The skeletal Class III malocclusion represents a significant source of both facial and occlusal discomfort for affected patients (Hiller, 2002, Angheben et al., 2013). The etiology of skeletal Class III can involve maxillary retrusion, mandibular protrusion, or a combination of both factors (Ellis and McNamara, 1984). While its origins are multifactorial, genetics exerts a substantial influence on the manifestation and severity of skeletal Class III (Cruz et al., 2017). In addressing therapeutic interventions for this malocclusion, a range of approaches exists. In childhood or early adolescence, various facial masks and orthopedic appliances are available as potential interventions. Additionally, compensatory treatments involving fixed orthodontics or orthognathic surgeries, often combined with orthodontic procedures, are considered for older patients. Early intervention is associated with more predictable and achievable results. However, seeking treatment after the cessation of growth presents challenges, with therapeutic options becoming more limited. Typically, treatment in adulthood involves a combination of orthodontic approaches and surgical interventions to address the complexities of skeletal Class III malocclusion (Schuster et al., 2003).

Many patients express concerns about the surgical phase and actively seek alternatives to circumvent a more invasive procedure. Currently, orthodontists are exploring non-surgical approaches, attempting to address skeletal issues through alveolar remodeling. This involves the use of intermaxillary elastics, either independently or in conjunction with dental extractions (Park et al., 2017). Despite these efforts, doubts persist among orthodontists regarding the efficacy of the results obtained through compensatory treatments. The overarching question revolves around determining the optimal approach for the patient: whether to persist with a surgical intervention without considering compensatory treatments, or to invest in a camouflage treatment? This dilemma underscores the ongoing debate within the orthodontic community. Choosing between surgery and camouflage treatment involves a nuanced assessment of individual patient factors, preferences, and the severity of the skeletal problem. Striking a balance between addressing the malocclusion effectively and accommodating patient concerns and preferences is crucial in making an informed treatment decision. Orthodontists may need to tailor their recommendations based on a comprehensive evaluation of each patient's unique circumstances, considering factors such as the desired treatment outcomes, potential risks, and the patient's willingness to undergo various procedures. Manuscript (without Author Details) Click here to view linked References Over time, various techniques have been developed to address skeletal Class III malocclusion by tailoring treatment approaches. The aim of this study was to compare cephalometric outcomes among individuals undergoing compensatory Class III treatment using two distinct bracket systems (Roth and Biofuncional), as well as those undergoing Class III surgical treatment.