## 3 Review
### Class II
\begin{tabular}{c} Surgery \\ \(-3.8\pm 2.4\) \\ \(-11.5\pm 3.6\) \\ \(-2.7\pm 2.2\) \\ \(-2.7\pm 2.2\) \\ U1-SN \\ LT-Md Plane \\ \end{tabular}  } & \multirow{4}{*}{
\begin{tabular}{c} Time \\ \(-1.2\pm 2.0\) \\ \(-2.7\pm 2.2\) \\ \(-2.0\pm 8.  
orthopedic appliances, and 20 with BSSO of the mandible without genioplasty (combined with orthodontics). No long-term follow-up was reported. Each patient group achieved a reduction in OVJ and no treatment-related changes in the maxillary area were noticed. Changes associated with the mandible included bony chin advancement and an increase in mandibular length in the sagittal-diagonal dimension, which was observed in the surgical and functional orthopedic groups. However, the extent of treatment-related skeletal change was only significant in the surgical group. Regarding dental outcomes, the surgical group demonstrated a significant protrusion of upper incisors--likely as part of the pre-surgical decompensation, while the orthopedic plan resulted in retusion of maxillary incisors and proclination of mandibular incisors (camouflage); the extraction group showed retrusion of both upper and lower incisors (likely because of space closure). OVB only increased in the extraction group. Regarding soft tissue remodeling, orthognathic surgery led to the most marked profile changes, while fixed functional orthopedic appliances resulted in a moderate reduction in the soft-tissue profile convexity. Camouflage orthodontics resulted in an increase in the nasolabial angle, which is often esthetically undesirable. The authors concluded that functional treatment is suggested in mild skeletal Class II, but it does not represent an alternative to surgery when the desire for an improved chin projection is the main complaint. In the study, the sample size for each group was modest and no information is available regarding group homogeneity. The surgical group is represented exclusively by a mandibular advancement procedure so it is not known if the addition of maxillary surgery would have resulted in more significant changes in the soft-tissue balance and profile. In 2009, [PERSON] et al. [23] retrospectively compared treatment effects and long-term stability of the stepwise Herbst Appliance and BSSO in skeletal Class II adult patients. Cephalometric data were recorded and compared at baseline (T0), after Herbst-treatment or immediately after surgery (T1), at the end of treatment (T2), and three years post treatment (T3). Both groups achieved a Class I occlusal relationship and a reduction in skeletal and soft tissue convexity at T2; however, as expected, the surgery group showed more skeletal movement and reduction in soft tissue convexity (as NAPg and NS/Sn/PgS) than did the Herbst group. Three years post-treatment (T3), no significant relapse was seen within the Herbst group when compared to the surgery group. Long-term stability in the skeletal and facial profiles was comparable in both groups. It is suggested that holding the new position for at least 6 months is the key for long-term stability in the camouflage orthopedic treatment, whereas surgery remains a better option for improving profile convexity, if the patient is willing to accept the related risks and potential complications. It would have been interesting to compare the camouflage groups to other orthodontic modalities of Class II correction, and to compare the BSSO group to a bimaxillary surgical group. Limits of this study are the small sample size and an over-representation of women in both groups. A 2018 meta-analysis performed by [PERSON] et al. [14], aimed to compare dental, skeletal, and aesthetic outcomes between orthodontic camouflage and surgical-orthodontic treatment in non-growing skeletal Class II malocclusions. Seven articles were included, but only one presented moderate scientific quality.