Anterior open bite refers to the opposing incisors do not come into contact. Skeletal class II malocclusion is characterized by maxillary protrusion, mandibular retrusion, or both. These two types of malocclusion can affect the patient’s facial appearance, masticatory function and mental health. They are big challenges to orthodontists and orthognathic surgery is usually needed to solve these problems. This case report describes an adult patient with the facial-skeletal problem of anterior open bite, narrow upper arch and skeletal Class II malocclusion, and malocclusion of severe dentition crowding, impacted premolars and posterior crossbite, meanwhile with periodontitis (stages III, grade B). The multidisciplinary management included teeth removing, maxillary skeletal expansion, posterior teeth intrusion, en masse retraction of upper anterior teeth and without orthognathic surgery. The esthetic facial profile and proper occlusal relationship were obtained.