Abstract
BACKGROUND: Tongue position plays a vital role in craniofacial development, influencing skeletal structure and dental alignment. This study aims to assess tongue position and investigate its relationship with various dentofacial skeletal patterns using a novel cephalometric analysis method. METHODS: This cross-sectional study included 550 orthodontic patients (ages 6-50) with pre-treatment lateral cephalograms. Participants were divided into mixed dentition (6-11 years) and permanent dentition (12-50 years) groups and classified into three sagittal skeletal patterns (Class I, II, III) based on ANB angle and three vertical patterns (high, average, low angle) based on FMA angle. Statistical analyses were selected according to data distribution and variance. Correlation analysis included Spearman's rank and partial correlation, the latter of which adjusted for age, FMA, and adenotonsillar hypertrophy. RESULTS: In the mixed dentition group, tongue position showed no significant variation by vertical pattern. In the permanent group, patients with low angles had a lower tongue tip. Class III patients exhibited an anterior and inferior tongue tip, while Class II patients had a higher tongue tip in the permanent group, after controlling for adenotonsillar hypertrophy, age, and FMA. CONCLUSIONS: This study introduces a simplified method for measuring tongue position. A superior tongue tip correlates with skeletal Class II malocclusion, while an anterior and inferior tongue tip and lower tongue position are linked to skeletal Class III malocclusion. A lower tongue tip is also associated with low angle skeletal patterns.