###### Abstract  
This systematic review (SR) and meta-analysis (MA) aimed to compare the treatment effects of orthognathic surgery and orthodontic camouflage treatment in adult subjects with Class III malocclusion (C-III-M). Two independent reviewers conducted the literature search comprehensively from 1990 to 8 November 2021. PubMed, Science Direct, Scopus, EBSCOhost and Google Scholar databases were included for literature search. Moreover, a manual search of references from relevant studies was performed. Based on the literature search, a total of six articles were selected for SR and three articles fulfilled the criteria of a MA. Standardized mean difference (SMD) was used to evaluate and compare the treatment effects of orthodontic camouflage treatment and orthognathic surgery in adult C-III-M patients. Test for overall effect from the studies was used to estimate the treatment effect of C-III-M. However, Significant heterogeneity and publication bias was apparent among the selected studies. More research on the treatment effects of orthodontic camouflage treatment and orthognathic surgery in C-III-M is necessary to conclude possible interactions with better specificity. class III malocclusion; orthognathic surgery; orthodontic camouflage treatment +
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Though orthognathic surgery provides the most stable occlusion, borderline C-III-M could be treated only with orthodontic camouflage treatment. In orthodontic camouflage treatment, skeletal problems disguise with the dentoalveolar compensation, whilst the function, aesthetics and occlusion are allowing for an enhancement [4; 5]. Camouflage treatment was initially familiarized between the 1930s and 1940s while the extraction technique became trendy to correct the skeletal malocclusion. The main idea of camouflage treatment in C-III-M cases comprises retroclination of the lower incisor teeth and proclination of upper incisors to correct the dental occlusion. Though the skeletal and facial appearance are mostly compromised [6], some important parameters need to be considered before treating the camouflage treatment in the C-III-M, such as facial aesthetics, anterior-posterior position, the thickness of mandibular symphysis and anteroposterior discrepancy. Firstly, the extension of the facial aesthetics and its importance to the patient's perspective should be assessed before starting any camouflage treatment [7]. Next, whether the inclination of the incisors of both arches allows the orthodontic camouflage treatment for correcting the C-III-M and the mandibular symphysis should tolerate the extensive retraction of incisors. Finally, the most important parameter is an anterior-posterior discrepancy. Although all the parameters may fall in the acceptable range, camouflage treatment may not perform due to the severe discrepancy [7]. Patient compliance is another major factor, sometimes patients oppose the surgical treatment plan due to many factors so, camouflage treatment remains the only choice for treating the C-III-M cases. The orthodontic camouflage treatment aims to disguise the skeletal discrepancies with dental compensation. With the help of first or second premolar extractions, orthodontic camouflage treatment allows for an amendment in aesthetics, occlusion and functions [5; 8]. Many authors reported case reports regarding different treatment modalities for correcting C-III-M [9; 10; 11; 12; 13]. Few researchers have endeavored to specify cephalometric standards in terms of the most specific treatment plan C-III-M patients [14; 15; 16]. Previously, many systematic reviews and meta-analyses were performed on C-III-M. However, most of them were focused on prevalence rate [17], genetic factor [18], treatment stability [19], treatment effectiveness of different myorh  
all selected studies were included for this SR. In case of disagreement, it was reached a consensus by the third investigator. One of the reviewers extracted all the data from the selected studies and rechecked the data by the second reviewer.