10.

5005/jp-journals-10019-1020
YA Bindhoo et al
REVIEW ARTICLE

Posterior Palatal Seal: A Literature Review

1
YA Bindhoo, 2VR Thirumurthy, 1Sunil Joseph Jacob, 3Anjanakurien, 4KS Limson
1
Senior Lecturer, Department of Prosthodontics, Sri Ramakrishna Dental College and Hospital, Coimbatore, Tamil Nadu, India
2
Professor and Head, Department of Prosthodontics, Sri Ramakrishna Dental College and Hospital, Coimbatore, Tamil Nadu, India
3
Professor, Department of Prosthodontics, Sri Ramakrishna Dental College and Hospital, Coimbatore, Tamil Nadu, India
4
Reader, Department of Prosthodontics, Sri Ramakrishna Dental College and Hospital, Coimbatore, Tamil Nadu, India

Correspondence: YA Bindhoo, Senior Lecturer, Department of Prosthodontics, Sri Ramakrishna Dental College and Hospital
Coimbatore, Tamil Nadu, India, e-mail:bindhoomds@yahoo.co.in

ABSTRACT

Complete dentures may suffer from a lack of proper border extension, but most important of all is the posterior palatal extension on maxillary
complete dentures. The posterior border terminates on a surface that is movable in varying degrees and not at a turn of tissue as are the other
denture borders. Locating and designing of posterior palatal seal after thorough understanding of the anatomic and physiological boundaries
of this dynamic region greatly enhances border seal and increases maxillary complete denture retention.
The diagnostic evaluation and placement of posterior seal are often given only minor attention in complete denture construction. This
article reviews the importance of the posterior palatal seal with regard to its anatomy, location, design and placement.
Keywords: Complete denture retention, Border seal, Posterior palatal seal, Posterior palatal seal region, Vibrating line, Soft palate,
Velopharyngeal closure.

INTRODUCTION 4. Decreases the forces on the residual ridge by increasing

the denture bearing area.
GPT-8 defines postpalatal seal (PPS) area as the soft tissue
Silverman22 reported that the hypothesis for extending the
area at or beyond the junction of the hard and soft palates on
denture border more posteriorly to contact the soft palate during
which pressure, within physiologic limits, can be applied by a
function is supported by anatomic, neurophysiologic and
complete RDP to aid in its retention.1 This soft tissue seal
radiographic considerations. He stated that the contour and
around the posterior border of maxillary complete denture
design of the posterior border of a maxillary complete denture
requires special consideration during denture extension
should allow dual valving action of soft palate, permitting
determination because the range and extent of the soft tissue
uninterrupted speech and swallowing, thereby making the
activity along this border is profound, when judged with the denture work in harmony with patients function.
labial and buccal sulcus tissues.2 The range of soft palate movement and the degree of
The role of physical factors controlling retention has been displaceability of the seal area differ in every individual.
studied vastly by Cox, Fry, Howland, Moses, Page and House23 proposed three classes of palatal throat forms based
Pryor.1,3-9 Skinner and Chung have experimentally shown that on the angle, the soft palate makes with the hard palate and the
the posterior palatal seal effectively resists rotational thrusts soft palate muscle activity that will be necessary to establish
exerted on complete denture by utilizing the retentive function velopharyngeal closure.
of atmospheric pressure.1,10-12 Presence of intact border seal is In class I, the soft palate is horizontal (Fig. 1) as it extends
indispensable for the retentive function of atmospheric pressure. posteriorly, requiring minimal muscular activity for
Posterior palatal seal complements the buccal and labial border velopharyngeal closure allowing more than 5 mm of seal
seal and converts the denture to function as a sealed area
compartment resisting torquing forces.2,7,8,10,11,13-20 In class III, the soft palate is more acute in relation to the
hard palate, (Fig. 2) necessitating marked elevation of the
Functions of the Posterior Palatal Seal2,21- 26 musculature for velopharyngeal closure permitting a narrow
The primary function is that of completing the peripheral seal seal of less than 1 mm
and enhancing the retention of complete denture. The other Class II type of soft palatal contour lies somewhere between
purposes served by the palatal seal are as follows: class I and class III classes allowing 1 to 5 mm of seal area
1. Diminishes the gag reflex by making the posterior border depending on the muscular activity of the soft palate
indiscernible to the tongue. (Fig. 3).
2. Compensates for polymerization shrinkage of acrylic resin
Anatomy of Posterior Palatal Seal Area
thereby blocks air and food entry beneath the denture.
3. Strengthens the maxillary denture due to the additional bulk Edward, Boucher, Pendleton, Zack and Appleby4,27-30 have
at the posterior border. explained the general and microscopic anatomy of this area.

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Fig. 1: Class I soft palate: (a) Hard palate, (b) soft palate, (c) palatal Fig. 3: Class III soft palate: (a) Hard palate, (b) soft palate, (c) palatal
extension of denture extension of denture

contacts both masticatory mucosa of the hard palate and lining

mucosa of the soft palate.33
The mucosa of the seal region shows a transition from a
fixed to loosely attached tissue beginning from its anterior
extent on the glandular region of hard palate to its posterior
extent on the soft palate.25 The seal area extends from around
the hamular notch on one side across the junction of hard and
soft palate to the hamular notch on the other side. The seal area
narrows down in the midpalatine area due to the scarcity of
connective tissue and the prominence of posterior nasal spine.
The seal can be divided into postpalatal seal and pterygo-
maxillary seal for the convenience of locating and recording
this area.10,23,25,29,30,33 The seal must be placed to sufficient
depth to prevent air from entering under the denture during
functional movements.
As the seal zone contains varying thickness of loose
connective tissue covered by mucous membrane, it shows
Fig. 2: Class II soft palate: (a) Hard palate, (b) soft palate, (c) palatal differing areas of tissue vibration which are referred to as
extension of denture anterior and posterior vibrating lines with the seal area
stretching out between the lines. These lines are defined as
The palatal seal area has distinct anatomic and physiologic follows:
limits which once, when understood, make the placement of
the palatal seal a straightforward procedure with predictable Anterior Vibrating Line
outcome.
It is an imaginary line located at the junction of the attached
The location of the palatal seal is debated throughout the
tissue overlying the hard palate and the movable tissue of the
literature. Posterior palatal seal area is frequently referred also
immediately adjacent soft palate, visualized while the patient
as postdam area, vibrating line.2,4,23 Chen31 disapproved of
is instructed to say ah with short vigorous bursts.
terming the seal area as vibrating line stating that there is marked
variance in tissue movement in this area from its most anterior
Posterior Vibrating Line
aspect to its most posterior aspect and that it should be better
described as a vibrating area. Ultrasound investigation by It is an imaginary line at the junction of the aponeurosis of the
Rajeev Narvekar32 revealed that the posterior vibrating line lies tensor veli palatine muscle and the muscular portion of the
on the soft palate and that the seal area extends on average soft palate visualized, while the patient is instructed to say ah
4 to 6 mm anterior from here. Thus, the posterior palatal seal in short bursts in a normal unexaggerated fashion.13,23

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YA Bindhoo et al

GPT-8 defines vibrating line as an imaginary line across Studies measuring the efficacy of impression material in
the posterior part of the palate marking the division between recording PPS indicate that best seal can be achieved by using
the movable and immovable tissues of the soft palate.1 green modeling compound or Korecta wax No. 4, and tissue
displacement caused by zinc oxide and eugenol paste was less
Locating Posterior Palatal Seal Region than that of other materials.34
As tissues of this area are displaceable, the seal area can be Patient position during impression making of palatal seal area:
identified when the movable tissues are functioning.23 Methods As the denture should maintain contact with the soft palate
that can be employed are as follows: throughout its functional range, this region should be recorded
1. Palpation method using a T burnisher.3,4,33-35 in function. Therefore, an impression should be made when
2. Nose blow method or valsalva maneuverclosing both the patient is seated in upright position with head flexed
nostrils of the patient and asking him to blow gently through 30 degree forward, below FH plane to allow the soft palate to
the nose.4,23,31,33,35 reach its functionally depressed position. The patients tongue
3. Phonation methodvisualizing the vibrating lines as the should be placed under tension against either the handle of the
patient says ah.4,23,31,33,35 impression tray or the dentists finger which is held in the region
4. Anatomical landmarkusing fovea palatinae to identify of the upper maxillary incisors. If the tongue is excessively
vibrating area.10,12,23,36 protruded, the soft palate will foreshorten the posterior border
Clinically, different methods may result in different of the impression to the anterior flexion line.22,23
locations of the vibrating line. Chen31 in his study on the
reliability of methods to locate PPS reported that the vibrating Determining PPS on Master Cast
line in the same individual observed by the nose-blowing
The second commonly reported technique is locating and
method which is located slightly anteriorly than the vibrating
transferring the PPS area on the master cast followed by
line observed by the phonation method. But, the difference in
subsequent scrapping. The scraping of the PPS on the cast
the mean value between the lines identified was clinically
allows the seal area to have a convex surface on the denture
insignificant. Vernie et al35 studied a small study sample and
that slightly displaces the soft palate thereby achieving
found that the anterior vibrating line established by palpatory
peripheral seal.22 Some of the techniques of scrapping and
method was anterior to that established by nose-blowing
designs of PPS are explained here. All of these scoring
method. They explained this by stating that the palpatory
techniques are done after correctly transferring the PPS area
method locates the junction of hard and soft palate and nose-
on the master cast.
blowing method distinguishes the movable and immovable
portion of the soft palate. Bouchers Technique10,20
It is clear from the literature that the fovea palatini are not
reliable anatomic landmarks for locating the vibrating line and The width of the posterior palatal seal is limited to a bead on
that using them as a guide for determining the posterior the denture that is 1.5 mm deep and 1.5 mm broad at its base
extension of maxillary denture base can deprive from several with a sharp apex (Fig. 4A).
millimeters up to a centimeter of denture bearing area.3,11,33,37,39 The resulting design is a beaded posterior palatal seal. The
narrow and sharp bead will sink easily into the soft tissue to
Methods to Register Palatal Seal provide a seal against air being forced under the denture.
Numerous techniques are mentioned in the literature to record
Bernard Levins Technique40
PPS. Functional, semifunctional or empirical method by Hardy
and Kapur,1 conventional method by Winland and Young,4 For class III soft palate forms: He describes a double bead
William,20 conventional physiological and arbitrary method technique for class III soft palate (Fig. 4B). Here, the posterior
by Appelbaum M,23 etc. are a few to name. vibrating line is scrapped 1 mm deep and 1.5 mm wide. An
PPS determination methods can be broadly categorized anterior bead line is created about 3 to 4 mm from the posterior
based on stage of denture construction as follows: border. This is considered as the rescue bead. Bernard stated
1. PPS determination in final impression stage. that even though the anterior bead is located on the hard palate,
2. PPS determination or designing on master cast. the keratinization of the mucosa can tolerate small amount of
tissue displacement and pressure.
Recording PPS in Secondary Impression
Appointment Stage Bernard Levins Technique40
In a functional technique, the final impression is border molded For class I and class II soft palate forms: Using No. 8 round
in the PPS area with soft stick compound or impression wax bur of 2 mm diameter, two holes of 2 mm depth are drilled at
by making the patient perform sucking and bubbling the depth of the bur in the area between the midline and hamular
movements and, in semifunctional technique, border molding notches (Fig. 5). One hole of 1 mm depth is drilled to half the
is done by the dentist.1,23 diameter of the bur in the center. A cone-shaped acrylic resin

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Posterior Palatal Seal: A Literature Review

A B

Figs 4A and B: PPS designs with the cross-sectional views depicted in wax: (A) Single bead (Bouchers technique) and
(B) double bead (Bernard Levin class III technique)

hard palate, turning neither up nor down (Fig. 6A). From the
depth of this posterior cut, the cast is scraped in a tapering
manner, so that it tapers up to the anterior line.

Calomeni, Feldman, Kuebkers Technique14

A posterior bead line is scraped on the cast to a depth of 1 to
1.5 mm extending bilaterally through the hamular notches (Fig.
6B). The anterior line is placed 5 or 6 mm anterior to the
posterior line. The area between the anterior and posterior lines
is scraped with Kingsley Scraper No 1. The depth of the cast
scraped should vary from zero at the anterior line to the depth
Fig. 5: Bernard Levin PPS design for class I and II soft palates with
of 1 to 1.5 mm along the posterior border. In the midline, the
the cross-sectional view depicted in wax distance between the anterior and posterior lines should be
about 2 to 3 mm.
bur is used to rough out the seal. The hamular notch region is
not reduced more than 0.25 mm in width and 0.5 mm in depth Pounds Technique20
and not extended onto the tuberosity vestibules. The softest
Pound advocates a single bead posterior palatal seal with
part of the seal is scraped to 6 mm in width, whereas the median
anterior extensions for additional air seal (Fig. 7A). A V-
raphe region is scraped to 4 mm in width. A medium grid sand
shaped groove is carved across the palate from the hamular
paper is used to smooth the surface.
notch to hamular notch 1 to 1.5 mm wide and 1 to 1.5 mm
deep. This is placed 2 mm anterior to vibrating line. A loop is
Swensons Technique20,30
carved on either side of the midline to provide air seal. The
A groove is cut along the posterior line to a depth of 1 to 1.5 mm depth and width of the anterior loop are determined by palpating
that will cause the posterior border stand straight out from the the area with a blunt end of the instrument.

A B

Figs 6A and B: PPS designs with the cross-sectional views depicted in wax: (A) Butterfly (Swenson technique) and
(B) butterfly with bead (Calomeni technique)

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YA Bindhoo et al

Apple Baum-Winklers Technique23 Hardy and Kapur Technique1,20

A Kingsley scraper is used to score the cast (Fig. 7B). The The depth of the posterior palatal seal area is identified by
deepest parts of the seal are located on either side of the midline, pressing the ball portion of the T burnisher (Fig. 8B). The
one-third distance anteriorly from the posterior vibrating line. posterior palatal seal is extended 4 mm from the distal border
It is scraped to a depth of 1 to 1.5 mm. Close to mid-palatine of the denture and narrowed down to 2 mm in width through
region, the area is scraped to a depth of 0.5 to 1.0 mm as it has the hamular notch region. The scraping of the cast is done in
little submucosa and cannot withstand the same compressive such a fashion that the depth of the posterior palatal seal is
forces as tissues lateral to it. The scraping is gradually feathered maximum at the center and tapers to zero toward its anterior
out as it approaches the anterior vibrating line and is tapered and posterior border.
toward the posterior vibrating line. The posterior palatal seal Winland and Young surveyed the commonly employed
resembles, like Cupids bow. posterior palatal seal designs and summarized them as follows:4
1. A bead posterior palatal seal
Silvermans Technique22 2. A double bead posterior palatal seal
3. A butterfly posterior palatal seal
A pencil line is inscribed from hamulus to hamulus midway 4. A butterfly posterior palatal seal with a bead on the posterior
between the anterior and posterior flexion lines (Fig. 8A). A limit
shallow scratch mark is placed on the anterior flexion line and 5. A butterfly posterior palatal seal with the hamular notch
the posterior flexion line is scored to a depth of one half of that area cut to half the depth of a no. 9 bur
of the midscore line. The cast is scraped over the entire seal 6. A posterior palatal seal constructed in reference to Houses
area. The depth of the cast scraping diminishes from the midline classification of palatal forms.
to the anterior and posterior vibrating lines. He also suggested On comparison of these designs with the scrapping
that complete maxillary dentures can be extended on an average techniques discussed above; a beaded PPS design results from
distance of 8.2 mm dorsally to the vibrating line. Bouchers technique of scrapping, a double-beaded technique

A B

Figs 7A and B: (A) Pounds technique and (B) Winklers technique of PPS designs with the cross-sectional views depicted in wax

A B

Figs 8A and B: (A) Silvermans technique (B) Hardy and Kapurs technique of PPS designs with the cross-sectional views depicted in wax

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results from Bernard scrapping design for class III soft palate, 3. PPS is an area which can be located successfully by palpation,
butterfly PPS design using Swensons method, a butterfly nose blow or phonation method without significant
design with a bead on the posterior limit results from differences.4,9,20,23,26,31,34
Calomenis technique. 4. Determining posterior seal can be performed in final
impression stage or scrapped on the master cast after
DISCUSSION correctly locating the area.1,4,10,20,22,23,26,31,40
Literature on posterior palatal seal reveals the following 5. When it comes to scrapping patterns, no one type of design
findings as follows: is found to be superior to the other. Posterior palatal seal
1. Except for mucostatic concept, all other studies on complete enhances retention irrespective of the design.4 Literature
denture retention clearly emphasize the need for placing reveals butterfly pattern is the most common design
posterior palatal seal.1,3-14,20-40 advocated.26
2. PPS design should follow soft palate configuration to allow
uninterrupted velopharyngeal closure.20,23,26,40 RECOMMENDATIONS

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YA Bindhoo et al

CONCLUSION 17. Darvell W, Clark RKF. The physical mechanisms of complete

denture retention. Br Dent J 2000;189:248-52.
Providing posterior palatal seal for complete denture has been 18. Porter Chastain G. Mucostatics: Panacea or Propaganda? J
practiced almost universally for so long that its origin is not Prosthet Dent 1953;3:464-66.
discernible in dental history.20 Numerous studies exist in 19. Laney WR, Gonzalez JB. The maxillary denture: Its palatal relief
literature to support the effect of posterior palatal seal in and posterior palatal seal. J Am Dent Assoc 1967;75: 1182-87.
complete denture retention. Deficiencies of the distal border 20. Avant William E. A comparison of the retention of complete
denture bases having different types of posterior palatal seal. J
maybe in the width and the depth of the posterior palatal seal
Prosthet Dent 1973;29:485-93.
or both. These errors may lead to inadequate retention due to 21. Ettinger Rl, Scandrett FR. The posterior palatal seal: A review.
the lack of peripheral seal.22 Porter4 stated, The determination Aust Dent J 1980;25:197-200.
of the posterior limit and palatal seal of the maxillary denture 22. Silverman SI. Dimensions and displacement patterns of the
is not the technicians obligation, but the responsibility of the posterior palatal seal. J Prosthet Dent 1971;25:470-82.
dentist. So, this phase of denture fabrication should be given 23. Winkler S. Essentials of complete denture prosthodontics (2nd
due consideration for the success of the denture and the health ed). St Louis: CV Mosby 1988:119.
of the patient. 24. Miller TH. Obtaining the posterior palatal seal. J Prosthet Dent
1984;51:717-18.
25. Heartwell CM Jr. Syllabus of complete dentures (1st ed).
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