## 3 Review
### Class III
#### 3.2.1 Study Design and Treatment Interventions
The camouflage group treatment, built on the already-existing dental compensations, resulted in non-skeletal changes as expected. Post-treatment, the surgical movements improved 90% of the skeletal discrepancies, but only 60 to 65% of the patients reached the ideal value, implying that there were no statistically significant differences between the two study groups. The authors suggest that surgical skeletal correction was compromised by an incomplete presurgical incisor decompression. In their 2015 case-control study, [PERSON] et al. [18] aimed to analyze skeletal, dental, and soft tissue cephalometric changes occurring as a result of treatment, with emphasis on the influence of premolar extractions in the final incisor position and inclination. Although skeletal, dental, and soft tissue discrepancies were comparable, it was found that a negative OVJ was a key factor in choosing between orthodontic camouflage and orthognathic surgery treatment. As expected, skeletal parameter normalization was only visible in the surgery group, but slightly protruded upper incisors were found in both surgery and camouflage groups at the end of treatment. In the camouflage group, lower premolar extraction did not result in a reduction in lingual tipping of lower incisors. While there was a general improvement in lip soft tissue position and contours with both treatment methods, a wide range of individual variation is probable, due to individual characteristics. At the end of treatment, surgery patients are more likely to have fuller lips, and a more favorable lower lip and chin contour than camouflage patients. Long-Term Follow-Up and Result Stability  
The only study including a long-term follow-up for skeletal Class III malocclusion treatment that we managed to find in our literature search, was a 2013 study by [PERSON] et al. [19]. They retrospectively compared results stability and esthetic satisfaction between a group of subjects treated with orthodontic camouflage (25 females) and a group treated with orthognathic bimaxillary surgery (21 females). Cephalometric data were recorded and compared at baseline (T1), at the end of treatment (T2), and three years post-treatment (T3). Patients completed questionnaires about their satisfaction and current problems, regarding teeth and profile, temporomandibular joint (TMJ), and functionality. Cephalometric data in both groups showed a satisfactory stability over the mid-term (3-year follow up). It is interesting that the percentage of patients who were satisfied with their profile changes was higher in the camouflage treatment than in the surgery group. Different expectations about profile changes were a key factor in determining esthetic patient satisfaction. It was observed that the camouflage group had little expectations, whereas profile and soft tissue changes were the main motivations for a surgical decision. Even if at baseline no TMJ disorder was elicited in this study, most of the surgical patients reported some form of functional and/or TMJ problems following their surgery, while the orthodontic group rarely had these issues, perhaps because during jaw surgery the proximal segment (which includes the condyle) can move backward, exerting stress on the articular surfaces and disc of the TMJ complex. Despite treatment differences, both modalities largely met their treatment objective. Therefore, if patients do not readily accept surgery because of potential surgical complications or financial difficulties, camouflage treatment could be an effective and stable alternative treatment. The major limit of this study was the short follow-up, as it has been shown that a 5-year follow up is the minimum period to verify stability of surgical treatment [30].