## 3 Discussion  
Orthognathic surgery combined with orthodontic treatment has been well known as a clinically safe and stable procedure for the correction of skeletal Class III, open bite, and asymmetry [1; 2; 3; 4; 5; 6]. However, with the advent of skeletal anchorage, non-surgical approaches have become more common for the correction of skeletal malocclusions using miniscrews or miniplates [7; 8; 9; 10; 11; 12; 13; 14; 15; 16; 17; 18; 19; 20; 21; 22; 23; 24]. The patient, in this case, showed an anterior open bite with a Class III skeletal pattern and insufficient maxillary incisor exposure when smiling. [PERSON] [17] suggested that the vertical cephalometric position of the maxillary central incisors relative to the lip line should be about 4 mm downward and a guide for the anterior limit of the maxillary occlusal plane, and the vertical position of the mandibular incisors should be positioned at the level of stomion in relation to that of the maxillary incisor position to obtain a proper overbite. [PERSON] et al. [28] and [PERSON] et al. [29] also reported that the vertical distances between the maxillary incision tip and the stomion were 2.7 mm and 2.1 mm, respectively. Figure 14: 22-month retention facial and intraoral photographs. Figure 15: 22-month retention radiographs and cephalometric superimposition. Red, posttreatment; Green, 22-month retention. In this patient, U1 MP and L1 MP were positioned 0.8 mm and 7.9 mm inferior to the stomion, respectively, at the lip, closed position, and no incisor display was shown when smiling. Therefore, extrusion of the incisors in both arches and control of the occlusal plane [25] was necessary to close the open bite and improve the smile aesthetics. The intrusion of the posterior teeth followed by autorotation of the mandible might be necessary to correct an open bite with a Class II skeletal pattern. But in this skeletal Class III patient, some extrusion of the posterior teeth was necessary to improve the facial profile. Backward rotation of the mandible was accomplished by increasing AFH. But this camouflage treatment worsened the vertical proportion of the face because the patient initially had a normal AFH. This might be a drawback with the non-surgical camouflage treatment of Class III malocclusion with anterior open bite. At 6 months into treatment, the vertical position of the stomion had moved slightly anterosuperiordy even though AFH was slightly increased due to uprighting and extrusion of the mandibular molars. This might have been due to the extrusion of the mandibular incisors. At posttreatment, the stomion had moved postorinferiordy due to an increase in AFH and retraction of the mandibular incisors, which means that more extrusion of the maxillary incisors was still necessary to obtain the proper smile esthetics. In our patient, the vertical position of his maxillary incisal tips was not appropriate in relation to the lip line due to the downward movement of the stomion. Fortunately, he showed an acceptable exposure of the maxillary incisors when smiling posttreatment because he had a hyperactive muscle that elevated the upper lip. Unfortunately, the distance between the stomion and maxillary incisal tip will steadily decrease throughout his life due to the continuous elongation of his upper lip [30]. The patient showed a skeletal Class III malocclusion with open bite due to the downward position of his mandibular incisors, so extrusion and uprighting of his mandibular incisors and molars with a counterclockwise rotation of the mandibular occlusal plane and total distalization of the mandibular dentition were necessary to correct the open bite and Class III dental relationship. In dental casts, Class III molar relationships can be corrected into Class I molar relationships by distalization of the mandibular molars by 3.0 mm and 4.0 mm on the right and left sides (Figure 2). Posterior available spaces were sufficient for the distalization of the mandibular molars after extraction of the third molars (Figure 5).