Class III treatment planning has never been a matter of clear-cut protocols—especially in a time when personalized and patient-centered care challenges us to balance clinical possibilities with individual expectations. In this lecture, I will reflect on the evolving decision-making process between skeletal anchorage and orthognathic surgery. While modern biomechanics and skeletal anchorage can achieve remarkable outcomes, they also tempt us to push biological and esthetic limits. Knowing when to stop, when to refer, and when to reframe the case as surgical is not always straightforward—and sometimes, these lessons are only learned in hindsight. Through selected clinical cases and honest insights from both successes and failures, the aim is not to provide a fixed recipe but to share a mindset: how to approach Class III cases with clarity, humility, and shared responsibility between doctor and patient. This perspective acknowledges that orthodontics today is less about rigid protocols and more about integrating biomechanics, biology, and ethics into truly individualized strategies. By recognizing uncertainty not as a weakness but as an inherent part of complex treatment planning, we can move toward a more pragmatic, sustainable, and humane orthodontics.


Learning Objectives
After this lecture, you will be able to evaluate the decision-making process between skeletal anchorage and orthognathic surgery in the management of Class III cases.
After this lecture, you will be able to recognize the biological, functional, and ethical limits of modern biomechanics to avoid overtreatment.
After this lecture, you will be able to apply a pragmatic, patient-centered mindset to finishing challenging Class III cases with clarity and shared responsibility.