The lingula serves as a key skeletal reference during mandibular operations such as sagittal split ramus osteotomy (SSRO) and intraoral vertical ramus osteotomy (IVRO). This research aimed to map the lingula’s position in both horizontal and vertical orientations across four distinct ramus-shape categories. Cone beam computed tomography was performed on 90 individuals (60 women and 30 men) to determine how far the lingula tip (Li) lies from the anterior border (AB), posterior border (PB), sigmoid notch (SN), and inferior border (IB) of the ramus. Its proportional placement was expressed by the Li–AB/AB–PB and Li–SN/SN–IB ratios. Lingula configurations were sorted into triangular, truncated, nodular, and assimilated types. Statistical testing was used to assess shape-related and sex-related variations. The average Li–AB measurement was 18.88 mm, and this value was significantly larger in the truncated form than in the remaining three shapes. The Li–PB distance averaged 15.23 mm, showing no shape-based differences. The mean Li–AB/AB–PB proportion was 55.3%, with the truncated type reaching 57.2%, exceeding both the nodular (54%) and assimilated (50.4%) patterns. The Li–SN and Li–IB values were 19.95 mm and 31.34 mm, respectively, without meaningful variation among the 4 lingula types. The Li–SN/SN–IB proportion averaged 38.5%. No measurements differed between male and female participants. The four lingula forms showed significant variation in the location of the Li, which tended to lie superior and posterior to the ramus midpoint. Awareness of these shape-dependent differences is essential when performing SSRO or IVRO.
