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.