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 patients
who 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 incorporating
palatal rugae in a newly fabricated and existing complete denture. (J Prosthet Dent 1999;81:237-9.)

O ne of the factors influencing denture fabrication

is the restoration of the patient’s speech patterns. To
accommodate speech properly, the dentist must have
an understanding of the components that make up
speech. 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 sound
formed into meaningful speech by the movements and
interaction 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, the
hard palate, and the alveolar processes create valves for
the production of specific sounds of speech. These Fig. 1. Tinfoil trimmed and adapted to cast with prominent
sounds include the lingual-dental, lingual-alveolar, rugae.
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/ are
made by flattening the tongue and elevating the lip to
make contact with the maxillary alveolar ridge. The
palatal consonants or the fricatives /sh/ and /z/ are
formed with the tip of the tongue forward and elevat-
ed, contacting with the lateral surfaces of the maxillary
posterior teeth.4 A complete denture alters these rela-
tionships. Normally, most patients have the ability to
adapt their speech production to compensate for the
presence of a denture.5-8 However, there are persons
whose speech is sensitive to these changed relation-
ships and have difficulty accommodating. These
patients often require a tactile sense to orient the
tongue. The palatal rugae and the incisive papilla can Fig. 2. Sealing of tinfoil pattern to palatal area of completed
often serve as a “cue.”9,10 Because the lack of texture wax-up.
on the palatal portion of a complete denture can

impede proper articulation, one solution is to add

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

FEBRUARY 1999 THE JOURNAL OF PROSTHETIC DENTISTRY 237

THE JOURNAL OF PROSTHETIC DENTISTRY GITTO, ESPOSITO, AND DRAPER

Fig. 6. Acrylic resin rugae is secured to existing prosthesis

with autopolymerizing acrylic resin.

Fig. 3. Tinfoil adapted to cast.

Fig. 7. Completed addition of rugae.

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

PROCEDURES
pattern.
New prosthesis
1. Cut tinfoil (0.001 tinfoil, Buffalo Dental Mfg. Co.,
Inc., Syossett, N.Y.) to the desired shape and adapt
it 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 to
the palatal area of the completed wax-up with hot
baseplate wax (Tru Wax, Dentsply International
Inc., York, Pa.) (Fig. 2).
3. Flask, process, finish, and polish as usual.
Existing prosthesis
1. Adapt tinfoil on any available cast with prominent
rugae; flow hot baseplate wax over the surface to
reinforce the tinfoil (Figs. 3 and 4).
2. Prepare the existing prosthesis by roughing the
rugae area.
Fig. 5. Autopolymerizing acrylic resin is applied to pattern to 3. Remove wax reinforced tinfoil from the cast and
fabricate rugae. trim to desired shape; salt and pepper autopoly-

238 VOLUME 81 NUMBER 2

GITTO, ESPOSITO, AND DRAPER
merizing acrylic resin (Perm Reline and Repair
Resin, The Hygenic Corp., Akron, Ohio) onto the
underside of the tinfoil pattern (Fig. 5).
4. When cured, remove the tinfoil and secure acrylic
rugae to the palatal area of the existing prosthesis
with autopolymerizing acrylic resin (Fig. 6).
5. Refine, finish, and polish (Fig. 7).
SUMMARY
The advantages of the described procedures are that
they 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 existing
prosthesis in approximately 30 minutes eliminating the
need 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 laboratory
support is available, the dentist can add the foil pattern
at the time of the final try-in appointment and return it
to the laboratory for processing. In the event that a
patient’s speech is not improved, is worsened, or the
patient 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 is
not a full-proof method of eliminating speech prob-
lems. Some patients may still experience difficulty with
speech accommodation.
A simple method of adding rugae to a newly fabri-
cated complete denture and an existing prosthesis has
been presented. It is a tool for the alleviation of the
speech problems encountered by patients sensitive to
FEBRUARY 1999
THE JOURNAL OF PROSTHETIC DENTISTRY
the changed relationships caused by the introduction of
a prosthesis into the mouth.
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Reprint requests to:
DR CHRISTINA A. GITTO
DEPARTMENT OF DENTISTRY, DESK A70
THE CLEVELAND CLINIC FOUNDATION
9500 EUCLID AVE
CLEVELAND, OH 44195
Copyright © 1999 by The Editorial Council of The Journal of Prosthetic
Dentistry.
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