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Original Article

A study of correlation between posterior palatal seal width

and soft palatal angulation with palatal contour
Rupal J. Shah, Sanjay B. Lagdive, Divyeshkumar B. Modi, Bhavyata Darji, Vedanshi A. Amin,
Ghanshyambhai C. Patel
Department of Prosthodonontics, Government Dental College and Hospital, Asarwa, Ahmedabad, Gujarat, India

Abstract Context: The spatial relationship of posterior palatal seal (PPS) width and vibrating lines varies among
individuals. Such variability could be related to contour of the palate.
Aims: The study was carried out to evaluate the relationship between PPS width of the patient intra‑orally and
cephalometric tracing of the same patient. Second part of the study was formulated to determine whether
the anterior and posterior vibrating lines can be distinguished as two separate lines by different observers.
Materials and Methods: A lateral cephalogram was made to trace the hard and soft palatal contour, and the
angle of the palatal contour was measured with the v‑ceph program. Correlation analysis was conducted
to examine the relationship between the distance from anterior to posterior vibrating lines and the angle
of the palatal contour at the junction of the hard and soft palate.
Statistical Analysis Used: The data were analyzed using the Karl Pearson Correlation test.
Results: Correlation of the angle of the palatal contour to PPS width, showed perfectly positive value;
whereas, correlation of angle between anterior nasal spine‑posterior nasal spine (ANS‑PNS) and PNS‑Uvula (U)
to PPS width showed partially positive value.
Conclusion: The correlation of angle between hard tissue and soft tissue to PPS width, and the angle
between ANS‑PNS and PNS‑U to PPS width, increases with an increase in PPS width.

Key Words: Anterior nasal spine‑posterior nasal spine line, posterior nasal spine‑Uvula line, posterior
palatal seal, vibrating line

Address for correspondence:

Dr. Divyeshkumar B. Modi, 102/2, Samratnagar, Isanpur, Ahmedabad ‑ 382 443, Gujarat, India. E‑mail: drdivyeshmodi@gmail.com
Received: 15th June, 2015, Accepted: 30th December, 2015

INTRODUCTION efficiently during stomatognathic function (mastication,

phonation, etc.). [1]
Patient’s expectations are considered as paramount factor
in designing of the prosthesis for giving a successful A well‑fitting and retentive complete denture requires a
treatment. They expect a good prosthesis which is well‑fitting tissue surface, a peripheral border compatible with
well‑retained in mouth for a long duration that can work
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How to cite this article: Shah RJ, Lagdive SB, Modi DB, Darji B, Amin
DOI: VA, Patel GC. A study of correlation between posterior palatal seal width
10.4103/0972-4052.176519 and soft palatal angulation with palatal contour. J Indian Prosthodont Soc
2016;16:154-8.

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Shah, et al.: Correlating between posterior palatal seal width and soft palatal angulation with palatal contour

the muscles, and tissues which make up the mucobuccal and MATERIALS AND METHODS
mucolabial spaces so that a peripheral seal is created by the soft
tissue draping over them. It is usually obtained by labial and Prior to the initiation of the study, approval was granted by the
buccal seal. In the posterior region, it is mainly by the posterior Ethical Committee of the Institute. Seven dental postgraduate
palatal seal (PPS).[2] clinical students were selected as observers. Forty‑two dentulous
patients were randomly selected. The students were asked to
The accuracy or fit of complete dentures is essential for record the anterior and posterior vibrating line on one patient
providing retention.[3] However, even with the presence of each using colored marking pencils. The anterior vibrating line
newly improved dental materials spaces may develop under was also marked by the palpatory method (using t–burnisher)
dentures.[4‑9] For this reason, a compensating mechanism is using a different colored marking pencil. The marked lines
required. Whereas, the form of the anterior alveolar bone were then transferred to the previously made impression of
may resist the deformation when the denture is removed from irreversible hydrocolloid material.
its cast,[10] the posterior area of the maxillary denture is flat.
Therefore, it does not restrict the release of internal stresses Each subject was instructed by the study coordinator to rehearse
during processing of the acrylic base and cannot prevent the the valsalva maneuver until he/she became acquainted with
deformation occurrence.[11] Providing sufficient PPS of a it. The subject was then instructed to say ‘ah’ in a normal
maxillary denture is necessary for retention.[12,13] unexaggerated manner. He was then requested to perform the
above maneuvers when required to do so Figures 1 and 2.[20]
The PPS may be defined as an area of soft tissue along the
junction of the hard and soft palate on which pressure, within The study commenced by measuring the PPS width. PPS
physiologic limits of the tissues, can be applied by a denture width was measured in patient’s mouth using Vernier calipers.
to aid in its retention.[14]
A lateral cephalogram was made to trace the hard and soft palate
The definition of the vibrating line seems to be controversial contour, and the angle of the palatal contour was measured with
and indefinite. In the glossary of prosthodontic terms, the the v‑ceph program. Correlation analysis was conducted with
vibrating lime is defined as an imaginary area rather than a line statistical software to examine the relation between the width
at the junction of the movable and immovable tissue across the of PPS (the distance from anterior to the posterior vibrating
posterior part of the palate that can be seen extending up to line) and the angle of the palatal contour at the junction of
soft palate and extends bilaterally to the hamular notch. the hard and soft palate.

The currently used techniques for determining the location of The tracing points were anterior nasal spine (ANS), posterior
the vibrating line are based on:[15‑18] nasal spine (PNS), Uvula (U), and shadow of the hard and
• Phonation of ‘ah’ sound soft palate.
• The palpatory method
• The nose‑blowing method (valsalva maneuver) In contiguity with the second part of the study, observations
• The swallowing method. recorded in the study were made by two observers, the study

Location of the vibrating line relies on visual observation.

Hence, a difference exists between different observers in
determining anterior and posterior vibrating lines. Moreover, by
that variation occurs in the PPS location and size.[19] This study
focused on location and size of PPS boundaries in different
individual having different angles between hard and soft palate.

The study was carried out to evaluate the relationship

between PPS width of the patient intra‑orally and that in
the cephalometric tracingt. A second part of the study was
formulated to determine whether the anterior and posterior
vibrating lines can be distinguished as two separate lines of
flexion by unbiased observers and compare it with lateral
cephalometric tracings of angulations related to soft palate
position. Figure 1: Marking of vibrating lines in patient’s mouth

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Shah, et al.: Correlating between posterior palatal seal width and soft palatal angulation with palatal contour

coordinator and the observer. The study coordinator first dried a partially positive value. It means when increasing angle
the PPS area with a gauze sponge. The subject was asked to between hard tissue and soft tissue, there was also increment
perform the first maneuver (saying ‘ah’ in an unexaggerated in error determining anterior and posterior vibrating lines, but
manner). The hamular notch was located by palpation and in higher numbers Table 2.
marked using a pointed violet‑colored pencil. The observer was
then asked to mark the beginning of the line of motion of the Whereas the correlating angle between ANS‑PNS and PNS‑U
soft palate with the violet‑colored pencil. The dried impression tissue to PPS width and difference of marking errors of anterior
was then placed in the mouth by the study coordinator to
transfer the marking. Table 1: Correlating angle between hard and soft tissue to
posterior palatal seal width
The violet marking on the palate was then wiped off. The Angle Difference Difference Width
between between between of PPS
hamular notch was again located and marked with a pointed tip hard ant post
dipped in pink food color, and the subject was asked to perform tissue and vibrating vibrating
soft tissue line line
the next maneuver (nose blowing). When the soft palate moved
Angle between hard
after gently pinching the subject’s nose and having the subject tissue and soft tissue
attempt to blow air through the nose, the line of flexion was Pearson correlation 1 0.120 0.145 0.930
marked in violet color by the student; the dried impression was P 0.451 0.361 <0.001
n 42 42 42 42
again placed by the study coordinator in the mouth to transfer Difference between
the second marking. The marking was wiped off the palate. ant vibrating line
Pearson correlation 0.120 1 0.159 0.141
The anterior vibrating line was confirmed by the study P 0.451 0.314 0.372
n 42 42 42 42
coordinator by using the palpation method, wherein t– Difference between
burnisher was used. This marking was done using a pointed tip postvibrating line
dipped in violet food color, and the impression was repositioned Pearson correlation 0.145 0.159 1 0.193
P 0.361 0.314 . 0.220
in the mouth to transfer the third marking n 42 42 42 42
Width of PPS
A comparison of the two colored lines was made on the Pearson correlation 0.930 0.141 0.193 1
impression P 0.000 0.372 0.220
n 42 42 42 42
PPS: Posterior palatal seal
RESULTS

Table 2: Correlating angle between anterior nasal spine‑posterior

Correlation of the angle between hard tissue and soft tissue
nasal spine and posterior nasal spine‑uvula to posterior palatal
to PPS width and difference of marking errors of anterior seal width
and posterior vibrating lines, marked by different observers, Angle Difference Difference Width
showed a perfectly positive value. It means with increasing angle between between ant between of PPS
ANS‑PNS vibrating postvibrating
between hard tissue and soft tissue, there was also an increment and PNS‑U line line
of PPS width Table 1. Angle between
ANS‑PNS and PNS‑U
Correlation of angle between hard tissue and soft tissue to Pearson correlation 1 0.194 0.324 0.360
difference between anterior and posterior vibrating line showed P 0.217 0.036 0.019
n 42 42 42 42
Difference between
ant vibrating line
Pearson correlation 0.194 1 0.159 0.141
P 0.217 0.314 0.372
n 42 42 42 42
Difference between
postvibrating line
Pearson correlation 0.324 0.159 1 0.193
P 0.036 0.314 0.220
n 42 42 42 42
Width of PPS
Pearson correlation 0.360 0.141 0.193 1
P 0.019 0.372 0.220
n 42 42 42 42
*Correlation is significant at the 0.05 level (two‑tailed). ANS: Anterior
Figure 2: Tracing of angulations on lateral cephalograms nasal spine, PNS: Posterior nasal spine, U: Uvula

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Shah, et al.: Correlating between posterior palatal seal width and soft palatal angulation with palatal contour

and posterior vibrating lines, marked by different observer, and PNS‑U tissue to PPS width. With increasing angle, there
there is partially positive value. It means when increasing angle is also increase in PPS width. A significant difference between
between hard tissue and soft tissue there was also an increment errors in marking PPS was also noted. With increasing angle,
of PPS width but on higher numbers. there was an increase in error while marking vibrating lines.

DISCUSSION Acknowledgment
The authors would like to thank Dr. Ghanshyam C. Patel for
It has been agreed that the PPS area lies between these anterior helping with the statistical analysis of the data.
and posterior vibrating lines. In order to correctly locate
these lines, careful observation and palpation of the tissue Financial support and sponsorship
are necessary, as their locations vary with the contour of the Nil.
soft palate.[21] In addition, the palatal tissues anterior to the
posterior border need to be palpated with a blunt instrument Conflicts of interest
to determine their compressibility in width and depth. The There are no conflicts of interest.
termination of the glandular tissues usually coincides with the
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