夏医学，2002，15(3)：430-431．
[10] Zachrisson B U. Clinical Kxperience with Direct-bonded Orthodontic Retainers[J]. Am J Orthod, 1977, 71: 440-448.
[11] Hawley C A. A Removable Retainer [J]. Int J Orthod Oral Surg, 1919, 2: 291-298.
[12] Ponitz RJ. Invisible retainers. Am J Orthod 1971; 59: 266-72.
[13] H. S Balk, S. H. Jee, K. J. Lee etc. Treatment effects of Frankel functional regulator in children with class III malocclusions. American Journal of Orthodontics and Dentofacial Orthopedics, 2004; 125(3): 2942301.
[14] Angle EH. Treatment of malocclusion of the teeth. 7th ed. Philadelphia: S. S. White, 1907.
[15] Sheridan JJ. The three keys to retention. J Clin Orthod 1991;25: 717-8.
[16] Houston WJB, Stephens CD, Tulley WJ. Stability and retention. In: A textbook of orthodontics, 2nd ed. Oxford: Wright, 1992:346-56.
[17] Little RM. Stability and relapse of dental arch alignment. Br J Orthod 1990; 17:235-41.
[18] Proffit WR. Rentention. In: Contemporary orthodontics. 2nd ed. St. Louis: Mosby-Year Book, 1993:534-5.
[19] Haines WF, Williams DW. Consent and orthodontic treatment. Br J Orthod 1995;22:101-5.
[20] Nada RS, Nada SK. Considerations of dentofacial growth in long term retention and stability: is active retention needed? Am J Orthod Dentofac Orthop 1992; 101:297-302.
[21] Kaplan, H. The logic of modern retention procedures. Am J Orthod Dentofac Orthop 1988;93:325-40.
[22] Houston WJB, Isaacon KG. Orthodontic treatment with removable appliances. 2nd ed. Bristol: John Wright & Sons Ltd., 1980:123.
[23] Wood CM. The effect of retention on the relapse of Class 2 Division 1 cases. Br J Orthod 1983; 10:198-202.
[24]Cabassa SR, Keeling SD, Garvan CW, Wheeler TT, King GJ. Relapse following bionator and headgear therapies with and without retention. J Dent Res 1995;74:142.
[25] Gottlieb EL, Nelson AH, Vogels DS. JCO study of orthodontic diagnosis and treatment procedures. Part 1: results and trends. J Clin Orthod 1996;30:615-29.
[26] Samuels RHA, Pender N, Last KS. The effects of orthodontic tooth movement on the glycosaminoglycan components of gingival crevicular fluid. J Clin Periodontal 1993;20:371-7.
[27] Pender N, Samuels RHA, Last KS. The monitoring of orthodontic tooth movement over a 2-year period by analysis of gingival crevicular fluid. Eur J Orthod 1994; 16:511 -20.
[28] Tenshin S, Tuchihashi M, Sou K, Lew H-S, Hayashi H, Tanimura I, Kawata T. Remodeling mechanisms of transceptal fibres during and after tooth movement. Angle Orthod 1995;65:141-50.
[29] Colin M, Declan T. M. Toward a perspective on orthodontic retention? Am J Orthod 1998; 113:507-14.
[30] Tanne K, Inone Y, Sakuda M. Biomechanical behaviour of the periodontous before and after orthodontic tooth movement. Angle Orthodont. 1995;5:123-8.
[31] Reitan K. Clinical and histologic observations on tooth movement during and after orthodontic treatment. Am J Orthod 1967;53: 721-45.
[32] Rossouw PE, Preston CB, Lombard CJ. Longitudinal change in male and female orthodontic subjects and its value in assessing post-orthodontic stability in orthodontic treatment: management of unfavorable sequelae Craniofacial Growth Series, Center for Human Growth and Development University of Michigan. Ann Arbor, Mich., 1996;31:389-437.
[33] Nielsen IL. Growth considerations in stability of orthodontic treatment. In: Nanda R, Burstone CJ. Retention and stability in orthodontics. Philadelphia: W. B. Saunders, 1993:9-34.
[34] Nanda RS, Nanda SK. Considerations of dentofacial growth in long-term retention and stability. In: Nanda R, Burstone CJ. Retention and stability in orthodontic. Philadelphia: W. B. Saunders, 1993:35-44.
[35] Burstone CJ. Perspectives in orthodontic stability. In: Nanda R, Burstone CJ. Retention and stability in orthodontic. Philadelphia: W. B. Saunders, 1993:45-60.
[36] Nanda R, Zernik J. retention and stability: an overview. In: Nanda R, Burstone CJ. Retention and stability in orthodontic. Philadelphia: W. B. Saunders, 1993:1-8.
[37] Proffit WR. On the aetiology of malocclusion. Br J Orthod 1978: 13: 1-11.
[38] Behrents RG, Harris EF, Vaden JL,Williams RA, Kemp DH. Relapse of orthodontic treatment results: growth as an etiologic factor. J Charles H Tweed Int Found 1989; 17:65-80.
[39] Parker WS. Retention: retainers may be forever. Am J Orthod Dentofac Orthop 1989;95:505-13.
[2] Sheridan J. J.; Gaylord R. E.; Hamula W.; Hickham J. H.; Kokich V. G.; and Tuverson D. L.: JCO Roundtable: Finishing and retention, J. Clin. Orthod. 26: 551-564, 1992.
[3] McNamara JA, Kramer KL, Juenker JP. Invisible retainers. J Clin Orthod 1985; 19: 570-8.
[4] 陈剑飞．压模正畸保持器的制作及临床应用[J]．北京口腔医学2001：9(3)：139-140．
[5] 李荣，赵煜．Hawley保持器与透明膜套保持器的临床应用的比较研究[J]．口腔正畸学2004年第1卷第1期增刊
[6] 张宝茹，王渠蔓．透明压膜保持器与传统可摘保持器对牙周健康的影响[J]．北京口腔医学，2003，11(3)146-147．
[7] Sheridan J. J.; LeDoux W.; and McMinn R.: Essix retainers: Fabrication and supervision for permanent retention. J. Clin. Orthod. 1993; 27: 37-45.
[8] Wang F. A new thermoplastic retainer. J Clin Orthod 1997; 31: 754-7.
[9] Mongini F. Remodeling of the mandibular condyle in the adult and its relationships to the condition of the dental archs. Acta Anat 1972; 82: 437.
[10] Mongini F. Dental abrasion as a factor in remodeling of the mandi bular condyle. Acta Anat 1975; 92: 292.
[11] Weinberg LA. Role of condyle position in TMJ dysfunction-pain syndrome. J Prosthet Dent. 1979; 41: 636.
[12] 赵燕平，马绪臣，邹兆菊，等．髁突位置改变在颞下颌关节结构紊乱中的诊断价值[J]．中华口腔医学杂志，1995，30(4)：235-237．
[13] Ramfjord SP, Ash MM. Occlusion. Philadelphia: Saunders, 1971: 176-193.
[14] Preti G, Bruscagin C, Fva C. Anatomic and statistical study to determine the inclination of the condyle long axis. J prosthet Dent. 1983, 49: 572.
[15] Van Eijden TM, Blanksma NG, Brugman P. Amplitude and timing of EMG activity in the human masseter muscle during selected motortasks. J Dent Res, 1993, 72: 599.
[16] Gianelly AA, Anderson CK. Longitudinal evaluation of condyla position in extraction and nonextraction treatment [J]. Am J Orthod Dentofac Orthop, 1991, 100: 416.
[17] Carlsson GE, Ingervall B, Kocak G. Effect of increasing vertical dimension on the masticatory system in subject with natural teeth[J]. J Prosthet Dent, 1979, 41: 284.
[18] Macaroll RS, Naeije M, Kim YK, etal. The immediate effect of splintinduced changes in jaw positioning on the asymmetry of submaximal masticatory muscle activity[J]. J Oral Rehabil, 1989, 16: 163.
[19] Visser A, Mcarroll RS, Naeije M. Masticatory muscle activity in different jaw relations during submaximal cleching efforts[J]. J Dent Res,1992,71:372.
[20] Owens SE,Lenr RP, Beggs NL. The functional significance of Centric relation as demonstrated by electromyography of the lateral pterygoid muscles[J]. J Prosthet Dent, 1975,33:5.
[21] Morimoto OT,Abekura H,Tokuama H,et al. Alternation in the bite force and EMG activity with changes in vertical dimension of edentulous subjects[J]. J Oral Rehabil, 1996,23(5).336-341.
[22] 黄朝隽,方达峰．健康人咀嚼肌肌电图的研究[J]．中华口腔医学杂志,1988：23(4)：227—230．
[23] John D, Rugh JD, Drago CJ. Vertical dimension: A study of clinical rest position and jaw muscle activity. The Journal of prosthetic Dent, 1981, 45(6): 670-675.
[24] Manns A, Spreng,M. EMG smplitude snd frequence in different muscular elongations under constant masticatory force or EMG activity. Acta Physiol Lat Am 27:259,1977.
[25] Manns A., Mirralles,R. Palazzi.C. EMG bite force and elongation of the masseter muscle under isometric voluntary contractions and varia tions of vertical dimension. J Prosthetic Dent. 42:674,1979.
[26] Garrett, F.A., Angelone,L.,Allen,W. L: The effect of bite opening, bite pressure and malocclusion on the electrical respone of the masseter muscles. Am J Orthod 50: 435, 1964.
[27] 俞凯，李克莉，刊、庚林，等．不同张口度下嚼肌与颞肌肌电变化的研究．Tianjin Med J，Jun 2005, Vol 33，No 6：378．
[28] 樊英显，孔宏晨．颞下颌关节紊乱综合征患者咀嚼肌肌电分析[J]．口腔医学纵横杂志，1994，10(3)：149．
[29] Josell SD. Tooth stabilization for orthodontic retention. Dent Clin North Am 1999; 43: 151-65.
[30] Rosenberg HM, Graczyk RJ. Temporomandibular articulation tomography: A corrected anteroposterior and lateral cephalometric technique[J]. Oral Surg, 1986, 62: 198.
[31] Mongini F. Remodeling of the mandibular condyle in the adult and its relationships to the condition of the dental archs. Acta Anat 1972; 82: 437.
[32] Pullinger A, Hollender L. Variation in condyle-fossa relationships according to different method of evaluation intomograms[J]. Oral Surg, 1986, 62: 719.
[33] Katzberg RW, Keith DA, Teneick WR. Interal derangements of the tempro mandibular joint: An assessment of condyle position in centric occlusion[J]. J Prosthet Dent, 1979, 49: 250.
[34] 张震康，赵福运，孔广熙等．正常人颞颌关节100例X线分析[J]．中华医学杂志，1975，55：130．
[35] Weinberg LA. An evaluation of duplicability of temporo mandibular joint radiography. J Pros Dent, 1970; 24: 512.
[36] Toshio D, Setsudo U, Yoshiko K. Clinical evaluation of temporomandibular joint disorders (TMD) in patients treated with chin cup. Angle Orthodontist, 1998, 68: 91.
[37] Van Sichels J E, Tiner BD, Alder ME. Condylar torque as a possible cause of hypomobility after sagittal split osteotomy: repoth of three cases. J Oral Maxillofac Surg, 1997, 55: 398.
[38] Amett GW. A redefinition of bilateral sagittal osteo tomy (BSO) advancement relapse. Am J Orthod Dentofac Orthop, 1993, 104: 506.
[39] Rebellato J, Lindaner SJ , Sheats RD. Condylar positional changes after mandibular advancement surgery with rigid internal fixation. Am J Orthod Dentofaccial Orthop, 1999, 116: 93.
[40] blaschke DD, Blaschke TJ. A method for quantitative determining TMJ bony relationships. J Dent Res. 1981; 66: 35.
[41] 杨进．髁突位置的定量研究新方法-关节断层的计算机分析．华西医科大学研究生论文，1986．
[1] 许天民．正畸治疗的目标之稳定性概念[J]．口腔正畸学，1997，4(4)：173-174．
[2] Arvystas MG. Maintaining orthodontic success: retention for the adult patient. J Esthet Dent 1996; 8: 279-83.
[3] Joondeph DR, Riedel RA. Retention and relapse. In: Graber TM. Vanaridal RL, eds. Orthodontics: current principles and techniques. St. Louis: Mosby-Year Book, 1994.
[4] Reitan K. Tissue rearrangement during retention of orthodontically rotated teeth. Angle Orthod 1959: 29: 105-13.
[5] White LW. Retention strategies: a pilgrim's progress. J Clin Orthod 1999; 33: 336-8.
[6] 明志强．塑胶成型保持器95例临床效果观察[J]．重庆医学，1999，28(4)：244．
[7] 陈洁，程杰，黄建清．无色透明活动保持器的临床应用[J]．福建医药杂志，2001，23(1)：45-46．
[8] 李炜烽，陈霓．改良式铸造无基托活动保持器的临床应用[J]．口腔正畸学，1999，6(3)：119．
[9] 陈玉梅．乙烯软塑料配合铸造保持器在正畸保持期的临床试验[J]．华夏医学，2002，15(3)：430-431．
[10] Zachrisson B U. Clinical Kxperience with Direct-bonded Orthodontic Retainers[J]. Am J Orthod, 1977, 71: 440-448.
[11] Hawley C A. A Removable Retainer [J]. Int J Orthod Oral Surg, 1919, 2: 291-298.
[12] Ponitz RJ. Invisible retainers. Am J Orthod 1971; 59: 266-72.
[13] H. S Balk, S. H. Jee, K. J. Lee etc. Treatment effects of Frankel functional regulator in children with class III malocclusions. American Journal of Orthodontics and Dentofacial Orthopedics, 2004; 125(3): 2942301.
[14] Angle EH. Treatment of malocclusion of the teeth. 7th ed. Philadelphia: S. S. White, 1907.
[15] Sheridan JJ. The three keys to retention. J Clin Orthod 1991;25: 717-8.
[16] Houston WJB, Stephens CD, Tulley WJ. Stability and retention. In: A textbook of orthodontics, 2nd ed. Oxford: Wright, 1992:346-56.
[17] Little RM. Stability and relapse of dental arch alignment. Br J Orthod 1990; 17:235-41.
[18] Proffit WR. Rentention. In: Contemporary orthodontics. 2nd ed. St. Louis: Mosby-Year Book, 1993:534-5.
[19] Haines WF, Williams DW. Consent and orthodontic treatment. Br J Orthod 1995;22:101-5.
[20] Nada RS, Nada SK. Considerations of dentofacial growth in long term retention and stability: is active retention needed? Am J Orthod Dentofac Orthop 1992; 101:297-302.
[21] Kaplan, H. The logic of modern retention procedures. Am J Orthod Dentofac Orthop 1988;93:325-40.
[22] Houston WJB, Isaacon KG. Orthodontic treatment with removable appliances. 2nd ed. Bristol: John Wright & Sons Ltd., 1980:123.
[23] Wood CM. The effect of retention on the relapse of Class 2 Division 1 cases. Br J Orthod 1983; 10:198-202.
[24]Cabassa SR, Keeling SD, Garvan CW, Wheeler TT, King GJ. Relapse following bionator and headgear therapies with and without retention. J Dent Res 1995;74:142.
[25] Gottlieb EL, Nelson AH, Vogels DS. JCO study of orthodontic diagnosis and treatment procedures. Part 1: results and trends. J Clin Orthod 1996;30:615-29.
[26] Samuels RHA, Pender N, Last KS. The effects of orthodontic tooth movement on the glycosaminoglycan components of gingival crevicular fluid. J Clin Periodontal 1993;20:371-7.
[27] Pender N, Samuels RHA, Last KS. The monitoring of orthodontic tooth movement over a 2-year period by analysis of gingival crevicular fluid. Eur J Orthod 1994; 16:511 -20.
[28] Tenshin S, Tuchihashi M, Sou K, Lew H-S, Hayashi H, Tanimura I, Kawata T. Remodeling mechanisms of transceptal fibres during and after tooth movement. Angle Orthod 1995;65:141-50.
[29] Colin M, Declan T. M. Toward a perspective on orthodontic retention? Am J Orthod 1998; 113:507-14.
[30] Tanne K, Inone Y, Sakuda M. Biomechanical behaviour of the periodontous before and after orthodontic tooth movement. Angle Orthodont. 1995;5:123-8.
[31] Reitan K. Clinical and histologic observations on tooth movement during and after orthodontic treatment. Am J Orthod 1967;53: 721-45.
[32] Rossouw PE, Preston CB, Lombard CJ. Longitudinal change in male and female orthodontic subjects and its value in assessing post-orthodontic stability in orthodontic treatment: management of unfavorable sequelae Craniofacial Growth Series, Center for Human Growth and Development University of Michigan. Ann Arbor, Mich., 1996;31:389-437.
[33] Nielsen IL. Growth considerations in stability of orthodontic treatment. In: Nanda R, Burstone CJ. Retention and stability in orthodontics. Philadelphia: W. B. Saunders, 1993:9-34.
[34] Nanda RS, Nanda SK. Considerations of dentofacial growth in long-term retention and stability. In: Nanda R, Burstone CJ. Retention and stability in orthodontic. Philadelphia: W. B. Saunders, 1993:35-44.
[35] Burstone CJ. Perspectives in orthodontic stability. In: Nanda R, Burstone CJ. Retention and stability in orthodontic. Philadelphia: W. B. Saunders, 1993:45-60.
[36] Nanda R, Zernik J. retention and stability: an overview. In: Nanda R, Burstone CJ. Retention and stability in orthodontic. Philadelphia: W. B. Saunders, 1993:1-8.
[37] Proffit WR. On the aetiology of malocclusion. Br J Orthod 1978: 13: 1-11.
[38] Behrents RG, Harris EF, Vaden JL,Williams RA, Kemp DH. Relapse of orthodontic treatment results: growth as an etiologic factor. J Charles H Tweed Int Found 1989; 17:65-80.
[39] Parker WS. Retention: retainers may be forever. Am J Orthod Dentofac Orthop 1989;95:505-13.