WITS APPRAISAL

The name Wits is short for Witwatersrand, which is a University in South

Africa. Jacobsen in 1975 published an article called "The Wits appraisal of
jaw disharmony"
ANB angle

the anb angle commonly is commonly used for measuring

the anteroposterior disharmony of the jaws .
the ANB angle in normal occlusion is 2 degrees , greater
than this value indicate tendency toward class ii jaw
disharmony

while smaller angles reflect class iii jaw disharmony

The purpose of the Wits appraisal is to identify instances in which the ANB
reading does not
accurately reflect the extent of anteroposterior jaw dysplasia.
 there is some situations where this angle cannot be relied
on for example
relating the Jaws to the cranial reference planes is
faced with the variations in

1- the anteroposterior spatial relationship of the jaws relative To the

nasion
the relative anteroposterior positioning of the dental bases in the
craniofacial complex may directly influence the ANB Reading
 in figure A diagrammatic representation of tracing for normal
occlusion

in figure B the denture bases are retro positioned and the ANB
angle is reduced from 2 degree to -2 ° . while the relationship
between the jaws remain unchanged.

in figure C the jaws are positioned forward and the ANB angle is
increased from 2 degree to 5 degrees . while the relationship
between the jaws remain unchanged.
2- rotational effect of the jaws

clockwise or counterclockwise rotation of the jaws relative

to cranial reference planes also affect the ANB angle
Reading
in figure b the relationship of the jaws to each other
is unchanged but the jaws are rotated in
counterclockwise Direction relative to the SN plane

the rotation had the effect of producing class iii

jaw relationship. the ANB angle is reduced from 2 °
to -5 ° .

in fig c the clockwise rotation increase the ANB

angle from 2 ° to 8 ° , despite the jaws maintain
identical relationship to each other.
method of appraisal of jaw disharmony
 by drawing perpendicular lines from points A and B onto the occlusal
plane

the points of contact on the occlusal plane are labelled AO and BO .

 in a sample of 21 adult males the point BO was
approximately 1 mm ahead of the point AO .

in a simple of 25 adult females The points AO , BO were

Generally coinceded .

the average jaw relationship according to Witt's Reading

is - 1 mm for men and 0 mm for women .

the greater the witts reading deviation from these values

the greater the horizontal anteroposterior jaw disharmony
In skeletal Class II jaw dyplasias, point BO would be located

well behind point AO (a positive reading) whereas in skeletal

Class Ill jaw disharmonies, the “Wits” reading would be

negative, namely, point BO being forward of’ point AO.

Application of the
witts' appraisal
“
Class ii malocclusion and the
normal occlusion. The ANB in
each instance is 7 degrees
According to the “Wits” ap­
praisal, however, the Class ii
reading is 10 mm (mark­edly
Class II), whereas the reading
for the occlusion is 0 mm
“
 A) Class II ANB
6 and “Wits”
6mm • B) Same
ANB and but
“Wits” is 0 mm. 
“
A) Mild Class III
with ANB -1.5
and “Wits” -
-1.5mm
B) B) Severe
Class III
where ANB is
-1 and but
“Wits” is -12
 “
Class II
malocclusion
tracings. The
ANB instance
was 9 degrees
The Wits reading
in A and B,
however, Were 8
and 2.5 mm
Shortcomings
of ANB Angle
Since its introduction into cephalometry in
1952, the ANB angle is probably the most
popular method
of evaluating the anteroposterior
relationship of mandible to maxilla. In
spite of its shortcomings, it
is still used by many dentistes
Those shortcomings were recognized as early as
1955 by Jenkins,who elected to use the
functional occlusal plane (OP) as a reference base
for the measurement of jaw disharmony. He
reasoned that all phases of dentistry traditionally
use this plane as a primary plane of orientation,
since all masticatory forces are focused on and
intimately related to it. He argued that even Angle
used this plane of reference for his classical
classification of malocclusion.
Jenkins established the
“a” plane drawn through point A at
right angles to the OP, and then
measured from the “a” plane to
point B, Gn, and the mandibular
incisor edge
To predict growth patterns of the jaws, Harvold likewise used an
OP. He projected points A and B onto the OP and named the
resultant measurement the A-B difference. A negative value is
assigned to measurements in which point B is posterior to point A.
From 6 to 9 years of age, point B moves forward relative to point
A;
however, Harvold recognized the effect of the inclination of the OP
on the A-B reading, which in extreme cases could change so much
that the projection of point B could fall behind point A.
Taylor in 1969 also pointed out that the ANB angle did not
always indicate true apical base relationship.
Varied horizontal discrepancies of points A and B could
give the same ANB measurement because variation in the
vertical distance from nasion could compensate for other
variation.
A relative forward or backward position of nasion would
likewise change the ANB reading
Beatty in 1975 reported that the ANB angle is not always an accurate method of establishing
the actual amount of apical base divergence. As an alternative to the ANB angle, he devised
the AXD angle, where point X is formed by projecting point A onto a
perpendicular to the SN line, and point D is located in the bony symphysis as described by
Steiner.
The two variables, nasion and point B, were eliminated. He also introduced a linear
measurement,
AD, to describe the anteroposterior relationship of the jaws.
follow up studies on ANB and wits appraisal
Kim and Vietas :
Mean reading in
adolescent white
control group of 51
boys and 51 girls with
normal occlusion is
comparable values
with the Jacobson
McNamara and Ellis
recorded the mean
values –o.72 in men
and + 0.93 in women
Ferrizzini: The
ANB angle is not
only dependant on
anteroposterior
relationship of jaws
but on the
inclination of the
palatal plane,
maxillary
prognathism, and
vertical facial
dimension. 
Binder recognized the geometric
effects on the ANB angle He
showed that for every 5 mm of
anterior displacement
horizontally, the ANB angle
changed 2.5 degree
 Bishara et al ( AJO –
1983) showed the effect
on the ANB angle of
moving nasion forward
or backward 0.5 inch
(12.7mm), and
vertically up or down
by the same amount.
 A 5 mm upward
displacement of nasion
altered the ANB angle
0.5 degrees, a
downward
displacement of Nasion
changed the ANB angle
1 degree
Sperry ;
anteroposterior
dysplasia should be
assessed relative to the
cant of the OP, and that
true dental base
discrepancies can be
noted relative to the OP.
Roth and Martina et al
recognized the ANB
angle invalid measure
of sagittal skeletal
disharmony. The mean
value measured by him
is 0.27 which
correspond to the mean
value of Jacobson
During the investigation
there is significant mean
annual change of 0.59 mm
in the wits measurement.
The angle A-B occlusal
decreased 0.29 degrees per
year during the same
period.
This is contrary to the
finding of the Bishara et al
who concluded that the
ANB angle significantly
change with age, where as
wits appraisal does not.
 😉References
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Thanks!
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