Access to the surgical orthodontic pathway for the treatment of the adult's dental-skeletal classes 2 has objectively changed in the last decade. The measure of the severity of malocclusion no longer addresses the cephalometric criterion but lies in the individual perception that the subject in class 2 feels with a different intensity from his usual interlocutors or the orthodontists themselves. A paradigm shift that decisively supports the principle of the patient at the center of therapeutic choice. In addition, the evolution of surgical techniques has changed the habits of orthodontists, who can lead their patients to surgery with a different timing than in the past. Today, the advent of Surgery First and Early Surgery have made less frequent the choice of traditional protocols based on pre-surgical Orthodontics of sagittal decompensation and mutual adjustment of arch form preliminary to the Surgery itself. It can also be added that, always from a patient-centered perspective, orthodontic-surgical treatments are increasingly carried out using the therapeutic device "clear aligners", another cornerstone of the revolution that has occurred inexorably in recent years.