Skeletal Class III is a relatively rare malocclusion of the craniofacial complex and the accurate differential diagnosis of its aetiology is necessary so that it may be correctly treated. Differential diagnosis of Class III aetiopathogenesis should distinguish between: a) true skeletal Class III as opposed to pseudo Class III; b) three forms of Skeletal Class III, in which there is either maxillary deficiency only or mandibular excess only or combination of both; and c) skeletal Class III that may be treated with orthodontic treatment alone, as opposed to Class III that is difficult to manage with orthodontic treatment alone and requires combine orthodontic and surgical approach. Differential diagnosis is mainly based on clinical examination and cephalometric analysis. The aim of this paper is to present the basic principles and modes of achieving differential diagnosis in skeletal Class III cases.
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