Wits Analysis

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The wits appraisal and analysis has been around in orthodontics since 1952. The wits appraisal has become one of the most popular practices in evaluating the cephalometric evaluation of the anteroposterior relationship of the apical bases. Along with multiple other cephalometric analyses such as Rickett’s analysis the Wits analysis is still being used in practice today.

What is the Wit’s Appraisal?

The Wits appraisal was created to relate patient’s jaws anteroposteriorly to the cranial reference planes. This presents an inherent consistency of variations because of the craniofacial physiognomy.

The appraisal was intended to eliminate such inherent variations and the problems associated with relying on the ANB angle (A point nasion B point). Wits decided to come up with an alternative method to assess the sagittal jaw relationship. This method is independent of apical base relationships to cranial landmarks.

The appraisal entails projecting points A and B in two perpendicular lines, along the functional occlusal plane. Once these points have been projected they’re called AO and BO. Once you’ve measured the distance between points AO and BO the plane in between is what’s referred to as the Wit’s Appraisal.

The Original Study

The original study was performed on caucasian adults, all of whom showcased excellent occlusions. This meaning in female subjects the distance between AO and BO was exactly zero, whereas in male instances the average BO was one millimeter anterior to the AO, giving them a wits reading of approximately -1 millimeter.

This study was originally performed on Class I type malocclusions, in these cases we typically see points AO and BO coinciding in average. On the other hand, class II type in skeletal dysplasia point BO is typically posterior to point AO hence giving a positive wits appraisal. In the third scenario a class III skeletal disharmony, point AO is forward from point BO making a negative wits appraisal.

Past Studies

Ever since the introduction of the wits analysis reading, numerous papers have been written attempting to describe different populations and classes using the wits analysis measurement. For instance Kim and Vietas’ study analyzed A-P dysplasia indicators. In this study they found that the mean measurement of the Wits appraisal within their control group of adolescent caucasian males and females was comparable to previous studies with normal occlusions.

The study performed by the Foundation for Orthodontic Research by McNamara and Ellis comprised of 41 males and 81 females all with ideal facial aesthetics and normal untreated class I relationships. The recorded means found in this study were -0.72 for males and +0.93 for females. Similar studies in the South Wales population of England found nearly identical results using 25 head films of 15 year old females.

In a study by Binder in 1979, he randomly varied the positions of the points, angles, and lines on the cephalometric drawing. Regardless of the arbitrary lines, they found the same ANB angles and geometric effects. He showed in this study that for every 5 millimeter anterior displacement horizontally the ANB angle was changed by 2.5 degrees. He also utilized an upward displacement of nasion altering the role of the ANB angle by 1 degree.

All of the above findings reflect no correlations between two consecutive values when the wits appraisal is negative. When the ANB measurement is less than 4 degrees however, the wits analysis could be either positive or negative. When the ANB angle is somewhere between 4 and 8 degrees then all wits measurements will be positive. When both values are positive and the ANB measurements ranged from 1 degree to 8 degrees, the ability to predict the wits measurement is with 28% accuracy.

All in all, what the wits analysis has given us is the linear measurement, an adjunctive diagnostic aid to assess the extent of anteroposterior skeletal dysplasia and determining the reliability of the ANB angle. Today we have tools such as CephX to our advantage, this makes it easier for dentists and orthodontists to perform cephalometric analyses and tracing with complete accuracy and track progress.

Read more about Case study – using CephX in imaging centers
and Retainers and Maintenance: Preserving Your Patients’ Investment

Ortho Technology- Make your Job Easier

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With all of the new technology and resources available to us, orthodontic practices have changed quite drastically over the last couple decades.

Not all that long ago, the standard for care was much different in orthodontics. Standard ‘one-size-fits-all’, procedures brackets and wires that were all too big, and frequent tooth extractions were all common occurrences.

Now many orthodontists are adopting the new technology trends to keep their customers happy with their treatment results, and also to make their own lives a whole lot more simple. This is also an essential criteria for dentists, when suggesting orthodontists in the area to their clients for future treatment. They’re looking for orthodontic practices which are using the latest technology and treatments and proving good outcomes.

The recent modern technologies in orthodontics have allowed practices to achieve far greater results, with less discomfort to the patients, and with much greater ease to the orthodontist performing the treatment as well. Check out these ortho technologies that can make your job a whole lot easier.

Cone Beam CT Scanners

Talk about a revolution. Ever since the introduction of the cone beam CT, the diagnosis and treatment planning for patients today has been changed completely. The 3D images of a patient’s full skull, jaw, and underlying bone structure gives the orthodontist a much clearer and full picture of everything that’s going on to reveal more detail about the patient’s symptoms.

With this newfound ability to manipulate and view these images from any particular angle, the CT scanners are a great tool to plan and evaluate treatments. While there’s been debate recently about the risk of radiation with in-office CT scans, studies have shown that a typical 5-second Cone Beam CT Scan actually exposes the patient to the equivalent radiation as two conventional X-rays. That being said the benefits, of the CBCT greatly outweigh the potential risks in nearly every situation.

Custom Smile Design

Custom Smile Design is one of the newer and more exciting orthodontic technologies of the bunch, consisting of a rather unique method to indirectly bond custom-designed brackets and wires. The system uses 3D treatment planning software and actual brackets and wired which are customized personally to each individual patient.

This technology takes an average set of impressions and places it into a 3D virtual model of the patients teeth. Once it’s in this form the orthodontist can them make any modifications necessary to create the patient’s ideal smile. The brackets and wires are manufactured according to this 3D model by using precision placement guides (aka jigs). Not only is this treatment much easier and efficient for the orthodontist to perform, but much more comfortable for the patient as well.

Clear Brackets

Since the invention of clear brackets, braces usage has sprung greatly. Today, many people are desperate to improve their smile, yet not desperate to the fact that they’ll put up with a metal mouth full of wire to get there. Up until lately products like invisalign, clear aligners have been popular on the market to resolve this issue.

The problem with clear aligners is that they’re ineffective for achieving great tooth movement, and they take a much longer time to see results than regular braces. Innovative technologies like Damon Clear uses an invisible bracket system that doesn’t stain or discolor. This allows orthodontists to provide their patients with a comfortable alternative to braces that still works speedily and effectively without sacrificing your looks.

As many orthodontic treatments are evolving to become more innovative and modern, orthodontic practices must keep up to date with the latest management technologies as well. Many practices are moving all of their storage and dental images into the cloud for convenience, and better access. CephX provides solutions for cephalometric analyses and image storage, giving you complete and accurate analyses, photos, and x-rays available anywhere you can access the cloud.

What other ways have orthodontic innovations and new technology trends made your job easier?

Read more about Wits Analysis
and Top Dental Products for 2015

Orthodontic Trends in 2015

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In the past 20 years the orthodontic industry has experienced massive growth. Especially in the adult market, typically when people think about orthodontists they think about small kids wearing braces. Today however, this trend, along with many others, is changing. The overall number of adult patients has increased by 23%, and now one in every five orthodontic patients is an adult.

What are these new orthodontic trends hitting the industry in 2015? And how will they affect your practice? Keep on reading to find out.

Patient-Centric Experience

This 2015 trend is not just one we’re seeing in the orthodontist’s office. Industries everywhere are shifting toward a more user-centered trend. With the increase in options, and the world wide web making these options all the more accessible it’s increasingly important to guarantee your patients with a top of the line experience.

In addition, patients are spending a lot more out of pocket these days to come and see an orthodontist. This makes them become more vocal about receiving the exact treatment and and experience they want from their orthodontist. Orthodontist’s should be proactive in order to provide the patients with everything before they even knew they needed it, answer questions before they can even think of them, and allow no time for any second thoughts.


While orthodontic implants are nothing new, the trend that we will be seeing is more and more artificial teeth and surgical techniques to implement these implants. With new technologies and capabilities the entire process of obtaining implants is a lot more efficient and cost effective making it a more popular option.

The World Implant Orthodontic Conference 2015 is set to take place in Dubai in November 2015. Here experts will showcase all of the new research and technology that’s being developed to help improve this procedure even further. If your practice isn’t already taking advantage of the orthodontic implant trend, you could be missing out on a lot of potential business. 1 out of 5 americans over the age of 65 have lost all of their teeth due to decay and this is an entire new market for you to poach.


In 2015 this trend is certainly growing because of the sheer cost of running your own solo orthodontic practice. You may find moving to a group practice not only a safer route for your wallet, but also for insurance purposes, marketing, payroll, scale of equipment, etc.

Whether you’re new to the orthodontic field and looking to join in on an existing practice, or you’ve been trying the solo route for awhile and you’re ready for a change, there are many benefits to be found in this popular trend.

Preventative Care

Going along with the notion of proactivity which we spoke about earlier, preventative care is another trend that orthodontic practices can not ignore indeed. Instead of focusing on fixing problems once they’ve already occured, think like we’re living in 2015 and act to prevent measures in the future.

The 2015 trend will extend not only to warning patients to take care of their teeth by giving special instructions on how to prevent and avoid periodontal disease, enamel erosion, etc. But also using different technologies to track progress and see what measures need to be taken in advance to treat a patient.

CephX, located in the cloud, allows patients and orthodontists to view cephalometric analyses and other dental images anywhere with an internet connection to find potential dangers before they occur and track progress to be on top of treatment methods.

Read more about Retainers and Maintenance: Preserving Your Patients’ Investment
and Digital Dentistry: How it Increases Patient Quality of Care

How to Start A Dental Office

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Starting your own dental office really is essentially starting off with a brand new business. In the professional lives of a dentist this decision, while you may have had a vision or it may have been one of your goals for awhile, is one of the biggest career steps you may ever take.

For this reason it is all the more important to begin setting these goals early, and analyzing the costs and benefits of going into the dental business beforehand. Unfortunately these days it’s all too common to see dentists opening a new practice without a basic understanding of what they need to start and make their business fulfill the vision and become successful.

While many dental professional are focused purely on patients and other dental costs right from the start, their business foundation is clearly missing to get the practice on the right foot. Successful practices know the majority of the hard work takes place before you’ve even obtained your first patients. This guide on how to start a dental office should help highlight the key areas you should focus on in the beginning when starting your own dental business.

Decide who’s on your team

In the dental setting that we’re currently living in today, dentists have infinite resources available to them to help get off to a good start. Right off the bat, it’s important to assemble this team of valuable resources to ensure you’ve got all of the bases covered for your future practice.

This team could consist of future employees looking to help with the business foundations; other business with a similar vision that we could learn from, finance specialists to help you evaluate your costs, maybe even a mentor etc. This way you don’t have to feel like all of this weight and pressure is purely on your shoulders. Once you have a team to rely on, you can divvy up the tasks amongst teammates, and most importantly utilize their knowledge, experience, and insight in the field to ask great questions and propel yourself forward.

You never know who on your team could come up with a great lead for quality real estate, or inspire great ideas when goal setting. Each team member is a great asset in their own unique way, but make sure you keep the discussion open to everyone because you might not always know where the best vision may come from within the practice.

Develop your business plan

Now that you’ve assembled your top-notch team filled of expertise, and swimming with experience, it’s time to put all of these minds to good use through the development of your practice’s strategic business plan.

If you remember just one thing from this guide in starting your own dental practice, remember this: the five components that fuel every dental practice behind the scenes. Each of these components should be highlighted respectively in your business plan to find funding.


In this section it’s important to talk about how many treatment rooms your facility will obtain, in which hours you will work, and how you plan on retaining your patients over a long period of time. These are important for funders to see that you have a plan for the long run, not just the initial startup of your business.


Your revenue section will include your estimated number of patients, the rate of growth you expect amongst new patients, as well as dollars per hour. This is where your financial expertise from your power team will come into play helping you assess your financial policy.

Managing Expenses

Predicting your overhead and at which point you’ll break-even is essential for funders to see their payback. Make sure to emphasize how much healthy cash flow you’ll be seeing in order to pay for any bills acquired and debts along the way.


While we may have discussed number of patients, this section will delve more deeply into demographics of patients. Depending on your location your demographic may differ greatly. The technology you invest in, and the type of periodontal program you implement will all be dependent upon this demographic so it’s important to establish this in the business plan.


Future employees are obviously a vital part of your dental practice, but where will you find them? What specific personality traits are you looking for in the hiring process? These are all important questions to ask yourself before obtaining team members.

Through this business plan your lenders get a more thorough idea and further understanding of your goals and vision. This process also shows them that you’ve done your due diligence and research. The more information you show i.e. demographics, location, specific equipment costs etc., the better and more professional your business plan looks which can assure you more financing to get your dental practice off the ground.

Defining your goals

Defining your goals consists of both goal setting, and goal writing, two steps which are often times very overlooked in the scheme of things. However overlooked, this is still a fundamental part in establishing a successful practice.

To give you some perspective, imagine all of the big decisions that need to be made when starting any business. You must decide where you want to live, who’s your main clientele, how much you would like to earn etc. All of these major decisions need a premise in which to be made off of.

Your goals are a perfect outlet in which to base these decisions. Your goals give you an indication of where you will be in the coming years of your career, in order to guide and measure that you’re growing in the right direction.

So before you start your dental business, do yourself a favor and write down these goals. Try out goal setting exercises that line up with your vision. Make sure they’re measurable, easy to obtain, relevant to your business, and something you can keep track of. While you’re making these tough decisions at the start of your practice you can use these goal setting practices to help guide your decisions and make sure you wind up where you want to be.

Revenue Drivers

Without a doubt when it comes to your dental practice, your patients are going to be your #1 factor in driving your revenue. Every businessman knows without clients it doesn’t matter how good of a facility you have or how strong your team is. In order to drive new patients you’ll need to spend a majority of your team’s efforts in the marketing realm.

Not only effort and energy but also financially, external marketing is a chunk of your budget that deserves a fair concentration. The most successful practices see cash flow in the beginning right up front and begin to meet payroll. For many practices it’s beneficial to find an outside patient financing partner who can help you to make the most out of your resources without putting you at risk for your non-paying patients.

It’s also important to remember as a new dental clinic you’ll need to be bringing in about 50-60 new patients every month to keep up with those goals you set and grow optimally.

Once you’ve thought about and put into practice all of the above, in theory you’re ready to hop right in and start your own dental practice. Now in reality, nothing works that easily and it will take your full will and effort to make these dreams become that reality. What other tips would be helpful to assess before starting your own practice? We’d love to hear your experiences!

Read more about Cephalometric Analysis
and Orthodontic Services