Camouflage Modalities of Treatment for Skeletal Class III Malocclusion in Adults-A Narrative Review

Background: Orthodontic camouflage in Class III patients is a widely used treatment approach. However, its application is subject to specific clinical indications. This narrative review aims to synthesize the current scientific evidence and provide an overview of the available methods, their advantages and limitations, in order to guide the appropriate management of Class III camouflage cases. Methods: A literature search was carried out using five main scientific databases without restrictions. Inclusion criteria were all types of articles published on various orthodontic camouflage techniques for Class III malocclusion in adult patients. The string searches included "camouflage" and "Class III malocclusion". In addition, a manual search was performed to identify further relevant articles. The methodological quality was assessed using the Oxford Centre for Evidence-Based Medicine (OCEBM) classification. Results: This narrative review synthesizes 128 studies on orthodontic camouflage in adult Class III malocclusion. Among the 128 articles included, 110 (86%) were case reports or small case series, corresponding to level 4-5 evidence. The remaining studies were observational in design, most of them retrospective, corresponding to level 2-3 evidence. Extractive or non-extractive treatment can be used for non-surgical treatment of a Class III in adults. In recent years, aesthetic techniques, such as clear aligners or lingual fixed appliances, have been efficiently performed. Carriere Motion III is a fast and efficient method to mask a Class III occlusal relationship. Moreover, the use of temporary anchored devices (TADs) has proven to be an effective and minimally invasive method for managing mandibular distalization and a retraction of the lower incisors. Conclusions: Although most reports are case-based, recent advances such as TADs and clear aligners offer effective non-surgical alternatives for selected mild-to-moderate cases. Careful patient selection remains critical. The evidence was low-quality, and further prospective studies are needed.