Wits Analysis

Wits Analysis
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 Comparison between 2D and 3D Cephalometric Analyses
and Case study – using CephX in imaging centers

Wits Analysis

Wits Analysis
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 Root Inclination and Today’s Orthodontics
and History of Cephalometric Analysis – Using Our Heads

Ortho Technology- Make your Job Easier

Ortho Technology- Make your Job Easier

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 Reticent Orthodontic Patients – What’s On Their Minds?
and How do patients choose their Orthodontist

Ortho Technology- Make your Job Easier

Ortho Technology- Make your Job Easier

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 The History of Orthodontics
and Are Clear Aligners Right for Your Patient?

Orthodontic Trends in 2015

 Orthodontic Trends

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.

Implants

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.

Group-Practices

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.

Orthodontic Trends

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