Cephalometric analysis of the position of the hyoid bone and tongue in patients with different types of facial skeletal structure

Background. Modern development of personalized medicine dictates the advisability of a detailed study of the variants of individual-typological variability of the structures of the craniofacial region, as well as the patterns of their interrelations in assessing the harmonious development of the dentoalveolar system. Expanding knowledge about the topographic and anatomical features of the position of the hyoid bone and tongue, as well as their relationships with other structures of the maxillofacial region using digital technologies, will allow individual lizing diagnostics and increasing the effectiveness of therapeutic measures of dentists and related specialists.

Goal. Identification of individual-typological variability of the position of the hyoid bone and tongue in adult patients with physiological types of bite based on the results of cephalometric analysis.

Materials and methods. Cephalometric analysis of the TRG of the head in the lateral projection (OnDemand3D™ Dental software, CEPH module) was performed in 106 patients aged 18–32 years with physiological types of occlusion. The patients, taking into account the value of the angle of the lower jaw, were divided into three groups: Group 1 – patients (n = 29) with a vertical type of facial skeleton growth; Group 2 – patients (n = 39) with a neutral type of facial skull structure; Group 3 – patients (n = 38) with a horizontal type of facial skeleton growth. To determine the topography of the hyoid bone, linear (H-Me, H-CIII, CIII-Me, H-Н’, H-Х, H-Y) and angular (<S-N-H, < Ba-S-N) indicators were identified, characterizing the position of the os hyoideum relative to the cervical spine and bones of the facial skull. When analyzing the morphometric values of the tongue, the method of T.M. Graber (1997) was used, establishing its length (TGL), thickness (TsurA), and when assessing the position of the tongue, the distance between points on the lateral surfaces of the tongue and the dome of the palate in the sagittal plane along the lines T1-T7.

Results. In people with the horizontal growth type, the distance H-Me (according to Me) exceeds similar values in people with the neutral type by 1.52 (p≤0.05) times, in the vertical type – by 1.50 (p≤0.05) times, while the increase in the radiographic length of the tongue TGL (according to Me) is not reliable (p≥0.05), and is 1.10 and 1.05 times, respectively. The prevalence of the linear values H-Me and TGL in people of the 3rd group is due to the tendency of the lower jaw to the horizontal growth type.

Conclusions. The stability of the hyoid bone topography in patients with physiological occlusion is affected by the inclination of the lower jaw, the growth type (vertical, neutral, horizontal) of the facial part of the head, as well as the position of the head and neck (postural compensation). Studying the position of the tongue on CBCT of the skull in sagittal, frontal projections by assessing the degree of filling of its dome of the palate is an important predictive diagnostic criterion indicating the presence/absence of anatomical and functional disorders in the dental apparatus.

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