国际口腔医学杂志

国际口腔医学杂志 ›› 2026, Vol. 53 ›› Issue (1): 26-35.doi: 10.7518/gjkq.2026004

• 正畸学专栏 • 上一篇    下一篇

成人均角安氏Ⅰ类、Ⅱ1类及Ⅲ类患者平面偏斜量的对比研究

兰菁(),伍军()   

  1. 南昌大学附属口腔医院正畸科 口腔疾病江西省重点实验室江西省口腔疾病临床医学研究中心 南昌 330000
  • 收稿日期:2024-11-28 修回日期:2025-03-07 出版日期:2026-01-01 发布日期:2025-12-31
  • 通讯作者: 伍军
  • 作者简介:兰菁，住院医师，硕士，Email：17807069105@163.com

Contrastive analysis of occlusal plane canting among adult patients with average-angle profiles with class Ⅰ, class Ⅱ1, and class Ⅲ malocclusions

Jing Lan(),Jun Wu()   

  1. Dept. of Orthodontics, Affiliated Stomatological Hospital of Nanchang University, Jiangxi Key Laboratory of Stomatology, Jiangxi Clinical Medical Research Center for Oral Diseases, Nanchang 330000, China
  • Received:2024-11-28 Revised:2025-03-07 Online:2026-01-01 Published:2025-12-31
  • Contact: Jun Wu

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摘要：

目的 通过研究不同矢状向成人均角患者的上颌尖牙及第一磨牙𬌗平面偏斜量，探讨上颌𬌗平面偏斜量与矢状向之间的相关性，以及安氏亚类患者𬌗平面偏斜方向与磨牙矢状关系间的差异，为此类患者的临床治疗提供参考。 方法 选择180例成人均角患者，其中安氏Ⅰ类60例，安氏Ⅱ1类60例，安氏Ⅲ类60例（其中安氏Ⅱ1、Ⅲ类的亚类与非亚类患者各30例）。应用Mimics软件对患者的锥形束CT（CBCT）成像进行三维重建，分别测量上颌双侧尖牙及第一磨牙至眶耳平面的垂直距离，计算𬌗平面偏斜量；同时记录尖牙及第一磨牙的𬌗平面偏斜方向以及与磨牙的矢状关系。采用SPSS 26.0软件对𬌗平面偏斜量与不同矢状向关系的相关性及安氏亚类的磨牙关系与𬌗平面偏斜方向的相关性进行统计学分析。 结果 尖牙及第一磨牙𬌗平面偏斜量与不同矢状向组别之间存在相关性（P<0.05）。安氏亚类组与非亚类组之间，𬌗平面偏斜量存在相关性（P<0.05）。安氏亚类组中，两侧磨牙关系与𬌗平面偏斜方向存在相关性（P<0.05）。 结论 不同矢状向成人均角患者的𬌗平面偏斜量有一定差异性。临床诊断、分析及治疗安氏Ⅱ类、Ⅲ类及其亚类患者时，不应忽视𬌗平面偏斜的纠正。

关键词: 𬌗平面偏斜, 锥形束CT, 安氏Ⅲ类, 安氏Ⅱ类, 矢状向

Abstract:

Objective　This study aims to investigate the correlation between the inclination of the occlusal plane of maxillary canines and first molars in adult patients with different sagittal skeletal patterns, as well as the differences in the direction of occlusal plane inclination and the sagittal relationship of molars between Angle’s subclasses, which provides a reference for the clinical treatment of such patients. Methods　A total of 180 adult patients with normal occlusion were selected, including 60 cases of Angle class Ⅰ, 60 cases of Angle class Ⅱ division 1, and 60 cases of Angle class Ⅲ (with 30 cases of subclass and non-subclass for Angle class Ⅱ division 1 and Ⅲ). Three-dimensional reconstruction of cone beam computed tomography was performed using Mimics software. The vertical distances from the maxillary bilateral canines and first molars to the Frankfort horizontal plane were measured, and the inclination of the occlusal plane was calculated. The direction of the occlusal plane inclination and the sagittal relationship of the molars were recorded. SPSS 26.0 software was used to statistically analyze the correlation between the inclination of the occlusal plane and diffe-rent sagittal skeletal patterns. The correlation between the sagittal relationship of molars and the direction of occlusal plane inclination in Angle subclasses was also explored. Results　A correlation existed between the inclination of the occlusal plane of canines and first molars and different sagittal skeletal groups (P<0.05). A correlation existed between the inclination of the occlusal plane in Angle subclass groups and non-subclass groups (P<0.05). In the Angle subclass group, a correlation existed between the bilateral molar relationships and the direction of occlusal plane inclination (P<0.05). Conclusion　Certain differences are observed in the inclination of the occlusal plane in adult patients with different sagittal skeletal patterns. The correction of the occlusal plane inclination should not be ignored in the clinical diagnosis, analysis, and treatment of patients with Angle class Ⅱ and Angle class Ⅲ, as well as their subclass.

Key words: occlusal plane cant, cone beam computed tomography, Angle class Ⅲ, Angle class Ⅱ, sagittal direction

中图分类号: 

  • R783.5

图1

在Mimics软件中创建三维方向上的参考平面a：FHP；b：CP；c：CMSP；PoR：右侧耳点；OrL：左侧眶下点。"

表 1

平面偏斜的测量标志点"

标志点含义定位方法
Po（L，R）耳点（左侧，右侧）左、右侧外耳道之最上点
Or（L，R）眶下点（左侧，右侧）左、右侧眶下缘最低点
N鼻根点鼻额缝的最前点
Ba颅底点枕骨大孔前缘之中点
R6\L6上颌第一磨牙近中颊尖顶点左、右侧上颌第一磨牙近中颊尖顶点
R3\L3上颌尖牙牙尖顶点左、右侧上颌尖牙牙尖顶点
R3D\L3D上颌尖牙牙尖顶点至FHP距离左、右上颌尖牙牙尖顶点至FHP的垂直距离
R3D\L6D上颌第一磨牙近中颊尖顶点至FHP距离左、右上颌第一磨牙近中颊尖顶点至FHP的垂直距离
OC3上颌尖牙??平面偏斜量上颌左右两侧尖牙牙尖顶点（R3、L3）至FHP的距离差，即OC3=|R3D-L3D|
OC6上颌磨牙??平面偏斜量上颌左右两侧第一磨牙近中颊尖顶点（R6、L6）至FHP的距离差，即OC6=|R6D-L6D|

图2

OC3、OC6测量示意图OC3=|R3D-L3D|；OC6=|R6D-L6D|。"

图3

??平面偏斜方向示意图以上颌尖牙为例，若R3D>L3D，??平面右侧低于左侧；若R3D<L3D，??平面右侧高于左侧。"

图4

在Mimics软件中进行三维方向定点（以右侧上颌第一磨牙近中颊尖R6点为例）a：横断面；b：冠状面；c：矢状面"

表 2

各组患者的一般资料"

基本信息Ⅰ组ⅡN组ⅡS组ⅢN组ⅢS组χ2/Z值P值
性别（n/%）男37/61.621/70.015/50.014/46.720/33.30.2670.992
女23/38.39/30.015/50.016/53.310/66.6
年龄/岁22.10±1.5120.80±1.5520.90±1.5221.70±1.8921.90±1.992.0490.091
∠ANB/°0.92±1.451.90±1.422.40±0.87-2.82±1.21-2.24±2.0514.269<0.001**
∠MP-FH/°28.40±0.9027.90±0.4529.80±0.5628.50±2.5429.00±0.61109.580.656

表 3

Ⅰ、Ⅱ、Ⅲ组OC3和OC6的比较 (mm/（Q25，Q75）)"

??平面偏斜量Ⅰ组（n=60）Ⅱ组（n=60）Ⅲ组（n=60）H值P值
OC30.30（0.18，0.5）0.40（0.23，0.68）a0.60（0.4，1.0）a,b20.06<0.001**
OC60.30（0.2，0.5）0.50（0.2，0.88）0.80（0.3，1.3）a,b12.70<0.05*

表 4

ⅡS 和ⅡN 组OC3和OC6的比较"

??平面偏斜量ⅡN（n=60）ⅡS（n=60）Z值P值
OC30.40（0.20，0.60）0.55（0.30，1.35）2.460.01*
OC60.30（0.20，0.50）0.80（0.20，1.53）3.47<0.001**

表 5

ⅢS 和ⅢN 组OC3和OC6的比较 ( mm/（Q25，Q75）)"

??平面偏斜量ⅢN（n=30）ⅢS（n=30）Z值P值
OC30.60（0.20，0.80）0.70（0.50，1.55）2.540.011*
OC60.50（0.10，1.23）0.90（0.50，1.33）1.970.049*

表 6

ⅡS 组磨牙矢状向关系与偏斜方向的相关性分析（尖牙区）"

偏斜方向例数尖牙区（n/%）P值
右侧亚类左侧亚类
+1815/83.33/16.70.001**
-122/16.710/83.3

表 7

ⅡS 组磨牙矢状向关系与偏斜方向的相关性分析（第一磨牙区）"

偏斜方向例数第一磨牙区（n/%）P值
右侧亚类左侧亚类
+1111/100.00/0.00.001**
-196/31.613/68.4

表 8

Ⅲ S 组左右侧矢状向位置与偏斜方向的相关性分析（尖牙及第一磨牙区）"

偏斜方向例数尖牙及第一磨牙区（n/%）P值
右侧亚类左侧亚类
+1919/100.00/0.00.001**
-110/0.019/100.0

表 9

OC3和OC6测量值比较"

组别OC3OC6Z值P值
Ⅰ0.30（0.18，0.50）0.30（0.20，0.50）0.520.60
ⅡN0.40（0.20，0.60）0.30（0.20，0.50）0.490.62
ⅡS0.55（0.30，1.35）0.80（0.20，1.53）0.680.50
ⅢN0.60（0.20，0.80）0.50（0.10，1.23）0.190.85
ⅢS0.70（0.50，1.55）0.90（0.50，1.33）0.080.94
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