Section33 - PosteriorPalatalSeal:DentureRetention

Handout

Abstracts Dent Factors inthe Retention ol Dentures. J Prosthet Z. andNeuman, M. Physical 001. Blahoua, 25:30-5,1971. palatalseals Dent with varans tql4lql-b4l!. J Prosthet 002.Nikoukari, H. A studyofposterior 3 4 : 6 0 5 - 6 13 1, 975. pArcr!! qllh! pa!t!9Il!t!I4!4!ql aqddisplacement 003. SidneyI Silvennan,DDS. Dimensions 19'll. J Prosthet Dent25.4'70-488, !9a1. andimportance. J Prosthet borderscal- Itsrationale 004.Hardy,l.R. andKapur,K.K. Poslerior 1958. Dent8:386-397, calzier, BS,DrvidN Fincll,DDS,MA. andLarryL Hamon.DDS.Postcrior 005.Stcphen pe4plq4!!94! d 1 {ion related 510,1980. to hcightofmaxillaryridse.J Prosthet Dent43:5{)8 006. LaneyW. andGonzalezJ. The maxillary--del1jll9.ti!!-palalaLlg! JADA 80:1 182-l187, 1969. seal 007.Millsap,C. Thc pa$9!iorpalatal 6'73. u-ptdirtalleal.

. DCNA: Nov 1964;663-

plsltrrie!]qldt4lllql-yadlliQ!! denture Winland, RD aid YoungJM. Maxillarvcomplete 001i. J Prosthet Dent 29:256-261,1973. in size.shapc a!!Lle!al[e!. of completlellg4lllqba$lbqtdlgilif&Igltlypss-a!-pa$star 009. Avant, W. E. A comparison p4lqtal$4LJ Prosthet Dent29:484-493, 1973. view oflhe f'actors involvcdin complete Jacobson, T. E. andKrol, A. J., A contemporarv 010aDent49:5-15, 1983. I: Retention. J Prosthct denture retention. stabiljty. andsupporl.Parl 4 contemporary revicw ofthe tu !-ab!'hry,lqtdjuppa4 1983. A contemporar-v reviewofthc factors J Prosthet Dent49, 165-172, PartII. Stability. 49:306-113. 19113. J Prosthet Dent in complete dentures. Partlll: Support. involved Borderofdre Palatini lbr DetemininethePostedor M. Reliabilitvoi theFovea 01l. Chen, Dent43:133-137. 1980. Mqrll!ly_De!!u9. i Prosthet -femperature. to Proccssinq J I'alalalSealDislortionRclatcd 012.Firtell,D. et al. Postcrior 45:5911-601, l98l. Prosthet Dent

posbalatal DDS, MEd, ar,dMG Duncanson, Jr.,DDS, PhD. l he olastic 013.DL Johnson, denture seal.Quint lnt l8:457-462, 1987. 014. Barco MT, et al. Ihe ellect ofrelininq on the accwacy and stability ofnaxillarv cornplete denturesAn in vitro and in vivo study.J ProsthctDcnt 42: l'7-22.197t). 015. Ettinger:,R.1.,Scandrett, F.R. Thc PostcriorPalatalSeal.A rcvicrv. Aust Dent J 25: 197200. 1980. Inlluenceofprocessins techniquq 016. Sykora,O., Sutow, E.J. Posteriorpalatalseal adaptation. oalateshapeand immersion.J Oral Rehabil20: l9-3 l, 1993. 017. Naylor, w.P. and Rcmpala,J.D. 'fhe PosteriorPalatalSeal- Its Forms and Functions(l and ofDcntal Technology, l0:41'7-422 dnd 489-492,July/August 1986. llL Quintcssencc Scction 33 - Posterior Palatal Sal: Denture Retention {Handout) I. Introduction Completedentures may sufl'erliorn a lack ofproper border extension,but ronc arc more impoftant than the posterjorljmit and thc posteriorpalatalsealon maxillary completedentures. that contiDues and is movablein varying degrces The postcriorbordcr is terminatedon a sud'ace and not at a turn oftissue as aaethe other dentureborden. DelicieDcies ofthe distal bordermay bc in thc lcngth ofthe dcnturebase,or the depthofthe posteriorpalatalseal or both. Thcsc errorsmay leadto inadequate retentiondue to the lack of penphual seal. (Millsap 1964). with complctcdmturc rctention, The purposeofthis seminaris to discussthe factoN associated the importanceof the posteriorpalatalscal,its location,design,placementof and processing inlluence. II. Historical review pressure as a meansofdcnturc 1883:Ames and the Greenebrothersintroducedatmospheric retmtion iurdrecommended the useoff'unctional denturebordersas opposcdto passivcborders in the l'abication ofcomplete denturcs. 1886: Wilson desc bed adhesion as thc primary dctcrminantirl dcnturcretcntion. 1907:Grccn brothcrs " Modeling compound" as a reteitive factorby interpreting 1920:Hall revivcd intcrcst in the useofatmosphericpressure the functional dentureborde6. and dcmonstrating

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is in cquilibrium with lluid that atmospheic pressurc 1948.Stanitzuscd a lab model to suggest with a liquid level in a containeras well as prcssurcexefied on moleculeswithin a capilJarytubc -fhcsc modelsexplainedhow lluid film contributedto dentnrc the attractionof two glassslabs. rctention. l95l: Craddockdescribcdthc gripping action ofthe buccinatormuscleon the buccal flange of pad". the mandibulardcntureand also coinedthe telm "pear shaped pressure conrbincdwith intimate tissuecontactand 1962:Stamoulisbelievedthat atmospheric peripheralsealcomprisethe most critical rctcntivc forces. deteminants ofretentjon and diffcrentiatedbetweentissue,polished,and 1964:Fish discussed mechanical, biologic, and and how eachpermits thc dcntist to incorporate occlusalsurl'aces physical l'actors ofthe dentue retcntion. in the movementof a dentureaway from its tissuc Dentureretention:(definition)Thc rcslstance denturethat holds it to thc tissue foundationespeciallyin a vcrtical direction.A quality o1-a fbu[dation and /or abutmentteeth.GPT-7 Wlrat are fivc factorsofretention? ( -Blaliova, Ilardy, Jacobson) . . . . . Adhesion Cohesion I ter.facialsur.face rcnsion Atmospheric pressure Mechanicallocking into undercuts( NP(iDS denturesyllahus).

Describethe di{ferencebetlvccnadhesionand cohesion:( B/aiova, Hardv, Jacobson)

to separatjon by thc film ofliquid betweenthe denture Interfacialsurfacctension:is a resistance It combinesthe actionsofadhesion and cohesionand is similar to baseand supportingtissues. capillary action. When is interfacialsurfacetensionmost effective?When lhe salivarylilm is very thin, thcrc is a to undcrlfng bone perf'ectadaptation ofthc dmture baseand the soli tissuesare firmly attached and not distortcd. have on retention What cffcct doesdistancebetweenthe denturebascand thc mucousmenrbrane and what is it called?Blahovapg 232. "Capillary attraction".

HamullrNotch: ifnot cxtcndcdproperly can causea lack ofrelention. It is lbrmed by thc pterygoidhamulusofthe sphenoidbone,the plaanidal processofthc palatincbonc, and the rraxillary tuberosity.This trougl is the lateralindication for completingthe posteriorpalatal raphe.What tendon/musclc relatesto thc actronofthe pterygomandibular seal.Its displncement is {iequeltly activc in this rcgion'l Tendonofthe tensorlevatorpalatini musclc bchjnd thc hamularnotch and vcrtical tendinousslips ofthe intemal pterygojdrnusclc. what el}'ectofthe Massctcrlnuscle haveon the denturebase?The nuscle activitv will cffect the mandibulardcnturebasecontouron the posteior lateralaspcct. that comprisethe morliolus? What are the intersection ofmuscles oflacial cxDrcssion Part II Pg 169 Jacobson/ltuol How docsthc buccinabr musclecontibute? The supcriorfibers ofthe buccinatormuscleact to scatthc maxillary denture,the middle fibers control the bolus offood and the infcrior fibers contributeto mandibulardenturestability.

Lingual vestibule:It may not be possiblcto achievea border sealwithout a correctliDgual What are they? Seedenturesyllabuspg I7 & flange,which is dividcd into three areas. pg 14. Jacobson,4<rol

when extendinethc lin{ual flanqesinto the vestibulesas tar as pe$illq Stability is increased Thesellangesoresnt"favorableinc Dlace. muscle arca.Influcnccdmainly by the genioglossus l. Antcrior lintaual=sublineualcrescent (retention)which raise and protrudc the tongue. 2. Middle vestibule:mylohvoid area:(stability) Mainly influencedby the mylohyoid muscle.which actsto raisethe {loor ol the mouth. 3. Distolinzual vestibule:lateral throat form or rctromvlohyoid fossa.Boundedallteriorly by thc by the mylohyoid muscle,latcrally by the pear shapedpad,posterolaterally nuscle and mcdially by the superiorconstrictor,postcromediallyby the palatoglossus tongue. The posteriorIimit ofthe mandibulardenturcis dctcrmincdmainly by what two muscles? Palatoqlossusand the supgtiellelltlgtel Ifa patientpresentwith a chiefcomplaint of a sorethroat what might be the contnbuing t'actor'l constrictor SuDerior

upon time and Bxplain why viscosityis the only factor in dentureretentionthat is dependent what can the patientdo to overcomesuchoccvtences?Blahata Pg 233

pressure: The peripheralscalis attainedby positive contactof Peripheralsealand atmospheric the entirpcrimeterofthe denturebaseto thc rcsilient tissuesthat outline the basalseat.How many poundsofatmosphericpressurcare neededto dislodgea denture?

patl I pg 7. 14.7pql Jacobson

(film thicknesspg 8) describethis phenomenon? How did Jacobson

Hardy dcscribedthe lactorsgoveminSdcntureretention.briefly, give examplcsofeach. pg 387. . . . . . Physicalfactors? Physiologicfactors? factors? Psychological Mcchanicalfactors? Surgicalfactors?

What is REALEF mean and how doesthis contributcto dentureretention? Resilientand like effect. Anatomic landmarks and musclesaffecting denture bordcrs. What are critical anatomicarcasthat influencemaxillary dentureretention,stability and support? Maxillary arch Mandibulararch 1. 2. 3. 45. Hamularnotches retentionBuccal shelf- suppofi Soli palate rctention Retromolarpad - support Posteriorpalatalseal- retentionRctromylohyoidspace- stability Hard palate Support,retentionSublinguallbld - stability Buccal vestibule retcntion,stability

Posterior Palatal Seal

I. Purpose ofthe posterior palatal seal The posteriorpalatalseal is looatedat the posteriorborderofthc dcnturc.It has bcen dcfincd as an arcaofsofi tissuealong thejunction ofthe hard and soil palateon which prcssurc, within physiologiclimits oftissues, can be appliedby a dentureto aid in its retention.* Summarizethe functionsofthe posteriorpalatal seal-Millsap, llfti ger 1. 2. 3. 4. 5. 6. To make the sunkendistal border lessnoticeableto the tongue Aids in compcnsating for dimensionalchangcsin curing The proximity ofthe tissuecontactprevcntsfood from gettingunder the denturebase Fim contactwith the tissueofthe soft palatereducesthc tcndencyto gag The thickenedareaprovidesaddedstrengthacrossthe denture To provide retention

ll. The location of the posterior palatal sal and identifying structures Dcscribethe vibrating line and its location?ranev, Naylor Pg 419 "Thc vibrating line is the imaginaryline acrossthe posteriorpart ofthe palatemarking the division betwem movableand immovabletissuesofthe soft palatc and can be idcntificd whcn the movabletissuesarc active". Why is the locationofthe vibrating line or the "ah" line critical and what muscleplays a major pafl in its movementwhen the patientsays"ah"? Naylor pg 419 (Levator veli pirlatini) Saying "ah" will causethc causeth soff palatcto lift. The vibrating line is not a line but an arca. This areais usedto lblTn the post palatalseal. Movementofthe vibrating line in the midline involves a thin, firm, tendonlike band.Name this tendonand what it suppods.Zdnel Pg 1183.

Thc linc usuallyforwardofthc vibrating or thc "ah' line is calledthe?Valsalva line.Whei the patient ( softpalatc attempts to blow air through thenose whatoccurs'l dropslrom thc air pressure) pg 420 Describe ihe lbveaPalatinae: -Iy'a.//or

palatinae Canthefovea be usedto accuatelylocatetheposte or palatal sealrrea?

iiardy attribuledsomedenturcfailure to improperly locating the hamular notchcs.Describethe techniquehc uscd. the use ofa "T" burnisherto idcntily thc notch sincethe instrumentwill drop into " He suggcsted the notch and identily it without question . The posteriorborder and the posteriorpalatalscal are two ofthe mosi critical areasfor maxillary rvill help designate the shapeofthe soft palateand dentureretention.What classification describes the amountofpostcrior tissuethat will acceptthe postcriorpalatal seal?Millsap pg 666 . . . . . House'sPalatalTlroat form: ClassL 5-13mm distal (more than 5mm ofmovable tissueavailablc) Ideal for retention ClassII: 3-5mm distal (l-5mm ofmovable tissueavailablc)Good retention ClassIII: 3-5rnm anterior(lessthan lmm ofmovable tissueavailable)Poor retention ClassIII difhculties are in tissucmovement,tlpically presentin high vaultcd patients, and because ofthe small arcafor the posteriorpalatalseal.

III. Designsofthe posterior palatal seal Descdbesix ofthe most common Posteior palatalsealconfigurationdescribedby Winland and Young. SecEttingcr pg 198. l. 2. 3. 4. 5. A bcad postcriorpalatalseal A double beadpostenorpalatalseal A butterfly posteriorpalatalseal A buttcrfly posteriorpalatalsealwith a beadon the posteriorlimit A butterfly posteriorpalatalsealwith the hamularnotch areacut to half the depthofa #9 bur jn rcfcrcnccto House'sclassilicationol palatal 6. A postcriorpalatalsealconstructed forms;

How did Silvermanplacethe posteriorpalatalsealon the maxillary cast? The castwas scoredas follows: A pcncil line was scribedliom the hamulusto hamulusmidway bctweenthe anteriorand posteriorflexion lines.A grcove was madc in thc castalong the line to a depthof 1-2mn. A shallow scratchindrk was placedon thc antcrior flexion line, iuttl the poste or flexion line was scoredio a depth onc halfthat ofthe midscoreline. The entire seal so that the antenorscgmmt on the castslopedliom the scratchmark anteriorlv areawas scraped portior at the rnidline. The depthofthe castscrapingdiminishcsfrom the midline to the deepest to the posteriorvjbrating line. What was thc cffect ofthe scraping? To allow the sealareaon the dentureto slightly displaceihe soft palatewith a convex surfacc.

Which postcriorpalatalsalconfigurationmay be usedin codunction with the classiliedthrcat form? Naylor pg 490 IV. Techniques used to achievethe posterior palatal scal (I.aney)

l. Functionallmpression- Class lll; to compensatc bccause thcre is so much movement 2. Arbitrary (semi lunctional) Combinationofboth techniques 3. Empirical Scoringcast Describethe techniquethat Millsap usedfor rccording the posteriorpalatal sealarea. l. 2. 3. 4. Use of Iowa wax or KorectaWax No. 4. Mark landmarkswith indelible pencil and reinsertimpression Palpatcscal arca. Apply wax and insertat moderate pressure and allow to cool for scvcnminutcs without pressure, pressure then apply moderate lbr live miDutes. 5. Checkto seewax is touchingil1 a]l areas, add as needed. 6. Trim to indelible pencil )ine. Distortion of acrylic resin What wcrc Johnson'sfindings as to the distortionalopcning of the posteriorpalatal seal? In test groupsof small flat and large V-shapedpalate,the distortionalopcning ofthe postpalatal peripherydecreased as the size and thicknessofthew denturebasewas increased. Distortional openingsalong the posteriorpalatalborder ofU-shaped and V-shapedpalateswere greatest at the midline and xtendedlaterallytwo thirds ofthe distanccfrom thc midlinc to thc hamular notcn, Whaf did he recommend? That the postpalatal seal shouldbe deeperin the centralpart ofthe palateand extendto the hamularnotch to compensate for acrylic distortion During processing ofthe dcnturewhat may contributethe most to acrylic distortion? Heatactivationand cooling. It is assumcd that thc g)'psummaterials,the metal flask and the positive pressure all combineto compensate for pollanerizationshrinkagc.Thc magnitudcofthe remaininglinear shrinkageis attributedto thermal changes, which occur after the plastic assumes the physicalprcpertiesofa solid. Linear sh.inkageis estimatedabout0.44% and by volume has bccn statcdto bc up to syo. (varicsaccordingto author) Cure Cycie: 165 F for E hrs. 2"dstageat 212 F for lhr. bcnch cool I hr. soakroom tcmp water % hr-

= porosity. lftemperatuedsestoo quicklywhatmay occurto thethin Monomer boilsat 213.4F base'J Dentue syllabus areas ofthe denturc
( Stoneactsas a hcat sink by pulling the heat away from the thin denturebaseareas. The thiD of 157 F. arcasofthe dmture baseneverreachactivationtcmperature Abstracts 33-001. Blahoua, Z. and Neuman, M. @. ProsthetDcnt 25: 30-5,1971. J

a model ofmechanismsinvolved in dentureretention. PurBelg:Presents Discussion: None ofthe physicalfactorsfor retentioncan be totally explaincd.However,they all by he commonly and intricatelyparticipateat the moment ofdislodgnlcnt. Rctcntionis enhanced ofthe basalseatareaand by a good border sealwhich keeps elasticityofthe mucousmembranes and mucosa as small as possiblespacebetwccndcnture Physicalfactorsthat influencerctntion:

1 . adhcsion(thebond betweenmucosamcmbranesand the dentue) and cohesion(thc

molecularbond betweensaliva or water) were claimed negligiblc. of imperl-ect seal pressure underthe denturewas not valid because Negativeatmospheric ofsaliva. and th prcsence l . The authorsclaimedcapillary action was the most important.The narower the space betweenthe dentureand mucosa,the more retentionoccurs. for initial rctcntion; as quality over time increascs, 4_ Viscosity ofsaliva was responsible prcvcnt dislodgmentofthe denture. dccreases. lt also helps retention
).

The Model: Biting or suckingforcesdeform elastictissueunder the dcnturcwhich when delbrmedallows for capillary action retention.As tissuesrctum to nafural statelutd saliva for a denture,from time to time, to be pushed incrcases, rctentionbeginsto fail. It is necessary back against(dcform) the mucosamembrancto maintain retentiol. 33-002.Nikoukari, II. A study ofposterior palatal sealswith varving palatal forms. J Prosthet Dcnt 34: 605-6f3, 1975. patternsofthe to measure the dimensionand displacement Purpose:'l'he study was desjgncd posteriorpalatalsealin diffcrent palatalshapes. The effccts ofdifferent materialson the displace ent oftissue in the posteriorpalatalareawere also evaluated. (deep,nedium, and flat) M9!hsd! 44d \1!1!441!: Threepatientswith differing palalal shapes wcrc madeofthe maxillary arch with plastcrof Paristo provide a were selectedlmpressions position. Permanent baseswere madeon thc recordofthe palatein an almostnondisplaceable heat curedclear acrylic rcsin. The distal wax; llasking and processing castsby adaptingbaseplate marking the posterior by having the patientssay "Ah" ar'rd was determined extcnsionofthe bases limit ofmovement ofthe palataltissue. Ihe anteriorextentand dcpth ofthc posteriorpalaial seal was determined by palpationwilh a ball bumishet.Thc baseswere usedto make inpressionsof

the posteriorpalatalsealareawith ZOE paste.low-fusing n'lodcljngcompound(green)and materialswcre applicd in varying amountsas indicatedby the Korcctawax #4. The impression amountofdisplacementofthe tissucin the bumisher palpationiridls. The impressions$ erc boxedand pouredin stoneand two additionalpourswere madeofthc bascswithout the impressions ofthc posfcriorpalatalsealarea.One ofthese sen'cd as a rcproductionofthe palatalscal cut into it using an arbitrurymethod original cast and the other one had the postcrioa a penetrometer. by Neill and Nain1.Measurcmcnts ofthe castswere madeusi|1g as dcscribed 'fhe caused by ZOE was lessthan that of Results: resultsindicatedthat thc tissuedisplacement The compoundhad thc highest the other two materialsin all thrce typesofpalatal shape. was for rcadingsand the Korectawax second all thrce palatetypes. lhe arbitrary displacement mcthod showedthat the highestreadingswcrc locatcdon the posteriorborder ofthe posterior palatalscalarea,whereas, in the other mcthodsthcre were midway betweenthe anteriorand postcriorborclers. This discrepalcy was due to the roundingofthe imprcssionmaterialadjacent to the vibrating lille and lack ofmore distal suppofi. Conclusions: It was concludcdthat the bestposteriorpalatalsealcanbc achicvedby using green on the cast modelingconpound or Korectawax #4. The posteriorbordcr only shouldbe scraped wcrc No apparentchanges oftissue displacement to accountfor the roulding ell'ectdescribcd. found in diflerent palatalshapes. Thc width ofthe posteriorpalatalsealareawas found to b greatest in the patierltwith tbe flat palatal shapeand the leastjn tbc paticnt with the deeppalatal shape. It \r'asalso found that the {lat palatalshapehas a vibrating linc located{artherposteriorly. This agccs with earlierstudiesofSwenson and Tcrkla that the directionofthe vibrating linc Thc higher the vault. the more abmpt and forward is thc varics accordingto palatalshape. vibratiig line. h a mouth with a flat paldtdlvault, the vibrating linc is usually farther posteriorly and has a gradualcunature, affording a broaderfostcrior palatalsealarea. 33-003.Silverman, Sidney L Dimensions and displacementpatterns of the posterior palatal ls? l. !Sd. J Proslhcl Denl 25:,170-488. Purpose: To test the h)?othcsisthat retentionand stability ofa complctcmaxillary denturewill be increascd by cxtcndingth posteriordentureborderbcyond the vibrating line wcrc cxamincdfor a period of two yearsafier completion. Matcrialsand Methods:92 dentures Thc findings describethe degreeand frequencyofmodification oldenture length and thc pcriod. Thc clinical procedure conditionofthe solt palatemorphology during the reexamination given impression is made,the halnular thc imprcssion is in the article. Affcr thc lbr making processcs are markedas is the anteriorflexion linc. This line is ma*ed twice, once with abrupt sayiDgah. On the vigorousburst ofsaying ah and oncc more with briefburst of soll speech mark was mitdeon the anteioa flexion linc and a scratchrnark half mastercasta shallow scratch as deepwas madc on the line rnoreposterior.The dcpth ofthc castscrappingdiminishedliom in many respects thc midline to the posteriorvibrating linc. Thc castwere measured was found betweenthe iiterhamular prccessdistanccand the Results:No signilicantdiff'erence sagittaldistanceor in any othcr correlation.The data indicateonly that thcre is a secondflexion line that can be clinically obscrvcd and recorded posterior to the fovea-oricntcd flexion line and that patients can tolcrate and use prosthesesthat are cxtcnded to this second postrior flexion lincqqllguqia!]icompletc maxillary denturescan be extendedfor an avcragcdistanceof 8.2 mm

l0

dorsallyto the vibrating line. The impressiontechniquedescribed in thc article is critical to its success. 33-004.Hardy, I.R. and Kapurr K.K. Posterior border seal- Its rationale and importance. J Prostbct Dcnt 8:386-397,1958. Purpqlg: Evaluatethe factorsgoverningcompletedenfurcretention. FactorsGoveming Retention: A. Physical l Adhesionand cohesion-perpendicular dislodgingforces. pressurc2. Interfacialsurfacetensionand atmospheric lateml torque and horizontal dislodgmentforces.Camot be usedto achieveretentionalone,due to failurc in casesof xerostomiaand patientswith thick rcpy saliva. B. Physiologic l. 2. 3. 4. 5. 6. 7. Physicalcondition Degreeoftissue tone Quality and quantity ofsaliva Condition ofmucosa and submucosa Neuromuscularcontrol Ridgecharacteristics Ridge relaiionship

C. Psychologic I. 2. 3. 4. lntelligence Expectation Apprehension or fear of embafassment Gagging

D. Mechanical L Occlusion 2. Leverage 3. Contourof denturebases E. Surgical 1. Implant dentures 2. Ridge extcnsion f3]44Nq41: Tle posteriorpalatalscal crcatesa partial vacuumthat will not opcrate PSSleItgI contjnuously, but only when horizontaland tipping forcesare in place.The vacuum is unlikely to

ll

or bordertissues.Excessiveborderseal do any damagcto do any damageto the supportinS dcstroysthe supportingtissuesdue to heavy pressure and the inte 'erence with vascularsupply. A. Advantages

food 1 . Provides a close contact ofthe denture with themucous membrane whichprcvcnts fiom getting undemeath thedenture. gagging. 2 . Diminishes or eliminates distalborders whicharelessconspicuous to thetongue. 3 . Supplics sunkcn 1. Supplies a thickborder to counteract denture warpage. B. Tcchniqucs
Functional-final impressionis border molded in the PPSareawith soft stick compound or wax, pcrformcdby the patient. 2. Semifunctionalborder molding is doneby the dentist. 3. Empirical- PPSis developed on the castby grooving thc castto thc dcsireddepth. l

c. Methods
t. Prcperimpressionpoured.Casttrimmcd and a singlethick pink baseplate wax is adapted
to the castinto thc bordcr roll area,labially and buccally. A hard occlusionrim is adapted to this base. 2 . Itatientusesan astringent mouthwashto rcmovc saliva and instructcdto say "Ah". A point were thereis little or no movementofthe soft tissue,invariably mark is done at the it will includc thc fovea palatini. lt hasthe disadvantage that it will olien deprivethe dentist ofthe useof.-. 33-005.Galzier, Stephen,BS, Firtell, David N. and Harmon, Larry L. !q$9I!gI-p9I!pIgI4! seal distortion related to heisht ofmaxillarv ridsc, J Prosthct Dcnt 43:508-510,l9{10Purpelg: To determincthc relationshipofdimensional changein the region ofthe posterior pcripheralsealto maxillary ridge height.Also to detemine the efl'ectporcelair and acrylic tccth might haveon distortionof acrylic resin in the samearea. Materialsand Methods:An original castwith an initial ridge height of4 mm was designed. Additional mastcrcastswere madeinc.easingthe rklge height 1.5 mm eachtime up to 12.5mm. Scvcnsetsof four casteachwere made.Two setsreceivedporcelainteeth and two selsrccqvcd acrylic teeth.The denturebaseswerc processed and scparation bctwccn thc castand denture baseswas measured with an optical micromctcr. Rcsults:Thc rcsultsarc chartedin two tablesin the afticle. Conclusion:A statisticallysignificantpositive relationshipexist betweenridge height ola cast and dimensionalchanges in the posteriorperiphcralscalrcgion ofits dcnturcbase.As the ridge height increases so doesthc dimensionalchangein posteriorperipheralsealregion. l herewas no rclationshipbctwccn the use ofporcelain or acrylic teethand any dimensionalchangein the posteriorperipheralsealregion.

IL

33-006. Lancy w- and GonzalzJ. @ palatalseal,JADA 80:1182-1187, 1969. reliefin a ma,rillarydcnturc and to examinethe lupgtet To cxaminc thc needfor palertal l'ablicationofthc posteriorpalatalseal. (]1-the authors,as thc opinionsand clinical experience Mcthods & Materials:'fhe arlicle presents ofa maxillary denlule. rvell as reviewingthe anatomicalconsiderations Discussion:The reliefofthe palatcand the posteriorpalatalsealshouldbe cvaluatcdby the According to the authors,most dentistand shouldnot bc left up to the laboratorytechnician. maxjllary dcnturcsdo not requirerelief. The posteriorpalatalsealmust be properly placedand border sealand incrcascstability-This phaseofdenture fabricationis designedto enhance ofthc dentureand the healthol the patient. cxtremelyimpofiant to the success 'l he posteriorborder ofthe dentureis bome by the palatineaponeurosis. Thc hamularnotch is ofthe palatincbone, and the maxillary lbrmed by the pterygoid hamulus,the pyramidalprocess palatini in muscleis active the arcaposteriorto the tuberosity,al1dits tubercsity.Thc tcnsorvcli medial cxtensiononto the laferalpalatelnay bc affectcdby the vertical tendonousslips ofthc intcmal pterygoid muscle. Limited el$ticity over tbe antcriorpart ofthe hard palateand in the arcaofthc antenor pain, or a burning palatineforamenmay contributeto the dentureproducingparosthcsia, jt lfpalatal reliefis desired, shouldbe kept to a minimum. sensationthe posteriorbordcr ofthc dcntureis A techniqueofscribing the mastcrcastby traurslerring provide relief is described. A functional as well as arbitraryseal described. The use oftin foil to ofthe cljnical arc lnentioncd.Scribingthe castno more than two thirds ofthe displacement palpatedareais recornmended. f'eature in the rctcntion ofthe maxillary Conclusion:The posteriorpalatalsealis an essential increases stability. Whcn propcrly placed, it enha[ces border seal and denture. 33-007.Millsap, C. @. r964i 663-613. DCNA: Nov

determinethe posteior limit for Purpelg: Review the andtomyand thc physiology to accurately the palatalseal. Discussion:The purposcis to allow movenent againstthe lelding tissucand maintain a includc: posteriorbordcr sealas the denturcmoveswith torqucproducingforces.Other purposes getting rcduces prcventsfood from beneath the denturc, compcnsates for dimensionalchanges, noticeable to the tongue. adds strength, and lcss Sagging, and is lined by non-keratinized A!a!p!lty: Antcrior soft palatecontainsthe palatineaponeurosis is lbrmcd is looseand containsmucousglands-The palatineaponeurosis tissue.Thc submucosa palatine muscles covered with a thick layer ofglands. the expanded tenclons ofthe tensor by and mark Locationo1': Locatethe hamularnotch $ ith a mirror by sliding ovcr thc tubcrosities with an indeliblc pcncil. The vibrating lille is locatedat thejunction ofthc movable tutd irnmovablesoft palate.lt is not alwayssyrnmctricaland is thinner in the midline. Mark with an indclible pencil. The vibratiDglinc is alwayson the soft palate. PalatalThroat lbnns: Ilow. flat vault in thc hard Dalate.

ts

II-a medium width posteriorpalatalseal. lll-high vault in the hard palate. Techniques lbr recordingl a. b. c. d. e. f. Use oflowalvax or KorectaWax #4. Mark landmarksas notedaboveand rcjnscrtimpression. Palpate seal area. and allow lo cool for sevenminutes. Apply wdx and insertat modffate pressure add as needed. Check to sewax is touchingin all areas, Trim to indclible pencil line.

33-008.Winland, RD ard Young JM. @ Variations in size. shaDand location, J Prosthet Dent 29:256-261,1973. Purpose: To review thc varioustypesofposterior palatalsealsand their constructionas taughtin our dentalschools. was sentto 53 dcntal schoolsin the United Statesand Pucrto Rico. Discussion:A questionnaire completedand retumed. Therc were 47 responses were questions aboutthe tlpe and mcthod ofconstructing a Includedin the questionnaire posteriorpalatalsealin their maxillary completedntutcs. Conclusions:Although there was much variety,it was found that most schoolstaughtthc q4g. There buttedlv casttechniqueand constructed liom as early as thc final was also vanation as to Ebg! the postedorpalatalsealwas developed, processing denture. to as late as the linal ofthe imprcssion, modling plastic was usedprcdominantlyto functionally place Also during linal impressions, soft glandulartissuesin the postriorpalatalsealarea. Most ofthc dcntal schoolsusedSwenson'sCompleteDentures(Boucher). The authorsstatethat no matterwhat techniqucwas used,the most impollant thing to rcmember was !qql, ie. to sealout air and food, and to sealin partialpressure. 33-009,Avant, W. E. A comparison of complete dcnture baseshavins different tvpes of posterior palatal seal.J Prosthet Dent 29:484-493,1973. for !uD9!9: The purposeofthe studywas to deteminc if a posteriorpalatalseal is necessary completedcntureretentioniuld ifaltering thc t)?e and location ofthat sealaffectsrctcntionby was designed to test the retentionofcomplete dentures Mcthodsand Materials:An appamtus The lbrce to the denturebaseapplyinga verlical dislodging force extraorallyto a rod attached was measured using a push-pulldynanorneter.Tlrrcc mcn and two women wete chosenas A mastercast subjcctsfor the study. Eachhad relativcly firm ridges and no postedorundercuts. was madefrom a plasterlina) imprcssion.The mastercastwas duplicatedfour times using reversiblehydrocolloid. The mastercasthad no posteriorpalatalscal inscribedand the duplicatedcastshad four diffefent typesofpostcrior palatalsealsinscribedCast A had a V-shapedgrcove acrossthc palateabout2mm anteriorto tlre vibrating line Cast B had a V-shapedgrooveas in castA and extendingthroughthe pterygomaxillarynotches.

I'f

also groovesforming a loop on both sidesofthe medianpalatineraphe.Cast C had an angleshapedgroovc carvcdacrossthe palateand thrcughthe pterygomaxillarynotches.fhe groove (1.0 to L5mm) at the vibrating liI1eand playedout completelyas it sloped was deepest anteriorly.It was widest on eachsidc ofthc pdatc on eachsidc ofthc palatcbctwcenthe notches.I he tuberosityand the rapheand narrowcstat the mcdianrapheand pterySomaxillary was palpatcd with to determine the outline lbr the anterior border. This tissue a ball bumisher mcthod hasbeen described by Swensoll.CastD was prepared in a mannersimi]ar to castC groove was usedand a V-shapedgrooveplacedin the deepest part of exceptthat an arc-shaped groove. the arc-shaped to the dentue Identicaldenturebaseswcre constucted on the five casts.The rod was attached jig to insurethat the wircs were basesby mcansofwircs that had beenplacedin the baseswith a in thc samcposition in eachdenturebase.Each patientwas testedwearing eachofthe five bases to determinethe amountofforce requiredto dislodgethe base.Each denturebasewas testedfivc tlmes. for optimum retentionofmaxillary complete Bglulb: A posteriorpalatalsealis necessary retntionel|ctively.'Ihe posteriorpalatal dentures. Each tlpe ofscal that was testedincreased scaluscd on castC was the most effectivefor threeofthe five patientsand a very closesecond for the other twoConclusions: A posleriorpalatalsealis necessary for optimum rctcntion.Altcring thc type of palatalsealallects retention.Eacht)?c ofscal usedin the study increased the retention effectivcly. No onc t)?c ofposterior palatalsealthat was testedprovedto be superiorin all posteriorpalatalsealwas the most llective ofthc four subjects.However,the angle-shaped designstested. 33-010a.Jacobson,T. [, and Krol, A, J. @ comDletedenture retention. stability. and support,Part I: Retention. J Prosthet Dent,l9:515, 1983. Purpose: Evdluatethe principles,factorsand thcir intcractions, that mablc us to analyzeand selectprocedures that lcad to dcnturefabrication. to displacement of the denturebaseaway Definition of Propcrties:Retentionis the resistance from the ridge. Stability is the rcsistance to horizontaland rotationalforces.Supportis thc resistance to vefiical movementofthe denturebasetoward the ridpc. Definition of RetentionFactors: l. Adhesion-attractionbctwecnunlike forces. 2. Cohesion-attractionbetweenmoleculesofthe samemateial. 3. lnterlacial sudacetensioll-refersto the lbrcesinvolved in maintainjngthe attractionof two intimately contactedobjccts,by virtue ofa thin fluid filrr in bctwccn them. Also definedas the force that maintainsthe surfacecontinuity of a fluid. 4. Gravity- sclf explanabry. 5. lntimate tissuecontact-close adaptation olthe denturebaseto the underJfng soft tissues6. Border seal-involves the irrtimatccontactofthc dcnturcborderswith thc surrounding tlssucs. physicallactor ofhydrostatic pressure 7. Atmosphericpressuredue to the weiglt ofthe atmosphere on the earlh.

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8. Neuromuscular control-ref'ers to the t'unctional lbrces exerled by themuscles ofthe patient, patients thatcanalTect retention. Older havemoredifficultyin adjusring to ne$ dueto theprogressivc atrophy dentures. oftheir neurological systems. ClinicalObservations: Measwemonts madcabove sealevelshowed a decrcase in denture pressurc, rctcntionWith a 70o% in ahrospheric dccrcasc a 50o/o dccrcase in retention wasnoted. gases The presence ofdissolved or air in saliva, serves to decrease the cffcctivencss ofthc 'l:herelbre pressure. atmospheric thepresence ofperlbrations in a PPS. reduces theretention of thedenture. Clinical Impliealiqls: L Impression mateial with adequate flow propedies should be used to avoiduneven pressure dunngimpressron making. 2. A slightgcncralized prcssure on the softtissucs is desirable. 3- Elimination of full archreliefspacers in thetray. 4. Useofnonperlbrated trayscanleadto inaccurate recordings. 5. Recovery ol abused oral tissues obtained by not allowingpatients to wenrtheirprostheses for a ninimum of48 hrsprior to inpression taking. palatal Anatomical Influences on MaxillarvDcnturc Retention: Highlytapered vaultsandthe (buccal rctrozygomatic space represent a problem in maintaining space), borderscal. presents Anatomic Inlluences on Mandibular Denture Retention: Themandibular denture the Reasons includc: movablc majorproblcmwith rcgard to rctcntion. floor ofthc mouth,which causes difficultyin establishing borderseal, andlack ofidealridgeheightandconformation, whichminimizes denture stability. Adequate sealcanbe obtained by gcntlycompressing thetissues ofthe Iateral wall ofthe padandtucking rctromylohyoid fossa lingualto thc retromolar thc distolingual flangelaterally against themucosa overlfng thesuperior constrictor muscle superiorly andthe looseconnective y. tissue ofthe mandible inf'eriorl The contour andinferiorextension ofthc lingualflange aredependent on theactionand anatomy ofthe mylohyoid muscle. The mostdifficult region in whichto obtaina bordcrscalis the anterior lingualborder. The mylohyoicl muscle actsanteriorly aswell asposteriorly to raise thefloor ofthe mouth.The superior fibersofthe genioglossus muscle attach to the superior genialtubcrclcs thcbodyofthe tongue. andfunction in dcprcssing Activation ofthe inferior fibersserve to protect thc tongue. Clonclusion: Some techniques recommend theextension ofthe zurterior lingualflange sublingLrally. The flange is exteidedinfedorlyto contact thehighest levelifthe floor ofthe mouth.Thc flangccanthenbe cxtcndcd thesublingual foldsandtherefore lostcriorlyto contact establish a sealwhenthetongue is at rest.
Another techniqueinvolves adding additionalsoftened border molding matcrial to thc inner surlaceofthe previouslymolded anteriorlingual areaand reseating the customtray-

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33-010b. Jacobson, T. E. and Krol, A. J, @ completc denturc retention. stabilitv. and suooort. Part IL Stability. J Prosthct Dent ,19, 165-t72.1983. I'urDose: Discussthe factorsthat contributeto denturestability. Relationshrpla] DqllrqBqq !ql!>us! A. Mandibularlingual flange: The most desirablefeatwe ofthe lingual slopcofthe mandibleis that it approaches 90" to the occlusalplanc.The extentofthe contactofthe lingual flange with the lilgual ridgc slopeis therebydictatedby the firnctionalmobility of the floor ofthe mouth. Any flange extensionbelow the mylohyoid ridge must incline medially away from thc mandible,to allow fbr the mylohyoid musclecontractionB. Residualridge anatomy: L Rcsidualheight and confomation- large , squarc,broadridgcs offcr a greaterresistdnce to lateralforcesthan do snall, narow tapcrcd.idges. tend to resistrotationofthe prcsthesis betterthan 2. Arch form- squareor tapcrcdarches ovoid arches. stabilityby providing gcatcr surfaceareaof 3. Palatalvault- a steepvault may enhance a right anglc to thc dircction ofthe lbrce. contact,and long inclines approaching Relationshipofthe Extemal Surfaceand Orofacial Musculature: A. lnlluenceoforofacial musculature:The basic geometricdesignofthe denturebase shouldbe tdangular.To direct a seatingaction on the nandibular denturc,thc tongueshould rest againsta lingual flange,irclined medially away from the mandiblc and somewhat The degreeofinclination dcponds on the balanceofthe muscularlbrces o1-the concave. tongueas opposedto the mylohyoid and superiorconstrictormuscles.Cenerally,the buccal shouldbe concavcto permit and labial flangcsofthe maxillary and mandibulardentures positive seating by the cheeksand lips. The primary musclesofthe lips and cheeksare the orbicul:ris ods and buccinatormusclc,rcspcctively. B. lmportanceofmodiolus: The modiolusor tendinousnode is an anatonic landmarknear of sevetalmusclsofthe cheeks the comer ofthlr mouth that is formedby the intersection and lips. Theseinclude the orbicularisoris, buccinator,caninus,triangularis,and so thy zygomaticus muscles.None ofthcse muscleshave more than one bony attachment, The denturemust be designedas to dependon the modiolus for isometriccontraclions. permit thc modiolus to function lieely. C. Techniques:Neutral zone- theorythat statcsthc beliefthat musclesshouldlunctionally mold not only to the border but to thc cntire polishedsurface. TheoriesofOcclusion: A. Semianatomic or anatomicteeth: ls thoughtto minimize localizedstressconccntration and latcral dislodging lorces by ensuringmultiple points ofcontact, to dist.ibutelunctional occlusallbrcesB. Lingualizedocclusion: Providclimited rangeofexcursive balanceand a directingof Suchconceptmay fbrcesto the lingual side ofthe lower ridge during working-sidecontacts.

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minimizc horizontalstrcssand control the lcvcrageinducedby ecccntnctooth contacts. C. Neuromuscular:Patients are instructedto chew in centricrelation contacts, bilaterally. Tooth Positionand OcclusalPlane:Anterior and posteriorteethshouldbe placedas closeas possibleto their original in the mouth. A nandibular occlusalplanethat is too high ciurresult in reducedstability, because the lateraltilting forcesaremagnifiedas the plane is raised.An elevatedocclusalplaneprcventsthc tolrgucfrom rcachingovcr thc food table into the buccal vcstibulc. Various anatomicallandmarksshouldbe usedto determinean accqrtablclcvcl ofthe pad. occlusalplane,suchas: Stensen's duct and the retrornolar Conclusion:Severe retrognathic or prognalhous ridge relationshipcan be renedied only to a limited extentthroughprosthetictreatment. The stability factor involves tissue,occlusal,and polishedsurfaces ofthe danture. 33-{ll0c. Jacobson,T.E, and Kiol A.J. A contemporarv review oI the factors involved in complete dentures. Part III: Support, J Prosthet Dent 49:306-313,1983. Purpe!9:Study thc rclationshipbetwcenthe denturcbaseand the supportingtissues. Natureof SupportinqTissues: A. Sofl tissucs: Idcally soft tissuesshouldbe firmly bounclto coftical bone,containinga resilient layer ofsubmucosa,arld be coveredby keratinizedmucosa.Keratin is a prcsentin the stratumcomeum and is the cnd product ofepitheljal scleroprotein degeneration. Excessive tmuma to ihe mucosabeneath n denturebasecalr leadto abnoma] tissuechanges suchas development ofparakeratin,localizedhlperkeratosis,and epithelial ulcerationor necrosis. The fatty and glandulartissuowork as a "hydraulic cushion". to be relatedto local anatomicand physiologic B. Bone factor: Thc bone factor appears variationswithin and betweenindividuals.At the presenttime bone factor can only be determined by comparingthe paticnt s response to bone stress( extractions, surgery)or by radiographicobservation. Tensionplaccd on bone on areasofbone attachment tend to preserve the quality ofthe bone and sometimes resultsin bone deposition.Cortical bone is more resistantto rcsorption than cancellousor medullarybone. Sharpey'sfibers cnsurctensjonon bone,minimizing the ofbone to prcssurc. Thcreforc a resorptivechangcsothcrwisebe the normal rcsponse keratinizedmasticatorymucosalirmly bound to underlyingcorticalbone througha variable \vith associated zone ofconnective tissueand submucosa muscleattachments that provides the ideal denture-bea.ing tissuc. Anatomic Considemtions:

A. Mandibularconsiderations: The primdry stressbearingarensoflhe mandiblemust include pad and the buccal shell'.The pear-shaped pad is the most distal extentofthe the pear-shaped kcratinjzednasticatory mucosaof thc mandiblc. Thc junction ofthc rctromolarpad and thc pcar-shaped arcademarcate the extensionofthe denturebase.'I'hepear-shaped areais associdted with the muscle attaclmentsofthe buccinator, superiorconst ctor, and temporal tnuscle.The muscleattachmcnts and the ovcrlying mucosaprovide a stress-bearing area.Thc in providing dcnturcsupport. othcr rcgions ofthc mandible are not usually essential

B. Maxillary considerations: layer everywhere exceptat the l. Keratinizedmasticatorymucosaoverliesa submucosal midiinc suturc. 2. The submucosa containsfatty alld g]alldulartissue. 3. Denseconnectivetissuetraverse the mucosa,exceptthe midline raphcwhich haslittle or no submucosa. of 4. The cortical bone ofthc hard palate(palatineprocessand the horizontalprocesses the palatineboncs),rcsistsresorptivechanges. 5- The tensorveli and the levatorpalatini may provide the sourceoftension that countemctthe pressure resorption. 6. The crestofthe ridge has a layer ofthick keratinizedtissue,densefibrous connective tissuebetweenmucosaand bone that actsas a resilient liner. The underlyingbone rs canccllous bonc which is subjectb resorptivechanges. in the denture 7. The ronaining facial slopesofthe maxillary fidge are not essential suppofi. to resorptionshouldnot be subjected to functionalprcssures: RelicfRcsions: Tissuessusceptible l. most maxillary and mandibularridge crcsts, 2. regionsof thin mucosadircctly ovcr hard cortical bone,theseinclude;midline raphe,tori, exostoses, and thc mylohyoid ridge, bulldlessuchas the incisive papilla, and thc 3. rcgionsofmucosa overlying neurovascular mental lbramenPracticalConsiderations: A tnrly mucostaticor prcssurcfrcc imprcssionis virtually impossibleto sometissue achieve. The fluid implessionmateriaicontainedin a rigid tray inevitablycauses According to Pascal'slaws ofhydrostatics,the pressure exertedon a confincdfluid compression. will transmitevenly throughoutthe lluid. Unfortunately,the fluid in oral tissucsis not confined, placedon them. to stresses the tissuellLridscan move fieely jr rcsponse provide equaldistributionofpressureto the suppofiingtissues imprcssions Selectivepressure so, the ideal techniquefor impression taking should during function. It has somedisadvantages proccdures. incorporate both pressure-liee and selective-prcssurc supporldepends Conclusion:Selectionofthe regionsthat shouldprovide primary and secondary on the anatomicvariationsuniqueto eachpatient. 33-0l1. Chen,M. the l{axillary Denturc. J Prosthet Dent 43:133-137,1980. Pumose:To irvestigatethe reliability ofthc fovca palatjni as anatomiclandmarksfor detenniningthe posteriorborder ofthc maxillary denture. were screened lbr the study. 72 of thesehad fovea palatini Methodsand Matcrials: 101 subjects locatedone on eachside ofthe palate.The vibrating lire (determined by the "blow mcthod") and the lbvea palatini ofthe 72 patientswith "idcal" fovca palatini wcre markcd with an indelible pencil. The dislaDce by two observers. Each bctwccn thcsetwo marks were then measured on eachpatient.The measurements madeby eachoperatoron operatorrnadcthrcc mcasurements cachsubjectwere averagedseparately and usedas dala in compiling the statisticalanalysisfor

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the study. Rcsults:Among the 72 "ideal" subjects,l8 had lbvea palatini whoselocation coincidedwith the vibrating line. None ofthe subjectshad lbvea palatini locatedanteriorto the vibrating line lurd remaining5,1were posteriorto the vibrating linc. Thc diffcrcnce in the mear valuesrecordedby was 0.05mm.Thc authorsconcludcdthat this diffcrencewas probablynot the two observers important from a clinical standpointsinceexistingtechniques and instruments for determining the vibrating line do not permit precisiongreaterthan 0.5mm. Conclusions: l. lhe noseblowing methodappears to be an accurate methodlbr locating the lbvea palatini and the vibrating line. had two fovca palatini. 2. Seventypercentofthe subjects 3. When present, the fovca palatini of257o of subjcctslay dircctly on thc vibrating line. 4. ln 7% ofsubjects,the fovea palatini were locatedwithin l-2 mm posteriorto the vibrating line, in 18.8% within 2-3 mm, in 27.1% within 3-4mm, ir l6% within 4-5 nrm, in 4.9% within 5-6 mm. md in L47u more than 6 mm posterior1()the vibrating line. 5. The fovea palatini are unreliableguidcs for locating the centu pofijon ofthc postcrior n'raxillarydcnturc. border ofthe 33-012. Firtell, D. et al. Posterior Palatal Seal Distortion Related to Processine IglllpSIellllg. J Prosthct Dcnt 45:598-601, 1981. Purpose: The objectivesofthis study were (l) to determinethe eff'ectofprocessingtemperature on the accuracy oflit of a complctemaxillary dcnturcand (2) to dctcnninc thc accuracyof a processed in boiling water and it to pol),methylmethyacrylate by specialacry1icresinproccsscd procedures. conventional Retentionlbrces are at a maximum when the distancebetweenthe denturesurl'ace and grcater minimum. Thc grcatcr thc hcat obtaincd during proccssing, thc supportingtissueis at a will bc thc shrinkageand the resultantstrain within the processed material.A lower temperature than suggested stalldard may producelessdistortion of the denturebase. Methods& Materials:A maxillary castwill minimal undcrcutswas duplicated33 timcs. Thrcc at eachtemperature from 135 F to 180 F in 5 degre de3nturebaseswerc thcn proccssed incrcmcntsfor a total of30 dmture bases. 3 denturebaseswere processed using a specialacrylic that was curedat 212 F for minutes.Afier denturerecoveryand storagein a humidor, the casts at were trimmed and dried, and the distancebetweeneachcastat its denfurebasewas rncasured the midline with an optical micromcterwith a toleranceof0.005 inches. C in the processing temperature Conclusion:It has beennotedthat a di{Lrence in 4 degrees could make a dif-lerence of60 degrcesC within the acrylic resin. Shrinkageand distorlion can be reducedby decreasing the amountofrnonomcr. Proccssing conventional heaFcurcdacrylic rcsin produccdno significant by the manufacturer at temperatures at or bclow that recornmcnded distortionofthc materialat the posteriorperipheralarea.When the processing temperature was raisedabovethe recommended tenperatureof 163 degees F, the distonion at the poste or peripheralsealbecamesigrilicant. thc specialacrylic, dcsigncdto bc processcd at 212 dcgrccsF, at or below conventional showcdsigrificantly lessdistortionthan conventionalacrylic prccessed temperatures. However.the overall strengthcan be debated. There is a possibility that a low processing temperature can produceweakened materialsbecause ofthe formationofshoder

zo

at higher temperatures is distortion in dcnturcbasesprocessed molecularchains-the increased with nore rapid polynerization. thoughtto be associatecl

M.G. Ile-pb$!s-p.a$p414!al-d9 33-013. Johnson, D.1,.and Duncanson, 19117. Int l8:457-462.

. Quint

Pumose:'l'odeterminethe effcct that variationsin palatalfbl.rn,sizc, and dcnturethicknesshave on distortion observcdalong the peripheralborder in the palatc ofa maxillary denture. flat, medium U shapcd, Materialsand Mcthods: Mastercastwerc made for fivc test specimens; medium V shaped,largeU shaped, and large V shaped.liwo additionalsmallersizcsfor each ofdenture bases shapewere also madefor a total of l5 mastercast.Threedif'ferentthicknesscs produced posterior palatal edge ofthe cast The distofiion along lhe were on the mastercast. every threemillimetcrs was rccorded. beginningat the n dljnc and measured individual variables displayeda high dgreeofcorelation with the BgsqLlqNone ofthc to posteriorpalatalopenings.More distortion was cvident in thin maxillary denturesas opposed thick ones.Distoftion along the posteriorpalatalborder showedthat flat contoursproduced opcningsextendingacrossthe arch from hamularnotch to hanrularnotch. tJ shapedirnd V palatalopelings tcndcdto tenniiate in the areaofthcjunction ofthe middle alrd crestal shaped third ofthe posteriorpalatalperiphery. sealthat is dccpcrin the centralpaft ol the palateand extcndsto the Conclusion:A postpalatal for tJ and V shapedparlate lbnns. Extcndingthe seal at leastto hamularnotch is recomrnended fbr flat palateft)rms. the crestofthe hamu!arnotch or beyond is recommended Barco lUT, et al. 33-01,1. complete dentures- An in vitro and in vivo studv. J Prosthct Dcnt 42: 17-22' 1979. is more accurate than Purpelg:To determineifheat-curcd maxillary denturebaseafter relir'ring by upon its removal lion the flask. Also, ifan improvementin fit ofthc order thaf is achieved the relining procedurcis reflectedin the stability ofthe denturein lunction. here. Discussion:An in vitro, as well as in vivo study was conducted 'Ihere was an increaseddistortion of heat-curcd denture baseswith teeth as compared to those without teeth. The rationalehere is that the teetharc hcld filmly in placeby the g)lsum investment, and thc polynerized acrylic resin ofthc baselocks to the teeth.When thermal shrinkageofacrylic resin occurs,thc tceth are held into place.and this probably inducescomplex relaxatr'on occurs.which resultsin in the denturebase.whcn the dentureis deflasked, strcsses present, against the mastercast. whcn no teeth are the resin shrinks distortion ofthe basc. The lab data clearly shorvcdthat a better fitting denture can be made by relining the hcat cured denture lvith an autopolymcrizing resin prior to delivery. This study did not show a signilicant reductionjn the amountofdenture movementaftcr rclining(althoughthere was some).thjs may bc duc to the small samplesize offivc patients. It was possibleto rcducc thc size ofthe posteriorpalatalscal without jeopardizingthe stability of lhe denturc. 33-015.Ettinger:, R.1.,Scandrett, l'.R. The Posterior Pala 25: 197-200. 1980. iew. Aust Dent J

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The poste.iorpalatalsealareais describedand its anatomicalbordersare defined-The methods usedto achievea sealare (l) scrapingthe cast,(2) a selectiveloading impressiontechnique, and (3) a physjologjcalimpressiontechnique.Eachmethodis described and its problemsare The authorsbclicvc that the physiologicalimpressiontcchniqucusiDgwax rcquircs dr'scusscd. thc lcast amountofskill and experience to master(:ompetently. Posteriorpalatallg4l_dgti4ql an drexof soft tissuealong the junction ofthe hard and soli p:rlate on which pressure, within the physiologicljmjts ofthe tissues, can be appliedby a dentureto aid in its retention. palatalseal-(1) to provide retention,(2) to prevcnt food from gctting Fur')ctions ofthc Posterior underthe denturebase,(3) to diminish gagging,(4) to make the sunkendistal borderless conspiouous to the tongue,and (5) to supply a thick border to counleract denturewarpagedue to dimensionalchanges during the curing process. guessby the clinician Teclniqlg! f1) Scrapingcasttechniquc-donc chairsidc,it is an educated (2) selectjvcloading tcchniquc-dcpendson making an itrpressionofthc cdcntulousmaxilla undff constantload and laking into accountthe varying tissuedensitiesofthe mucosa,effective (3) Physiologictechnique-usesx mouth temperature but requiresskill anrl experience. impression wax to createthe poste or palatalseal,advatltages are that it can be developed in stepsand that it can be coffected. thc most common problem associated with lack ofretention ofthc maxillary Conclusionscomplctedentureis a faulty posteriorpalatalsenl.Many dentures do not cover the tuberosities, nor do they extendinto the pterygomaiillary nolches,while othersarc extendedtoo far posteriorlypast the vibrating line. A carcful cxaminationofthe patient'stissueshelps to delineate the anatomicalboundaries ofthe posteriorpalatalsealareaso that an adequate sexl can be established. 33-016.Sykora, O., Sutow, E.J. Posterior palatal seal adaptation. In{lucncc ofprocessing tcchnique. palate shape and immersion. J Oral Rehabil 20: l9-31, 1993. Purpele:To comparethe djmensionalchangcof a ncwer continuous-injection techniqueu'ith a by measuring the posteriorpalatalborder opening. standard trial-packtcchniqucas determined Methodsand Materials:Ten high and ten llat maxillary caslsmadeliom mastersmoulds poured in dentalstone.Ten of the acrylic resin bases(high vault, n:5; llat vault, n:5)were process by the standard trial-packtechniquc(TPT) using a commcrcialproductdesigncdfor this purposc. Tte othcr group of 1{)acrylic rcsin baseswas processed by a continuous-injection technique (CIT). Measurements were marle after deflasking,trimming and polishing,and alter immersion in room temperature water lbr I h, I day and I week. Resuhs:Resultsshowedthat the flat vault had largcr opcningsfor both proccssingtcchniqucs, cxccpt for thc trial pack tcchniqueat deflaskedlocations I L and {). Conclusion:lt was concludedfhat the continuous-injection techniqueshowedsmaller dimensionalchanges comparedwith the standard trial-packtechnique, and that thesechanges were influenccdbv oalateshaocand immcrsronln watcr-

w.P. andRenrpala, 33-017, Naylor, J.D.The PostcriorPalatalSeal- lts Forms and

Functions (l and II). Quintcsscncc of Dental Technology, 10:.117-122and 489-,192, Jul-v/August l9tl6.

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PurBe!!:Thc authors providcinsightandinstruction in the evaluation ofthroat form,design and prenaratiun of lhePr,sterior Palalal Seal. palatal seal(PPS) is generally regarded asanimportant contributor to Dj!g!!qiq4: Theposterior placed maxillarycomplete denturc retention. A well designed andproperly PPSserves several functions. L Helpsmaintain the peripheral seal. 2. Prevents theingress ofair andfoodwhichcoulddislodge thedentur. 3. Helpscompensate for dimensional changes thatoccurduringthecuringofthe acrylic rcsin. 4- May reduce gagging firm contact with thetissues by maintaining ofthe softpalate. 5- lncreases thethickness ofthe acrylicresinat theposterior borderandstrcngthens the denture. 6. May makethedistalborderofthe denture lessnoticeable to thetongue by applying pressure to thetissues ofthe palate. Thedevelopment ofan appropriate design lbr thePPSrequires an assessment ofthe palatal throatform,tissue displaceability, andtheroleofindividualanatomic landmarks in establishing scal.Thefollowingstqrscanactasa guidcto diagnose a dcnturc thePPSdeign. I - Determine thepalatal throatform. House Class1, 2 or 32- Assess andnoteanyunusual anatomical features3. Evaluate thestatus of key anatomical features, i.e.hamular notches, foveapalatine, etcpalatal is an integral pa.t ofthe maxillarycomplete Posterior sealpreparation denture fabrication requiring assessmcnt andtechnical pammeters. In thc case ofphysiological ofpatients with eithera House Class1 or 2 throatfom, theclinicianmay havea choice for theplacement ofthe area ofgrcatest depth. A patient with a House Class 3 haslimitedoptions because it is the least favorablc ofthe threcclasses bccausc of limitedspace for theplacement ofthe PPS. It is important to point out thatthereis no singlcPPSdcsign for all patients.