Transformative Non-surgical Strategies for Adult Class III Malocclusion: A Narrative Review

Adult skeletal Class III malocclusion presents a complex orthodontic challenge, often necessitating orthognathic surgery for definitive correction. However, in carefully selected adult patients with mild to moderate skeletal discrepancies, non-surgical treatment strategies offer promising alternatives. This narrative review highlights current advancements in non-surgical management, including Bone-Anchored Maxillary Protraction (BAMP), Micro-Implant Assisted Rapid Palatal Expansion (MARPE), and hybrid tooth-bone-anchored appliances. These modalities enable maxillary advancement and transverse expansion while minimising undesirable dentoalveolar effects. Camouflage treatment, utilising extraction or non-extraction protocols, offers functional and aesthetic correction through controlled dental compensation. Techniques such as the Multiloop Edgewise Archwire (MEAW) and Mandibular Molar Distalisation (MMD), facilitated by Temporary Anchorage Devices (TADs), miniplates, aligners, or the Carriere Motion Three-Dimensional (3D) appliance, expand the spectrum of treatment options. While these strategies do not modify underlying skeletal bases, they offer improved occlusal function and facial aesthetics, particularly in well-selected cases. Emerging technologies such as digitally guided planning, 3D-printed expansion devices like the Dutch Maxillary Expansion Device (D-MED), and skeletal anchorage innovations continue to evolve the landscape of non-surgical Class III correction. Optimal outcomes hinge on accurate diagnosis, individualised planning, and patient compliance. Non-surgical management represents a dynamic, patientcentred alternative to surgery in selected adult Class III cases.