The “Wits” appraisal of jaw disharmony
ABSTRACT Alex Jacobson was born in South Africa and completed his dental education there in 1941. He received an MS degree in orthodontics from the University of Illinois in Chicago in 1953 and then returned to South Africa to private practice. He was head of the orthodontic department at the University of Witwatersrand (known as Wits, hence the name “Wits” analysis). He received an MDS degree in 1961 and a PhD in physical anthropology in 1978 and was named chair of the orthodontic department at the University of Alabama at Birmingham in 1976. He returned to private practice and part-time teaching again in 1989. He has written or edited 3 textbooks and about 100 articles in refereed journals, and is editor of the Reviews and Abstracts section of the Journal.
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ABSTRACT: Abstract Objective: To evaluate the treatment effects of a hybrid hyrax-facemask (FM) combination in growing Class III patients. Material and Methods: A sample of 16 prepubertal patients (mean age, 9.5 ± 1.6 years) was investigated by means of pre- and posttreatment cephalograms. The treatment comprised rapid palatal expansion with a hybrid hyrax, a bone- and toothborne device. Simultaneously, maxillary protraction using an FM was performed. Mean treatment duration was 5.8 ± 1.6 months. The treatment group was compared with a matched control group of 16 untreated Class III subjects. Statistical comparisons were performed with the Mann-Whitney U-test. Results: Significant improvement in skeletal sagittal values could be observed in the treatment group over controls: SNA: 2.4°, SNB: -1.7°, Co-Gn: -2.3 mm, Wits appraisal: 4.5 mm. Regarding vertical changes, maintenance of vertical growth was obtained as shown by a small nonsignificant increase of FMA and a small significant decrease of the Co-Go-Me angle. Conclusions: The hybrid hyrax-FM combination was found to be effective for orthopedic treatment in growing Class III patients in the short term. Favorable skeletal changes were observed both in the maxilla and in the mandible. No dentoalveolar compensations were found.The Angle Orthodontist 11/2014; · 1.18 Impact Factor
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ABSTRACT: Background: The individual variations in patients with skeletal class III malocclusions affect the cephalometric indices e.g., the curve of cranial base and anteroposterior displacement of nasion and the SN inclination can affect the cephalometric indices such as the ANB angle. Objective: The aim of this study was to compare some cephalometric indices in skeletal class III with skeletal class I patients as control group. Methods: Samples in this Case-control study were 65 lateral cephalometric radiographs randomly selected before the orthodontic treatment. The samples were divided into two study and control groups with skeletal class III relationship (ANB<1) and skeletal class I relationship (2<ANB<4), respectively. Cephalometric radiographs were traced and the statistical results obtained by the correlation coefficient test between the cephalometric variables and the t-test between the skeletal classes I & III while a p value <0.05 was considered as statistically significant. Findings: The mean variables of SNA, Wits, Jaraback index, GOGn-SN, IMPA, overbite, lower facial height, and Mandibular length were indicative of significant differences between two skeletal class I & III groups. The Wits appraisal showed a significant positive relation with ANB (P<0.001, r= 0.71) and a significant negative relation with FMA(P=0.01, r= -0.41), lower facial height (P=0.02, r= -0.37), anterior facial height (P<0.001, r= -0.47), and the mandibular length (P=0.02, r= -0.37). Conclusion: According to the data found in the present study, the Wits appraisal is a valuable diagnostic index for evaluating the intensity or anteroposterior jaw discrepancy in skeletal class III patients. From the jaw position and size point of view, the maxillary retrognathism and the mandibular length are the main determining factors for maxilomandibular relationship, respectively. The dental compensation for skeletal class III patients is more associated with the mandibular incisor retrusion rather that the maxillary incisors protrusion.
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ABSTRACT: Lateral cephalometric analysis is an integral part of orthodontic diagnosis and treatment planning. The usual practice is to compare the cephalometric analysis of the patient with the established normal values. Since craniofacial morphology varies among different populations therefore it becomes important to establish the cephalometric norms of all cephalometric analyses, for every population. The aims of this study were to evaluate the validity of newly introduced cephalometric analysis using W angle and YEN angle in Pakistani and Bangladeshi samples and to compare both populations with commonly used sagittal measurements. In this study 200 lateral cephalograms of Bangladeshi population and 209 of Pakistani population were traced for ANB, Wits appraisal, Beta angle, W angle and YEN angle. Patients were divided into skeletal Class I, II and III groups. A significant difference was found in all performed measurements among skeletal groups in both the samples (p<0.001). Mean values of ANB, Wits appraisal and YEN angle differed significantly between both the samples in class I and class II subjects (p<0.05). No statistically significant difference was found in Beta angle and W angle values. The norm for W angle was established for the Pakistani (54.5±3) and Bangladeshi population (55±3). YEN angle norm for the Pakistani population was found to be 119.5±3, and for the Bangladeshi population it was 120.5±3. These results suggest that all the performed analyses are valid and can be used to diagnose skeletal discrepancies and diagnosis based on single analysis is insufficient. Bangladeshi and Pakistani populations differ in craniofacial morphology; therefore their own cephalometric norms should be followed for treatment of patients belonging to their respective populations.Journal of Hard Tissue Biology 07/2014; 23(3):351-356. · 0.17 Impact Factor