Evidence map›Paper›PMID 40163142›Full record

ArticleJournal of orofacial orthopedics = Fortschritte der Kieferorthopadie : Organ/official journal Deutsche Gesellschaft fur Kieferorthopadie2026

Novel approach to three-dimensional intermaxillary skeletal assessment : Correlation between the ANB angle and the bisector Wits appraisal.

M Serafin, B Baldini, O Rossi, G Perrotti, A Caprioglio

Abstract readComparative Study
In one paragraph

Article in Journal of orofacial orthopedics = Fortschritte der Kieferorthopadie : Organ/official journal Deutsche Gesellschaft fur Kieferorthopadie, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Are the results of the Wits appraisal clinically interchangeable when evaluating 2D and 3D images? : A CBCT-dataset method-comparison study.Journal of orofacial orthopedics = Fortschritte der Kieferorthopadie : Organ/official journal Deutsche Gesellschaft fur Kieferorthopadie · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

M SerafinDepartment of Biomedical Sciences for Health, University of Milan, Milan, Italy.
B BaldiniDepartment of Electronics, Information and Bioengineering, Politecnico Di Milano, Milan, Italy.
O RossiDepartment of Biomedical Surgical and Dental Sciences, University of Milan, Via della Commenda 31, 20122, Milan, Italy. Ornella.rossi@unimi.it.
G PerrottiPrivate Practice, Como, Italy.
A CaprioglioDepartment of Biomedical Surgical and Dental Sciences, University of Milan, Via della Commenda 31, 20122, Milan, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe present study aimed to compare and correlate the ANB angle with the bisector Wits appraisal for a three-dimensional (3D) assessment of the maxillomandibular sagittal relationship using a cone beam computed tomography (CBCT) dataset.

methodsAfter outlier removal, 351 CBCT scans were chosen based on inclusion criteria (high quality, full-cranium field of view [FOV], slice thickness 150-300 μm) and analyzed using 3DSlicer software (Brigham and Women's Hospital, Boston, MA, USA, version 5.2.2). Eight anatomical landmarks were manually annotated, identified on axial views, and confirmed on the rendered volume image. The coordinates of each landmark were exported and the ANB (°) and bisector-Wits (mm) measurements were constructed. Dahlberg's D tested the intraobserver reliability and two-sample Kolmogorov-Smirnov test was executed to assess normality and to select the subsequent tests. Spearman's rank correlation coefficient (ρ) was utilized to correlate the angular (ANB) and linear (bisector-Wits) measurements, whereas the Siegel estimator for nonparametric linear regression was employed to establish norm values by the correlation equation. Significance was set at p < 0.05 with correlation coefficients exceeding ρ > 0.70 deemed clinically relevant.

resultsHigh (ρ = 0.773) and statistically significant (p < 0.001) correlations between the ANB and bisector-Wits measurements were found. The obtained equation was the following: bisector-Wits = 1.06 × ANB - 6.32. Therefore, the obtained rounded norm range for bisector-Wits for skeletal class I sagittal relationship was determined to be from -6.3 to -2.1 mm (-4.2 ± 2.1 mm). Values less than -6.3 mm correspond to a class III, whereas greater than -2.1 mm correspond to a class II skeletal relationship.

conclusionThe study revealed a statistically significant correlation between the ANB and bisector-Wits. From a 3D perspective, the bisector-Wits represents a reliable parameter to assess maxilla-mandibular skeletal discrepancies instead of the ANB angle, also adhering to radioprotection principles by limiting the FOV to the maxillary complex only and potentially reducing the radiation exposure in CBCT-based cephalometry.

Indexed as

Anatomic LandmarksCephalometryCone-Beam Computed TomographyImaging, Three-DimensionalMandibleMaxillaRadiographic Image Interpretation, Computer-AssistedAdolescentAdultFemaleHumansMaleMiddle AgedReproducibility of ResultsSensitivity and SpecificityYoung AdultANB angleBisector-WitsCone-beam computed tomographyThree-dimensional cephalometryWits appraisal

Identifiers

PMID40163142
PMCPMC13109169

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.