Defining the posterior palatal seal on

a definitive impression for a maxillary

complete denture by using a nonfluid
wax addition technique
Russell Wicks, DDS, MS,a Swati Ahuja, BDS, MDS,b and
Vinay Jain, BDS, MDSc
University of Tennessee Health Science Center, College of Dentistry
Memphis, Tenn
The posterior palatal seal area is dened as the soft tissue area at or beyond the junction of the hard and soft palates on
which pressure within physiologic limits can be applied by a removable complete denture to aid in its retention. The retention
of the maxillary denture is affected by the extent and the design of the posterior palatal seal. This article discusses a method of
dening the posterior palatal seal on a denitive impression for a maxillary complete denture by using microabrasion and a
nonuid wax addition technique. (J Prosthet Dent 2014;112:1597-1600)

Retention problems associated with
the maxillary denture are common. They
may be caused by postimpression
changes in tissue contours, by making
impressions on abused tissue, also
by having dry mouth, underextended
or overextended denture borders, inad-
equate relief of the frena, poor
neuromuscular coordination, improper
contours of the denture base, or
occlusal errors.1-4 A principle cause
of retention problems is an inaccurate
posterior palatal seal (PPS).4-7 Most
dentures are made of polymethyl-
methacrylate resin, which shrinks on
polymerization.8 This shrinkage affects
the posterior area of the maxillary den-
ture and often creates a gap in adapta-
tion between the denture base and the
palate.2,8 The incorporation of a PPS
helps compensate for the volumetric
shrinkage of the acrylic resin and main-
tains the denture-tissue interface, which
is essential for retention.
The PPS is dened as the internal
posterior border area of a maxillary
removable dental prosthesis.9 The PPS
area is dened as the soft tissue area
at or beyond the junction of the hard
and soft palates on which pressure
within physiologic limits can be applied
by a removable complete denture to aid
in its retention.9 The PPS is present on
the denture; the PPS area is present in
the mouth. There are several objectives
in identifying the PPS area and creating
a proper PPS. The seal should compress
the tissues at the distal extent of the
denture to enhance posterior border
closure. This imparts greater stability to
the denture, which may become less
noticeable to the tongue and help
reduce the gag reex. Intimate tissue
contact also decreases underlying food
accumulation, and the thickened pos-
terior border area provides added
strength to the denture.5,10,11 The PPS
area serves as a guide for developing the
appropriate extension for the denitive
impression tray and trial base.
Several methods of identifying the
PPS area have been described. It can be
done arbitrarily by scraping the cast, as
described by Winkler.12 This method is
popular but, because of wide anatomic
variations, lacks accuracy.7,13 Another
method of identifying the PPS area is to
identify and record it physiologically in
the patients mouth.2,5,7,10,13,14 Mill-
sap5 described the uid wax technique in
1964. He recorded the PPS with mouth
temperature wax (Korecta wax, Extra-
soft no. 4 [orange]; D-R Miner Dental)
at the time of making denitive
impressions. This technique was advo-
cated for use with plaster and ZOE im-
pressions because wax would readily
adhere to these surfaces.5 The potential
disadvantages of this technique are that
the wax may not have enough strength to
displace the tissues sufciently in the
glandular area and may not remain
dimensionally stable during the impres-
sion procedure or cast production.
Most contemporary denitive impres-
sions for tissue-supported prosthetics are
made with polyvinyl siloxane or polysulde
impression materials.15 This article pre-
sents a technique in which static wax can
be rmly applied to these elastomeric
impression materials and with which a
PPS can be precisely formed.
TECHNIQUE
Step I. Identify the PPS area in the
mouth
1. Make an accurate polyvinyl
siloxane (AquaSil; Dentsply Caulk)
maxillary denitive impression, and dry
the tissues with cotton gauze.
2. Identify the hamular notches in
the mouth by running the blunt head of
the mirror on the crest of the ridge from
anterior to posterior2 (Fig. 1).

a
Professor and Chair, Department of Prosthodontics.
b
Adjunct Assistant Professor, Department of Prosthodontics.
c
Assistant Professor, Department of Prosthodontics.

Wicks et al
1598
3. Identify the posterior vibrating line
by asking the patient to say Ah.
4. Palpate the glandular region of
the hard palate with a burnisher2 to
clinically evaluate its compressibility
and anterior extent (Fig. 2). Mark the
area intraorally with an indelible indi-
cator (Fig 3).10 This species the outline
Volume 112 Issue 6
of the PPS area, which must eventually that identies the PPS area to the
be transcribed to the denitive cast. polyvinyl siloxane material (Fig. 4).
2. Dry the impression and airborne-
Step II. Dene the PPS on the particle abrade the marked area with
denitive impression 90 mm aluminum oxide at 200 kPa
(Basic Quattro IS; Renfert) (Fig. 5).
1. Replace the impression in the This creates a precise zone of micro-
mouth, and transfer the marked zone abrasion on the impression material

1 Hamular notches palpated with mirror head. 2 Glandular region palpated with burnisher.

3 Posterior palatal seal area delineated with indelible 4 Posterior palatal seal transferred to denitive impression.
marker.

5 Posterior palatal seal abraded with aluminum oxide. 6 Zone of microabrasion in posterior palatal seal.
The Journal of Prosthetic Dentistry Wicks et al
December 2014
7 Mixture of half baseplateehalf sticky wax melted and
applied to impression.
9 Posterior palatal seal dened in denitive impression.
surface to enhance the bond of the wax
(Fig. 6).
3. Formulate a melted mixture of one-
half medium-soft base plate wax (Base
plate wax; Kerr Corp) and one-half sticky
wax (Sticky wax; Kerr Corp). This wax
mixture, when heated thoroughly, will
adhere to most nonaqueous impression
materials prepared in this fashion and
has the additional advantage of being
stiff enough to be shaped and carved
after cooling.
4. Create the form for the PPS by
using an additive drawn beading tech-
nique for mass application and detail it
into a suitable dimension by subtractive
carving (Figs. 7, 8). The form should
resemble the arbitrary measurements,12
which traditionally are carved as a
negative into the denitive cast (Fig. 9).
5. To help dene and customize the
wax, place the impression into the
mouth and evaluate retention and
Wicks et al
8 Excess wax carved away with hand instrument.
10 Denitive cast with posterior palatal seal area dened.
patient comfort. Add or remove wax for
the best result.
6. Bead and box the impression and
pour the cast to reveal a discretely
formed, customized PPS area (Fig. 10).
SUMMARY
The PPS plays a crucial role in the
retention of the maxillary denture. As
stated by Porter,16 the determination of
the PPS should be the responsibility of
the dentist and not the obligation of a
laboratory technician. Arbitrary mea-
surements of depth carvings of the
denitive cast have been recommended
to give the PPS its 3-dimensional like-
ness in the processed denture.12,17-22
The procedure depicted develops a
replica of the PPS in the denitive
impression, which creates a seal area
depression on the denitive cast. The
technique described gives the clinician a
1599
method of creating and evaluating a
3-dimensional PPS and transferring this
likeness to the poured denitive cast in
a customized fashion. This approach
may be considered less arbitrary than
traditional methods of carving the
denitive cast. If incorporated into the
subsequent record base, a PPS helps
promote stability and retention for the
interocclusal records and the wax trial
appointment steps.23
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Corresponding author:
Dr Swati Ahuja
University of Tennessee Health Science Center
875 Union Ave
Memphis, TN 38163
E-mail: sahuja@uthsc.edu
Copyright 2014 by the Editorial Council for
The Journal of Prosthetic Dentistry.
Wicks et al