Wits Appraisal

Marcello M. | July 8, 2025

A Key Indicator of Skeletal Anteroposterior Relationships

The Wits appraisal is a widely used cephalometric measurement that helps assess the anteroposterior skeletal relationship between the maxilla and the mandible. It serves as a valuable complement to angular measurements such as SNA, SNB, and ANB, providing a more occlusal and functional perspective of jaw alignment.

🔹 What is the Wits Appraisal?

The Wits appraisal was introduced by Jacobson in 1975. It involves projecting cephalometric points A (maxilla) and B (mandible) perpendicularly onto the functional occlusal plane, creating the points AO and BO. The linear distance between AO and BO reflects the jaw disharmony in the sagittal plane.

📏 Reference Values

  • Boys: +1 mm
  • Girls: 0 mm

These are standard normative values, though slight variations may occur based on the population studied.

🔍 Clinical Interpretation

Wits Value Interpretation
> +2 mm Class II skeletal pattern (mandibular retrusion or maxillary protrusion)
≈ 0 mm Class I skeletal relationship (balanced maxilla and mandible)
< -2 mm Class III skeletal pattern (mandibular protrusion or maxillary retrusion)

Unlike the ANB angle, the Wits measurement is not affected by cranial base rotation or anterior cranial morphology, making it especially useful in borderline or ambiguous cases.

🧠 Why Is Wits Appraisal Important?

  • Provides a linear complement to angular values like ANB.
  • Relates to the actual occlusal plane, giving insight into how skeletal discrepancies affect function.
  • Distinguishes between skeletal and dental origins of malocclusions, essential for treatment planning.

💡 Wits Appraisal in OrthoAnalyser

With OrthoAnalyser, the Wits value is automatically calculated once key points (A, B, and the occlusal plane) are identified. The system instantly generates:

  • The exact measured value
  • The standard reference based on patient gender
  • A visual interpretation and color-coded report
  • Clinical recommendations based on the deviation

👨‍⚕️ When to Use the Wits Appraisal?

  • Initial diagnosis: To clarify the skeletal cause of a malocclusion.
  • Growth monitoring: Evaluate changes in jaw position during orthopedic treatment in growing patients.
  • Surgical planning: Quantify the discrepancy to correct in orthognathic cases.

✅ Conclusion

The Wits appraisal is a powerful diagnostic tool that offers a clear and functionally relevant view of jaw relationships. When integrated into a digital platform like OrthoAnalyser, it becomes easier to interpret, share, and apply in clinical decision-making.

Streamline your diagnostics with Wits analysis in OrthoAnalyser and enhance the accuracy of your orthodontic assessments.