Marcello M. | March 3, 2026
The Wits appraisal is one of the most useful complementary measurements for evaluating sagittal jaw relationships. While the ANB angle remains widely used, Wits was introduced to reduce some of its geometric limitations.
Simple in concept but powerful in interpretation, Wits provides an alternative way to assess the anteroposterior relationship between the maxilla and mandible.
The Wits appraisal measures the linear distance between two projected skeletal points on the functional occlusal plane:
The horizontal distance between AO and BO represents the sagittal discrepancy.
As with all cephalometric norms, these values are guidelines — not absolute diagnostic rules.
The ANB angle is influenced by several geometric factors:
Because ANB is angular and dependent on the SN plane, changes in cranial base orientation can distort sagittal interpretation.
The Wits appraisal was designed to minimize these influences by using the occlusal plane as a reference instead of the cranial base.
In many situations, Wits can confirm or question the sagittal diagnosis suggested by ANB.
A patient presents with an ANB of 5°, suggesting skeletal Class II. However, Wits measures only +1 mm.
Clinical examination shows mild convexity but balanced lower facial height.
In this case, the increased ANB may be influenced by vertical growth pattern or cranial base configuration, while Wits suggests a milder sagittal discrepancy.
The discrepancy between ANB and Wits provides diagnostic insight rather than confusion.
Despite its advantages, Wits is not free from limitations:
Because the occlusal plane is a dental reference, any dental compensation can influence the measurement.
The Wits appraisal should not replace ANB.
Instead, the two measurements are best interpreted together.
Disagreement often reveals important skeletal dynamics.
Digital cephalometric software improves the reproducibility of Wits by standardizing occlusal plane construction and point projection.
Instant recalculation also allows clinicians to explore how slight changes in plane definition affect sagittal interpretation.
The Wits appraisal is a valuable sagittal indicator that complements angular measurements such as ANB.
By reducing cranial base influence and providing a linear perspective, it enhances diagnostic depth in everyday orthodontic practice.
Like all cephalometric values, Wits is not a rule — it is a tool. Its true power lies in thoughtful interpretation within the full clinical context.
