One of the factors influencing denture fabricationis the restoration of the patient’s speech patterns. Toaccommodate speech properly, the dentist must havean understanding of the components that make upspeech. Speech consists of respiration, phonation, res-onation, articulation, neural integration, and audi-tion.1 Of these components, articulation is most read-ily affected by the construction of a complete denture.By definition, articulation is the resonated soundformed into meaningful speech by the movements andinteraction of the mandible, lips, tongue, soft palate,hard palate, alveolar ridge, and teeth.2,3 The tongue,lips, and soft palate are dynamic structures that con-trol and direct air movement. Rapid and precise move-ments of the tongue and lips move air across the stat-ic structures. Their approximation to the teeth, thehard palate, and the alveolar processes create valves forthe production of specific sounds of speech. Thesesounds include the lingual-dental, lingual-alveolar,and palatal consonants. The lingual-dental or the/th/ sound is made with the tip of the tongue extend-ing through the maxillary and mandibular incisors.The lingual-alveolar or the fricatives /s/ and /z/ aremade by flattening the tongue and elevating the lip tomake contact with the maxillary alveolar ridge. Thepalatal consonants or the fricatives /sh/ and /z/ areformed with the tip of the tongue forward and elevat-ed, contacting with the lateral surfaces of the maxillaryposterior teeth.4 A complete denture alters these rela-tionships. Normally, most patients have the ability toadapt their speech production to compensate for thepresence of a denture.5-8 However, there are personswhose speech is sensitive to these changed relation-ships and have difficulty accommodating. Thesepatients often require a tactile sense to orient thetongue. The palatal rugae and the incisive papilla canoften serve as a “cue.”9,10 Because the lack of textureon the palatal portion of a complete denture can

impede proper articulation, one solution is to addpalatal rugae.

The purpose of this article is to present quick andeasy methods of adding palatal rugae to newly fabricat-ed and existing complete dentures.

A simple method of adding palatal rugae to a complete denture

Christina A. Gitto, DDS,a Salvatore J. Esposito, DMD,b and Julius M. Draperc

The Cleveland Clinic Foundation, Cleveland, Ohio

Restoring patients’ speech is an important goal in complete denture fabrication. For those patientswho have difficulty with their speech patterns accommodating to the introduction of a prosthesis,texture in the palatal region may prove helpful. This article describes methods of incorporatingpalatal rugae in a newly fabricated and existing complete denture. (J Prosthet Dent 1999;81:237-9.)

aAssociate Staff, Department of Dentistry and Maxillofacial Pros-thetics.

bChairman, Department of Dentistry and Maxillofacial Prosthetics.cChief Maxillofacial Prosthetics Technologist, Department of Den-

tistry and Maxillofacial Prosthetics.

FEBRUARY 1999 THE JOURNAL OF PROSTHETIC DENTISTRY 237

Fig. 1. Tinfoil trimmed and adapted to cast with prominentrugae.

Fig. 2. Sealing of tinfoil pattern to palatal area of completedwax-up.

PROCEDURESNew prosthesis

1. Cut tinfoil (0.001 tinfoil, Buffalo Dental Mfg. Co.,Inc., Syossett, N.Y.) to the desired shape and adaptit to the rugae area on the master cast or any avail-able cast with prominent rugae (Fig. 1).

2. Remove the tinfoil pattern from cast and seal it tothe palatal area of the completed wax-up with hotbaseplate wax (Tru Wax, Dentsply InternationalInc., York, Pa.) (Fig. 2).

3. Flask, process, finish, and polish as usual.

Existing prosthesis

1. Adapt tinfoil on any available cast with prominentrugae; flow hot baseplate wax over the surface toreinforce the tinfoil (Figs. 3 and 4).

2. Prepare the existing prosthesis by roughing therugae area.

3. Remove wax reinforced tinfoil from the cast andtrim to desired shape; salt and pepper autopoly-

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238 VOLUME 81 NUMBER 2

Fig. 3. Tinfoil adapted to cast.

Fig. 4. Hot wax is flown over surface of tinfoil to reinforcepattern.

Fig. 5. Autopolymerizing acrylic resin is applied to pattern tofabricate rugae.

Fig. 6. Acrylic resin rugae is secured to existing prosthesiswith autopolymerizing acrylic resin.

Fig. 7. Completed addition of rugae.

merizing acrylic resin (Perm Reline and RepairResin, The Hygenic Corp., Akron, Ohio) onto theunderside of the tinfoil pattern (Fig. 5).

4. When cured, remove the tinfoil and secure acrylicrugae to the palatal area of the existing prosthesiswith autopolymerizing acrylic resin (Fig. 6).

5. Refine, finish, and polish (Fig. 7).

SUMMARY

The advantages of the described procedures are thatthey can easily and quickly be accomplished by the den-tist or the laboratory technician. The dentist or techni-cian can complete the addition of rugae to an existingprosthesis in approximately 30 minutes eliminating theneed for the patient to go without their prosthesis.With a newly fabricated denture, the laboratory techni-cian adds the foil pattern as part of the completed wax-up in a matter of minutes. If no in-house laboratorysupport is available, the dentist can add the foil patternat the time of the final try-in appointment and return itto the laboratory for processing. In the event that apatient’s speech is not improved, is worsened, or thepatient finds the texture annoying, it can easily be elim-inated with an acrylic resin bur and routine polishing.Unfortunately, the addition of rugae to a prosthesis isnot a full-proof method of eliminating speech prob-lems. Some patients may still experience difficulty withspeech accommodation.

A simple method of adding rugae to a newly fabri-cated complete denture and an existing prosthesis hasbeen presented. It is a tool for the alleviation of thespeech problems encountered by patients sensitive to

the changed relationships caused by the introduction ofa prosthesis into the mouth.

REFERENCES

1. Haitas GP, Wolfaardt JF, Carr L. Speech defects in prosthetic dentistry, partI—the mechanism of speech production. J Dent Assoc S Afr 1985;July:381-6.

2. Chierici G, Lawson L. Clinical speech considerations in prosthodontics:perspectives of the prosthodontist and speech pathologist. J Prosthet Dent1973;29:29-39.

3. Curtis TA, Beumer J. Maxillofacial rehabilitation prosthodontic and surgi-cal considerations. St Louis: Ishiyaku EuroAmerica; 1996. p. 285-9.

4. Esposito SJ. Speech and palatopharyngeal function. In: Zlotolow I, Espos-ito S, Beumer J, editors. Proceedings of the first International Congress onMaxillofacial Prosthetics, Indian Wells, Calif., April 27-30, 1994. p. 43-8.

5. Petrovic A. Speech sound distortions caused by changes in complete den-ture morphology. J Oral Rehabil 1985;12:69-79.

6. Hamlet SL. Speech adaptation to dental appliances: theoretical consider-ations. J Baltimore Coll Dent Surg 1973;28:52-63.

7. Hamlet SL, Cullison BL, Stone ML. Physiological control of sibilant dura-tion: insights afforded by speech compensation to dental prostheses. JAcoust Soc Am 1979;65:1276-85.

8. Hamlet SL. Speech compensation for prosthodontically created palatalasymmetries. J Speech Hear Res 1988;31:48-53.

9. Palmer JM. Structural changes for speech improvement in complete upperdenture fabrication. J Prosthet Dent 1979;41:507-10.

10. Pound E. Esthetic dentures and their phonetic values. Dent J Aust1953;25:150.

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