This article describes a multidisciplinary approach to the treatment of a severe skeletal anterior open bite, complicated by severe chronological enamel hypoplasia, in a 12-year-old southern Chinese girl. Correction of the open bile, of which the cause was unknown, involved the extraction of all first permanent molars and provisional repair of the wafer-thin enamel to permit bonding of fixed orthodontic brackets. Several phases of maxillary and mandibular fixed appliance therapy followed. As she open bite resolved, further restorative treatment was performed. The result was stable 3 years after the end of retention. The case demonstrates the benefits of well-planned, integrated, multidisciplinary treatment.