Published Paper Details:

Background: Class III malocclusion represents one of the most complex orthodontic challenges, often requiring difficult decisions regarding treatment planning. In adult patients where growth modification is no longer feasible, two main options exist: orthodontic camouflage and orthodontic-orthognathic surgery. The dilemma is particularly critical in borderline cases, where discrepancies are moderate and both treatment modalities may seem viable. Aim: To review and compare the skeletal, dentoalveolar, and soft tissue outcomes of orthodontic camouflage and orthognathic surgery in borderline Class III malocclusion, and to provide a framework for clinical decision-making.Methods: A literature search was conducted using PubMed, Scopus, and Google Scholar with keywords: Class III malocclusion, orthodontic camouflage, orthognathic surgery, borderline malocclusion, dentoalveolar compensation. Inclusion criteria were clinical trials, cohort studies, and systematic reviews published between 2000-2024 that directly compared camouflage and surgical treatment outcomes.Results: Camouflage treatment achieved acceptable occlusal correction through dentoalveolar compensation but produced only minor skeletal changes. Orthognathic surgery, by contrast, provided significant skeletal correction, improved soft tissue esthetics, and higher patient satisfaction. Three major outcome domains--skeletal, dentoalveolar, and soft tissue--show consistent differences favoring surgery, though camouflage remains appropriate for selected cases with mild skeletal discrepancies.Conclusion: Both approaches remain valid in managing borderline Class III cases. Camouflage is less invasive, cost-effective, and suitable for patients unwilling to undergo surgery, while orthognathic surgery provides superior skeletal and esthetic outcomes. Individualized, patient-centered decision-making remains the cornerstone of effective treatment planning