J Bagh College Dentistry Vol.

24(2), 2012 A comparison of the retention

A comparison of the retention of complete denture bases

having different types of posterior palatal seal with
different palatal forms
Mayada Q. Abdul Khafoor, B.D.S, M.Sc. (1)

ABSTRACT
Background: The most common problem associated with the lack of retention of maxillary complete denture is faulty
posterior palatal seal pps. The methods for achieving a pps include arbitrarily scraping the cast, selective pressure
technique, and the physiologic impression technique.
Material and Method: In this study forces required to dislodge a maxillary complete denture bases were compared
for different types of posterior palatal seals (PPS) with different palatal forms by using a specially designed strain
gauge force tranducer and strain measuring device. Nine male and female subjects are selected with age range
55-70 years. These patients with different palatal forms according to House's classification of palatal forms: Class I flat,
Class II intermediate and Class III high. Using different impression technique the first ordinary impression with Zinc-
oxide eugenol and scraping the cast for pps, the second physiological impression by using korecta wax No.4.
Result: The results show very highly significant difference, between the different designs of pps and physiological
impression for each group.
Conclusion: The physiological impression of pps give better retention because no over compression of tissues (within
the physiological limit) and concluded that the form of palate has direct influence on the retention of complete
dentures and will aid in the selection of type of posterior palatal seal needed.
Keywords: Maxillary complete denture, posterior palatal seal. (J Bagh Coll Dentistry 2012;24(2):11-17).

INTRODUCTION
A well fitting and retentive complete maxillary - Provide a thicker posterior border to
denture requires a well fitting surface a peripheral compensate for processing shrinkage of the
border compatible with the muscles and tissues denture base in this area5, and
which make up the muco-buccal and muco-labial - Reduce discomfort when contact occurs
spaces so that a peripheral seal is created by the between the posterior border of the denture
soft tissues draping over them and finally, a and the dorsum of the tongue 4.
posterior palatal seal. Avants 1 has shown that "a The methods for achieving a pps of a maxillary
pps is necessary for optimum retention of complete denture include arbitrarily scraping the
maxillary complete dentures" and that of the cast prior to denture processing, the selective
designs he tested, none proved to be superior in pressure impression technique, and the
all of his five test subjects1. physiologic impression technique 6.
The pps area has been defined as an area of soft Winland and Young11 and Chen et al10 stated that
tissue along the junction of the hard and soft the most dental schools teach the method of
palate on which pressure, within the physiologic carving the pps arbitrarily in the maxillary cast.
limits of the tissues, can be applied by a denture This arbitrarily location and scraping of the
to aid in its retention 2. definitive cast was found to be the least accurate
The pps of a maxillary complete denture can be technique the effectiveness of pps of maxillary
established during the making of the final complete denture is confirmed only at the
impression by scoring the final cast, or by insertion appointment.
incorporating the seal in the finished denture base. The anterior vibrating line at the area of the
The technique can be classified generally as being junction of the hard and soft palate can be located
either functional or empirical 3. Regardless of the by palpation of the hamular process and the fovea
technique used or the stage of denture fabrication palatine. The anterior vibrating line serves as the
during which the pps is placed, the objective of its anterior border of the pps area. The posterior
utilization is the same. It provides aperipheral seal vibrating line lies in the junction of the
by selectively displacing soft tissue to 4: aponeurotic portion of the soft palate and
- Provide close tissue contact during speech and represents the posterior extension of the pps area,
swallowing, preventing food and debris from they considered a two separate lines of flexion 12.
impinging between the denture base and the The location and incorporation of the pps on the
underlying tissue. maxillary definitive cast are often done by the
- Enhance retention and stability. dentist or dental laboratory technician. However
these procedures should be the responsibility of
(1)Lecturer, Department of Prosthodontics, College of dentistry, the dentist, as the tissue displacement can only be
Baghdad University. determined clinically 13. A faulty pps may cause
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J Bagh College Dentistry Vol. 24(2), 2012 A comparison of the retention

poor retention and /or tissue irritation. Brian M et Antolinocolon et al 8 concluded that the form of
al 6 describe a technique for the location of the the palate has direct influence on the retention of
pps intraorally and accurate transfer to maxillary complete denture will aid in the selection of the
complete denture cast by indelible pencile. Laney type of posterior palatal seal needed.
and Gonzalez 14 discussed the need for knowledge
of the oral cavity's anatomy so that the static MATERIALS AND METHOD
surface of the denture base can be balanced A. The testing apparatus
against one dynamic tissue surface. In the pps For the purpose of this study, retention has
area, the tissues are displaceable and the degree of been expressed in term of force required to
displacement can be found by palpation with a vertically dislodge a maxillary complete
"T" burnisher 15, by closing both nostrils of the denture using a specially designed strain gauge
patient and having him blow gently 16 or by force tranducer. The data measured by gram 23.
visualizing the vibrating line as the patient says The apparatus consist of many parts as shown
"ah" 3. Also, by placing the tissues with various in figure 1.
impression materials, a functional or physiologic B. Selection of patients
pps can be impression made as early as the Nine edentulous patients were selected from
maxillary final impression 18. Another method, prosthodontic clinic, college of dentistry,
scraping the maxillary cast before final processing Baghdad University, 6 males and 3 females,
of the denture, can be used to construct a pps 19. the age range between 55-70 years, the criteria
Therefore, the pps takes on many various shapes, used for selection were relatively smooth, firm
size and locations. These various types of pps are alveolar ridge covered with healthy mucosa
discussed by winland and Young11, and their without any posterior under-cuts. The patients
construction as taught in our dental schools is with different palatal form according to
investigated. They discussed that no mather what House's classification of palatal forms: Class I
type of pps is used, the important word is seal-to flat palatal vault in the hard palate and Class
seal out air and food and to seal in partial pressure III a high vault and Class II intermediate
and they said that the determination of the between them 7,30.
posterior limit and palatal seal of the maxillary C. Impression techniques:
complete denture is not the technician's A preliminary impression with impression
obligation, but the responsibility of the dentist. compound (Quayle Dental, England) was
Abedalbaki et al 20 compare the retention of taken and 2 custom trays were fabricated on
complete denture bases with different types of pps the study model. Then two impression
(bead, double bead, and bufferfly). They found no techniques used:
design provide superior priority than the other I. First impression technique:
type of pps but a double beading and butterfly pps 1. Before the border molding procedure,
can improve the retention of a maxillary complete trim and adjust the posterior border of
denture. the custom tray 1 to 2 mm distal to the
Determinants of posterior extension: vibrating line.
During the final impression appointment, the 2. Complete the border molding and make
final extension of posterior border of the a final impression by using zinc oxide-
maxillary denture is determined. Factors to be eugenol (ZoE) paste.
considered include: 3. Remove the impression from the mouth.
- The drape of the soft palate in relation to the 4. Mark the vibrating line in the mouth
hard palate. A more abrupt relation between with indelible pencile by using "ah"
the hard and soft palates generally indicates sound with nose blowing and using the
increased muscular functional activity of the fovea palatinae in locating the vibrating
soft palate, thus reducing the potential line 24.
posterior extension of the palatal seal. 4 5. Reinsert the maxillary impression in the
The shape of palatal vault is related to the activity mouth and transfere the location of
of the soft palate. The flat vault has the least vibrating line to the ZoE impression.
movable soft palate and the widest area of 6. Poured with stone (Zeta, selensor,
displacable tissue. In contrast, the high vault or Industria Zingardi S,r,i, Italy). The
"V" shaped palate often has a soft palate virtually water to powder ratio recommended by
at right angles to the hard palate and is extremely the manufacturer was used.
mobile. Thus the area of tissue displaceability is 7. The master cast was then duplicated
very narrow. The intermediate palatal vault lies once by using heavy body silicon, the
between these two extremes 7,21.

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J Bagh College Dentistry Vol. 24(2), 2012 A comparison of the retention

master cast marked 2 while the to exert their displacing effect on wax,
duplicated cast was marked 3. there by achieving functional depth of
II. The second impression technique seal. Figure (2)
(Physiological posterior palatal seal). 8. Impression is carefully beaded and
1. The same steps 1, 2 and 3 used in the boxed and the impression then poured
previous technique. with stone (Zeta, Selensor, Industria
2. The anterior vibrating line can be Zingardi s.r.i Italy). The water powder
visualized by instructing the patient to ratio recommended by the manufacturer
say "Ah" with short vigorous bursts was used. This cast was marked 1.
while the posterior vibrating line can be D. Scraping the casts for incorporation of pps:
visualized by instructing the patient to The casts marked 2 and 3 were scraped to
say "Ah" in short bursts in a normal carve certain designs into their posterior
unexaggerated fashion, then mark the palatal areas. No. 4 round bur with a lacron
anterior and posterior vibrating lines in carver were used. The patients classified into
the mouth with indelible pencile and groups according to House's cassification of
transfer the location to the ZoE palatal form.
impression. Group A (Class I flat palatal form)
3. Kerr Korecta wax No. 4 was used to A1= physiological impression technique of
record the pps area, it’s a fluid, mouth pps
temperature wax, is preferred for this A2= scraping the cast 2 according to House-
procedure. It will flow sufficiently at modified butterfly 3-4mm wide and 1mm
mouth temperature to avoid over deep was carved in the center of the palatal
displacement of tissues. because the seal area passing through the hamular
wax continues to exhibit it property of notches and flushing out on approaching the
flow in the mouth, it permits the tissues buccal sulcus 26.
in the area of the pps to rebound, A3= Scraping the cast 3 –a single bead
establishing a degree of displacement design as described by boucher 25. A V
that is physiologically acceptable. This shaped groove 1mm deep and wide at the
wax is painting on pps area of base was carved; it passed to rough the
impression. hamular notches and flashed out approaching
4. Impression is reseated in mouth and the buccal sulcus.
held in place for about 3 minutes. Group B (Class II intermediate palatal form)
Patient is guided and instructed to tip B1= physiological impression technique of
head forward to approximately 30o from pps
vertical position and forcibly place B2= Scraping the cast 2 according to House-
tongue against tray handle or clinician's modified butterfly 2-3mm wide and 1mm
finger which is supporting tray, this deep was carved in the center of the palatal
maneuver allow pps area to be recorded seal area passing through the hamular
in functional position 4,22. notches and flushing out on approaching the
5. Excess wax will be displaced and will buccal sulcus 26.
flow posteriorly. B3= Scraping the cast 3-asingle bead design
6. Impression is removed and examined as described by Boucher 25, like A3 group.
wax that has flowed posterior to seal is Group C (Class III high palatal form)
removed with Bard-parker blades, C1= physiological impression technique of
intimate contact between wax and pps
tissues is indicated by glossy C2= Scraping the cast 2 according to House-
appearance of wax in contrast to dull single bead design 26 1mm width and depth
appearance where no contact exists. made on the posterior vibrating line.
Wax is painted on where indicated and C3= scraping the cast 3-abutterfly shaped
the impression is reseated intraorally configuration was carved as suggested by
until wax exhibits contact along entire Hardy and Kapur 3. An angled groove
posterior palatal area. 1.0mm deep and 1.5mm wide at the base was
7. After trimming excess wax, impression carved in the center of the palatal seal area
is reseated for five to eight minutes. passing through the hamular notches and
During this time, patient intermittently flushing out on approaching the buccal
repeats head and tongue positions. This sulcus Figure (3).
last seating allows tissues in area of pps

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J Bagh College Dentistry Vol. 24(2), 2012 A comparison of the retention

E. Construction of the test denture bases: The mean values of the statistical analysis for the
Identical denture bases for the pps were made data of group C (deep palatal form) between the
on cast 1, 2 and 3 for each group and were three groups C1, C2 and C3 as shown in Table
designated 1, 2 and 3 respectively. Base plate (5). The results of ANOVA table with LSD as
was formed for each of the casts using two shown in Table (6). The results explained that
mm thick layers of base plate wax, the bases there was a very highly significant difference
were processed using heat curing acrylic resin between groups and between groups (C1 and C3)
(Quayle Dental, England). and between (C2 and C3) groups. While a non
F. Clinical testing significant difference between (C1 and C2)
Astringe of about 1 inch length was secured groups.
on the polished palatal surface of each of the
maxillary denture bases in region relating to DISCUSSION
the second premolar and first molar teeth 14, An adequate seal of the posterior border of a
20
, with auto polymerizing acrylic assembly maxillary complete denture is essential for
(Figure 4). The dislodging force that is retention. Establishing the pps at final impression
directed to the maxillary denture bases was stage confirm the effectiveness of the pps and
applied at the middle of the denture base allows the dentist to control its location and the
where the middle location is considered the amount of tissue displacement 10,27. This is agree
most reliable region for testing the retention with the result of this study which revealed that
of complete maxillary denture 15. the physiological impression technique of pps
All tests for a subject were completed in one area give better retention for complete denture
appointment; all the denture bases for that subject base than the other technique of pps. Vintion 28
were stored in water for the same length of time stated, "where the tissues move in normal function
before being tested for retention. Thus, the time of is the area where maximum peripheral seal can be
day and water sorption was not variables. achieved with the least amount of tissue
The patient head was held firmly on the head rest displacement. This appears to be best
with occlusal plane parallel to the floor. Figure (5) physiologically. It is maximum result with
all measurements of retention involving in a given minimum activity 11.
subject were conducted at one sitting, each test The route of the vibrating line from one side of
denture base was subjected to three retention tests. the palate to the other is not of a definite pattern
The force values at which the denture base was but varies with the shape of the palate. This
dislodged completely from the palate at a steadily variation is such a constant observation that palate
increasing force was displayed on strain or throat forms have been classified as Class I,
measuring device represented by gram, the force Class II and Class III. Class I indicates a low, flat
values in grams could be calculated. vault in the hard palate which continues into a soft
palate that has a minimal amount of drop and
RESULTS movement. This situation permits a more distal
The mean values of the statistical analysis for the extension of the maxillary denture and provides
data of group A (flat palatal form) between the broader pps area 17. This agree with the result of
three groups of A1, A2 and A3 were shown in group A, it was found that the physiological
Table 1. Where as the results of ANOVA table impression technique and modified butterfly 3-
with LSD as shown in table 2. The results 4mm width for pps area give better retention than
explained that there was a very highly significant the single bead design of pps. Nikoukar 17 and
differences between the groups and between (A1 Swenson and Terkla 9 were found that the flat
and A2) and between (A1 and A3) and between palatal shape has vibrating line located farther
(A2 and A3) groups. While the mean values of the posteriorly.
statistical analysis for the data of group B While in Class III indicates a high vault in the
(intermediate palatal form) between the three hard palate and an acute drop and maximal
group B1, B2, and B3 as shown in Table (3). movement in the soft palate. The region where
Where as the result of ANOVA table with LSD as this acute drop occurs becomes extremely critical
shown in Table (4). The result explained that because it places greater limitations on the distal
there was a very highly significant difference extension of the maxillary denture and will
between groups and between groups (B1 and B3) accommodate only a narrow pps 17. This agree
and between (B2 and B3), while there was a non with the result of group (C) which revealed that
significant differences between groups (B1 and the physiological impression technique of pps and
B2). single bead design of House give better retention
for complete denture base than the butterfly shape

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J Bagh College Dentistry Vol. 24(2), 2012 A comparison of the retention

of pps (Hardy and Kapur) 3. Nikoukari 17, 10. Chen MS, et al. Methods taught in dental schools for
Swenson and Terkla 9 found that the higher the determining the posterior palatal seal region. J
Prosthet Dent1985; 53: 380-3.
vault the more abrupt and forward is the vibrating
11. Winland RD, Young JM. Maxillary complete denture
line. While the Class II designates those palatal posterior palatal seal: variation in size, shape and
forms which are intermediate between Class I and location. J Prosthet Dent 1973; 29(3): 256-61.
Class III 17. This agree with the result of group B 12. Vernie AF, Chitre V, Aras M. A study to determine
which revealed that the physiological impression whether the anterior and posterior vibrating lines can
of pps and modified butterfly 2-3mm width be distinguished as two separate lines of flexion by
unbiased observer: Apilot study Indian J of Dental
according to House give better retention for
Research 2008; 19(4): 335-9 [IVSL].
complete denture base than the single bead design 13. Winkler S. Essentials of complete denture
of pps (Boucher). prosthontics. 2nd ed. St. Louis: Ishiyaku Euro America;
The mucosal tissues of the pps area vary in 1994.
displaceability from patient to patient, the task of 14. Laney WR, Gonzalez JB. The maxillary Denture: Its
determining the shape, size and depth of the seal palatal Relief and posterior palatal seal. J Am Dent
Assoc 1967; 75: 1182-7.
must be accepted by the clinician and should not
15. Bylicky HS. Variable Approaches in obtaining a
be assigned to the Laboratory technician. It is posterior palatal seal: Description of Technique. NYJ
quite improssible to establish the posterior limit, Det 1966; 36: 280-2.
the width and depth of the seal in an edentulous 16. HeartWell GM, Rhn AO. Syllabus of complete
cast alone, and it is the clinician's responsibility to dentures. 1st ed. Philadelphia: Lea and Febiger
make the decision based on proper procedures in publishers; 1968.
17. Nikoukari H. A study of posterior palatal seal with
the mouth.
varying palatal forms. J Prosthet Dent 1975; 34: 605-
13.
18. House MM. Full Denture Techniques study club No.1,
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review. Australin Dent J 1980; 25 (4): 197-200. 21. Watt DM, Mac Greagor AR. Designing complete
3. Hardy IR, Kapur KK. Posterior border seal its dentures. Philadelphia: W.B. Saunders company;
rationale and importance. J Prosthet Dent 1958; 8(3): 1976. 83-6.
386-7. 22. Silverman SI. Dimension sand displacement patterns
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during the final impression procedure: a functional 23. Ilham HAA. The effect of three different denture
approach. J Am Dent Assoc 1977; 94: 505-10. adhesives on the retention of mandibular complete
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12: 67-81. 24. Behnoush R, Vicki CP. Current concepts for
6. Brian W, Robert F. Accurate location of posterior determining the posterior palatal seal in complete
palatal seal area on the maxillary complete denture denture. J Proth Dent 2003; 12(4): 265-70.
cast. J Prosthet Dent 2006; 96 (6): 454-5. 25. Boucher CO. Swensons complete dentures. St. Louis:
7. Sudhakara VM, Sudhakara UM, Karthik KS, Udita The C.V. Mosby Co.; 1964. Pp. 115, 453-60.
SM. A review on Diagnosis and treatment planning for 26. Sudhakara V M, Karthik KS. A review on posterior
completely edentulous patients. JIADS 2010; 1(1): 16- palatal seal. JIADS 2010; 1(1):16-21.
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Table 1: Means and standard deviation of Group A

Group A Mean N Std. Deviation
A1 309.3333 3 17.92577
A2 186.0000 3 12.16553
A3 119.6667 3 13.61372
Total 205.0000 9 84.33119

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J Bagh College Dentistry Vol. 24(2), 2012 A comparison of the retention

Table 2: ANOVA and LSD of group A

Group A Sum of squares df Mean square F Sig.
Between Groups 55584.667 2 27792.333 127.358 0.000
Within groups 1309.333 6 218.222
Total 56894.000 8

Group A Mean Difference (I-J) Std. Error Sig.

A1 A2 123.33333 12.06157 0.000
A3 189.66667 12.06157 0.000
A2 A3 66.33333 12.06157 0.002
The mean differences is significant at the 0.05 level

Table 3: Means and SD of group B (deep palatal vault)

Group B Mean N Std. Deviation
B1 490.0000 3 10.00000
B2 480.0000 3 20.00000
B3 257.0000 3 23.30236
Total 409.0000 9 115.21936

Table 4: ANOVA and LSD of group B

Group B Sum of squares df Mean square F Sig.
Between Groups 104118.000 2 52059.000 149.738 0.000
Within groups 2086.000 6 347.667
Total 106204.000 8

Group B Mean Difference (I-J) Std. Error Sig.

B1 B2 10.00000 15.22425 0.536
B3 233.00000 15.22425 0.000
B2 B3 223.00000 15.22425 0.000
The mean differences is significant at the 0.05 level

Table 5: Means and standard deviation of Group C

Group C Mean N Std. Deviation
C1 399.3333 3 6.02771
C2 392.6667 3 11.23981
C3 244.3333 3 41.78915
Total 345.4444 9 78.97011

Table 6: ANOVA and LSD of Group C

Group C Sum of squares df Mean square F Sig.
Between Groups 46072.222 2 23036.111 36.201 0.000
Within groups 3818.000 6 636.333
Total 49890.222 8

Group C Mean Difference (I-J) Std. Error Sig.

C1 C2 6.66667 20.59666 0.757
C3 155.00000 20.59666 0.000
C2 C3 148.33333 20.59666 0.000
The mean differences is significant at the 0.05 level

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J Bagh College Dentistry Vol. 24(2), 2012 A comparison of the retention

Figure 1: Strain gauge force tranducer Figure 2: Physiological impression of pps

Figure 3: All casts of each groups Figure 4: Astring of 1 inch in length on the
polished surface

Figure 5: The patient during testing procedure

Restorative Dentistry 17