Patients who have lost their teeth experience not only compromised mastication and pronunciation but also the emotional damage of losing their natural physical appearance. 1 Thus, the goal of a complete denture includes helping the patient to regain confidence in their appearance. This requires knowledge and understanding of both the physical and biologic factors. 2 The best way to select artificial teeth is from preextraction records, including diagnostic casts, radiographs, and recent images showing a natural smile. Patients without pre-extraction records will present a more challenging tooth selection process. [2][3][4] Error in the selection of the artificial teeth will affect correct tooth alignment. 3,5 Consequently, this will potentially compromise the patient's

An anterior open bite is one of the most difficult malocclusions in orthodontic treatment. For such malocclusion, orthodontic miniscrew insertion into both buccal and palatal alveolar regions has been indicated for molar intrusion, but it involves a risk of tooth root injury. To solve the problem, a midpalatal miniscrew-attached extension arm (MMEA) is adopted. However, this method causes palatal tipping of the molar because intrusive loads were applied only from the palatal side. Currently, a transpalatal arch is added to avoi0d tipping movement, but it induces the patient’s discomfort. Hence, the objective of this study was to evaluate the loading conditions for maxillary molar intrusion without tipping movement, only by MMEA through finite element (FE) analysis. FE models of maxillary right first molar and surrounding tissues were created. Three hook positions of MMEA were set at 6.0 mm perpendicular intervals in the occluso-apical direction along the mucosal contour. An intrusive unit load was applied from the palatal side of the molar, and various counter loads were applied from the buccal side. An optimal counter load for molar intrusion without palatal tipping was observed in each hook position. In conclusion, an ideal maxillary molar intrusion can be achieved only by MMEA with an optimal counter load.