What are the limits of orthodontic treatment before surgical intervention is required?

Orthognathic surgery is one of the modalities used to treat dentofacial deformities which cannot be corrected with an acceptable outcome by conventional orthodontic treatment. In certain circumstances, orthodontic camouflage can be a viable treatment alternative and involves orthodontic appliances to correct the malocclusion with a view to disguising the underlying skeletal discrepancy. The decision-making process is multi-faceted and can often pose a challenge to the clinical team in borderline cases. This article outlines the rationale behind both orthodontic and orthognathic treatment along with a discussion of the factors to consider when deciding between each treatment modality.