Assessment of Sagittal Jaw Relationships Determined By ‘Wits Appraisal’ From Pre-Treatment Lateral Cephalic metric Radiograph of Orthodontic Patients Visiting Jimma Medical Center, Jimma Zone, Southwest Ethiopia, 2022.

Abstract

BACKGROUND- Cephalometric analysis aims to determine skeletal and dental relationships. The ANB angle, initially suggested by Rediel and applied by Steiner is the most used angle in establishing the anteroposterior relationship of the mandible to the maxilla. However, limitations to the accuracy of the ANB angle for this purpose have been reported. To avoid these potential sources of inaccuracy a diagnostic tool is introduced by Jenkins and later modified by Jacobson and became known as the “Wits appraisal”. Wits appraisal is a common linear cephalometric analytic tool, which it has been reported to be superior to angular cephalometric measures as it is not dependent on per cranial structures and their variations both during growth and during orthodontic treatment unlike ANB angular measurement. OBJECTIVE: - To assess the sagittal jaw relationships determined by – ‘Wits Appraisal’ from pre-treatment lateral cephalometric radiograph of orthodontic patients visiting JMC from March 2020 – March 2022, Jimma Zone, Southwest Ethiopia, 2022 METHODS AND MATERIALS: - A cross sectional study design was conducted. Purposive non-probability sampling method used, in which deliberate subjective choice (patients who have pre-treatment radiograph) are selected what she or he regards as a “representative” sample to the reference population. The data had been collected from pre-treatment lateral cephalogram of patients by tracing on acetate paper with pencil. RESULT: - From - 278 sample patients 95 or 34.17% were male with mean 7.25, SD 3.745, C.V 0.516 & 183 or 65.83% were female with mean 14.17, SD 5.391, C.V 0.381 (Table 5.1)] were identified Wits Appraisal Measurement of orthodontic male & female patients with different skeletal classes (Class I, class II and Class III) in JMC orthodontic unit. From 180 sample patients, 57 or 31.67% male & 123 or 68.33% females were identified as Class I skeletal pattern – the mean Wits Appraisal value for male is 0.773 and 0.979 for female with SD of 0.823 for male and 0.360 for female as well as more variation of Wits Appraisal seen on males. From 61 sample patients 19 or 33.13% males & 42 or 68.87% female were identified as class II skeletal pattern - the mean ‘Wits Appraisal’ value for male is 3.911 and 3.567 for female with SD 4 of 1.059 for male and 1.154 for female as well as more variation of Wits measurement seen on females. From 37 samples patients 19 or 51.35% male & 18 or 48.65% female were identified as class III skeletal pattern - the mean ‘Wits Appraisal value for male is -1.849 and -1.883 for female with SD of 0.735 for male and 0.810 for female as well as more variation of angle seen on males. CONCLUSION & RECOMMENDATION: - Out of 278 orthodontic patients following treatment at JMC orthodontics unit, 180 (62.7%) were skeletal Class I pattern, 61 (21.9%) patients were skeletal Class II pattern & 37 (13.2%) patients were skeletal class III pattern. The more prevalent patients with sagittal relationship in JMC are Skeletal class I, Skeletal class II and Skeletal class III in decreasing order. The estimated – the mean Wits Appraisal value for skeletal class I pattern sample patients is 0.773 with SD of 0.823 for males and – the mean Wits Appraisal value for skeletal class I pattern sample patients is 0.979 with SD of 0.360 for females. The estimated Wits Appraisals for skeletal Class II pattern, the mean value of Wits Appraisal should be positive which is identical to Jacobson’s measurement - +3.911 for males and +3.587 for females. For skeletal class III pattern, the mean value of Wits Appraisal should be negative which is identical to Jacobson’s measurement, -1.849 for males and -1.759 for females.