## 1 Introduction  
Malocclusion is defined as an irregular teeth relationship compared to the accepted normal occlusion. According to the World Health Organization, it is one of the most common oral health diseases. It can affect normal individual daily functions that involve the facial area, including speaking, chewing, and swallowing, and can also have self-esteem impacts due to dentofacial appearance problems [1,2]. Teeth and skeletal relationships are based on [PERSON]'s classification 3. [PERSON]'s classification was based on the relationship of the maxillary to the mandibular teeth, with no reference to any skeletal structures [3,4]. Over the years, the classification has been modified, for diagnostic purposes, to facial structure classification as well [4]. Fixation of malocclusion involves orthodontic treatment for the leveling and alignment of the teeth. However, successful treatment is based on the correct diagnosis, which leads to precise planning for necessary teeth movement. The treatment will execute the above diagnosis and planning steps [5]. It was theorized that optimal facial esthetics is accomplished when teeth are straightened, and the occlusion is corrected to cephalometric X-ray optimal standards [5; 6; 7]. The \"envelope of discrepancy\" indicates that teeth movement is limited. Using teeth movement along with growth modifications is limited to the active growth period. Sometimes, orthodontic treatment can camouflage malocclusion problems, but such treatment does not change the skeletal relationship in facial-bone discrepancies. The camouflage treatment has been improved over time using temporary anchorage devices. However, these devices can present some adverse effects, such as of root injuries \"(root injury during interradicular insertion is the most common complication associated with orthodontic miniscrews)\" [8]. Additionally, failure of miniscrews for orthodontic anchorage, analysis of risk factors correlated with the progressive susceptibility to failure or fracture, have been reported and studied [9; 10]. Therefore, for patients with severe orthodontic problems, solely orthodontic treatment is insufficient, and these patients need combined orthodontic-surgical treatment [11]. Class-III occlusion is a condition in which the mandibular first molar is positioned anterior to the maxillary molar. Skeletally, it can be defined as an underdeveloped maxilla relative to the mandible, overdeveloped mandible relative to the maxilla, or a combination of both [11]. In such cases, it is essential to first diagnose the nature of the defect, whether the origin is dental-only or skeletal, and if skeletal, to decide the origin of the skeletal malocclusion. One of the traditional ways to indicate a Class-III discrepancy is to diagnose anterior crossbite (CB) or a negative overjet (OJ). The diagnosis is based on clinical examination combined with lateral cephalometric analysis. Various indices on the cephalometric radiograph, such as Steiner's and McNamara's, facilitate the assessment of mandibular or maxillary deviation from the normal values relative to the base of the skull [11; 12]. These demonstrate the severity of the malocclusion or skeletal discrepancy and help to decide the need for orthognathic surgery versus occlusion correction solely using functional devices [13]. Orthognathic surgery is a treatment process involving orthodontics and maxillofacial surgery, and it is used to treat those dentofacial discrepancies outside the scope of conventional orthodontic treatment. Treatment may correct various underlying skeletal discrepancies, including severe Class-II or Class-III problems [14]. When orthognathic surgery is indicated, the surgical treatment can be a mandibular setback, maxillary advancement, or a combination of both, respective to the patient's complaint, clinical examination, study models, and facial cephalometric radiograph analysis findings [15; 16].