Evaluation of the position and morphology of tongue and hyoid bone in skeletal Class II malocclusion based on cone beam computed tomography.

Background: The aim of the study was to analyze the morphology and position of the tongue and hyoid bone in skeletal Class II patients with different vertical growth patterns by cone beam computed tomography in comparison to skeletal Class I patients.

Methods: Ninety subjects with malocclusion were divided into skeletal Class II and Class I groups by ANB angles. Based on different vertical growth patterns, subjects in each group were divided into 3 subgroups: high-angle group (MP-FH ≥ 32.0°), average-angle group (22.0° ≤ MP-FH < 32°) and low-angle group (MP-FH < 22°). The position and morphology of the tongue and hyoid bone were evaluated in the cone beam computed tomography images. The independent Student's t-test was used to compare the position and morphology of the tongue and hyoid bone between skeletal Class I and Class II groups. One-way analysis of variance (ANOVA) was used to compare the measurement indexes of different vertical facial patterns in each group.

Results: Patients in skeletal Class II group had lower tongue posture, and the tongue body was smaller than that of those in the Class I group (P < 0.05). The position of the hyoid bone was lower in the skeletal Class II group than in Class I group (P < 0.05). The tongue length and H-Me in the skeletal Class I group with a low angle were significantly larger than those with an average angle and high angle (P < 0.05). There was no significant difference in the position or morphology of the tongue and hyoid bone in the skeletal Class II group with different vertical facial patterns (P > 0.05).

Conclusion: Patients with skeletal Class II malocclusion have lower tongue posture, a smaller tongue body, and greater occurrence of posterior inferior hyoid bone position than skeletal Class I patients. The length of the mandibular body in skeletal Class I patients with a horizontal growth type is longer. The position and morphology of the tongue and hyoid bone were not greatly affected by vertical facial development in skeletal Class II patients.