Abstract
Introduction: Skeletal class III malocclusion in adults is one of the most serious and difficult to correct maxillofacial deformities. The prevalence of Class III malocclusion in Caucasians ranges from 0.8 to 4% and up to 12% in Chinese and Japanese populations. It has been shown that more than 60% of cases of Class III malocclusion are due to skeletal discrepancies, requiring an integrated orthodontic-surgical treatment approach. Objective: It was to carry out a systematic review of literary findings on the main approaches and outcomes of clinical studies of orthodontic-surgical treatment in patients with class III malocclusion. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from February to March 2025 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 125 articles were found, and 58 articles were evaluated in full and 56 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 07 studies with a high risk of bias and 15 studies that did not meet GRADE and AMSTAR-2. Most studies showed homogeneity in their results, with X2=74.7%>50%. It was concluded that orthodontic-surgical treatment in Class III patients must be based on the diagnosis so that the treatment is implemented to correct the compromised structures instead of being compensated in places not affected by the malocclusion. The degree of involvement of the maxilla and mandible must be assessed so that the treatment is directed to that bone base and truly achieves its objectives and impacts of facial improvement. Redirecting growth in Class III cases is indicated as soon as the anomaly is diagnosed, as the displacement processes that occur in the midface can only be affected with treatment as long as the growth zones are capable of responding to the biomechanical stimulus. Therefore, the younger the Class III patient is treated, the better the facial correction effects will be.