Posterior palatal seal recording: fact and reasons among Iraqi dentists

Shorouq M. Abass; Bayan S. Khalaf; Tameem K. Jassim; Aseel M. Al-Khafaji

doi:10.12688/f1000research.154823.2

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Research Article

Revised

Posterior palatal seal recording: fact and reasons among Iraqi dentists

[version 2; peer review: 1 approved, 1 not approved]

Shorouq M. Abass ¹, Bayan S. Khalaf¹, Tameem K. Jassim², Aseel M. Al-Khafaji¹

PUBLISHED 29 Nov 2024

Author details Author details

¹ Department of Prosthodontics, University of Baghdad, College of Dentistry, Baghdad, Iraq
² Department of Prosthodontics, Mustansiriyah Unversity, College of Dentistry, Baghdad, Iraq

Shorouq M. Abass
Roles: Conceptualization, Data Curation, Formal Analysis, Methodology, Resources, Writing – Original Draft Preparation, Writing – Review & Editing

Bayan S. Khalaf
Roles: Conceptualization, Data Curation, Investigation, Methodology, Resources, Supervision, Writing – Original Draft Preparation, Writing – Review & Editing

Tameem K. Jassim
Roles: Data Curation, Investigation, Methodology, Resources, Software, Writing – Original Draft Preparation, Writing – Review & Editing

Aseel M. Al-Khafaji
Roles: Resources, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing

OPEN PEER REVIEW

REVIEWER STATUS

Abstract

Backgrounds

The retention of the maxillary complete denture may be influenced by adequate recording in the patient’s mouth, marking, and carving of the post-dam on the maxillary cast. Failure to do so may lead to loss of retention. Successful denture construction with patient’s comfort could be achieved by effective methods of recording, marking, and carving of the post-dam. The aim of the study was to assess Iraqi dentists in their knowledge and application of the post-dam in maxillary complete dentures.

Methods

Questionnaires were distributed randomly through online Google Forms and 118 Iraqi dentists with different academic degree participated in the study. A multinomial logistic regression model was also used to assess the nominal outcome variables.

Results

A High percentage of 90.7% of Iraqi dentists with different academic degree stated that they had the knowledge about the vibrating lines and their location and 84.7% stated that they mark the post-dam on the master cast, while 15.3% stated that the dental technician marks it. More the half (52.5%) of the participants carved the post-dam, while 47.5% of the participants stated that the dental technician did it. For participants not marking the post-dam, 30.5% of the participants stated they depend on the dental technician in marking and/or carve the post-dam, while the fear of denture failure and loss of retention was observed in 25.4% of the participants, followed by 24.6% of participants forgetting to carve, 10.2% of participants had no information about carving, and 9.3% participants found it was difficult to carve.

Conclusions

Within the limitations of the study, most Iraqi dentists with different academic degree stated that they had the knowledge on the location of vibrating lines. However, recording and carving the post-dam was influenced by the dentist’s personal preference and their dependency on the dental technician.

Keywords

Maxillary, complete denture, post-dam. 

Corresponding author: Shorouq M. Abass

Competing interests: No competing interests were disclosed.

Grant information: The author(s) declared that no grants were involved in supporting this work.

Copyright: © 2024 Abass SM et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

How to cite: Abass SM, Khalaf BS, Jassim TK and Al-Khafaji AM. Posterior palatal seal recording: fact and reasons among Iraqi dentists [version 2; peer review: 1 approved, 1 not approved]. F1000Research 2024, 13:1006 (https://doi.org/10.12688/f1000research.154823.2) First published: 04 Sep 2024, 13:1006 (https://doi.org/10.12688/f1000research.154823.1) Latest published: 29 Nov 2024, 13:1006 (https://doi.org/10.12688/f1000research.154823.2)

Revised Amendments from Version 1

We have added new paragraphs with references in the Introduction and Discussion sections.
Also we added new references in the reference list and checked paraphrasing throughout.

See the authors' detailed response to the review by Zena Wally
See the authors' detailed response to the review by Khurshid Ahmed Mattoo

Introduction

A successful prosthesis, accepted by a patient, is that prosthesis that functions effectively during mastication and speech and is adequately retained on the edentulous arches. Precise recording, marking, and carving of the posterior palatal seal (PPS) is an important step for the retention of the maxillary denture and overall treatment of the edentulous patient. Thus, the significance of the distal extent of the upper complete denture needs to be adequately performed.¹^,²

Many researches were aimed to enhance the retention of the maxillary denture by enhancing the denture base adaptation to the supporting structures.³^,⁴ Even the disinfection of dentures may have an influence on the dimensional stability and overall retention of the complete dentures or the damaging effects on denture base material itself.⁵^,⁶ Such attempts enhanced the adaptation but did not eliminate the need for a PPS. The purpose of the PPS is to offer retention for a well-adapted upper denture and this is provided by an appropriate seal to reduce the effect of shrinkage from polymerization setting of the denture base material. In addition, the presence of the PPS prevents food accumulation between the posterior border of the denture and the soft palate, reduces gag reflex, and renders the extension of the posterior border of the denture more comfortable to the touch of the tongue.⁷ Adding additives to the denture base may enhance the strength of the denture base but the presence of the PPS itself can add extra strength for the posterior part of the upper complete denture.⁷^,⁸

The preparation of the PPS should be performed with adequate understanding of palatal anatomy and the displaceability of the mucosa.⁹ The dentist should be responsible for recording, marking, and carving of the PPS and this responsibility and the completion of this step should not be shifted to the dental technician.¹^,²^,⁹

An essential constituent of the manufacturing of maxillary full dentures is the preparation of the posterior palatal seal. It necessitates a technical and physiological evaluation, and a thorough inspection during the diagnostic stage of treatment can prevent a lot of possible issues. Therefore, it is the dentist's vital duty to determine the posterior palatal seal effectively.¹⁰

Even though incorporating digital into traditional methods has many advantages, some dental clinics may not be able to use CAD/CAM CDs due to their higher laboratory expenses.¹¹

Several methods are employed to locate the vibrating line. These consist of the "Ah" sound phonation, the palpatory method, the swallowing method, and nasal blowing. Thus, it's critical to research this anatomical landmark and determine whether it may be used to approximate the vibrating line's location.¹²

Skinner¹³ stated that “The most effective addition to increase retention is the post dam”. In spite of the recommendations through previous researches concerning the importance of the PPS during denture manufacturing, the preparation and position was often ignored by dentists and dental students.¹⁴ Thus, a significant number of dentures were unsuccessful due to inadequate carrying out of the PPS.¹⁵

The dentist benefits from techniques that aid in the development of PPS during the final impression or border moulding stages. This is due to the fact that the dentist is no longer dependent on the technician and is fully responsible for finding and creating the seal.¹⁶

When the PPS is developed at the final impression stage, the dentist can take charge of the procedure instead of technicians using haphazard and imprecise cast scraping techniques.¹⁷

Adams¹⁸ investigated the methods for the PPS employed by clinicians and dental students during construction of complete dentures and determined how many carryout this step by themselves. He revealed that the location and measurements of the post-dam were overlooked or forgotten by the practitioners and dental students and placed in the hands of technicians. This showed the deficiency in attention given to the significance of the post-dam by the practitioners and dental students. There was a need for research directed to analyzing the reason for the decline in interest by students and experience dental clinicians for this step.

A survey was prepared by Sunil and Jain¹⁵ to investigate registering the PPS among dentists and dental students. The survey showed that they had satisfactory knowledge of the anatomical landmarks associated with the PPS, but were poorly associated with the size, shape, location, and compressibility of the mucosa of the PPS. This reflected the need for highlighting the importance of the PPS and its role in complete denture retention and the satisfaction of the patient.

Therefore, this study was aimed to evaluate the knowledge of Iraqi dentists with different academic degree for locating the vibrating lines, if Iraqi dentists mark and/or carve the post-dam, and what were the reasons for not recording the post-dam by the dentists themselves. The null and the alternative hypotheses for the study are shown with description in Table 1.

Table 1. The null and the alternative hypotheses for the study.

No.	Hypothesis	Description
1	Null	Dentists do not have the knowledge on the location of the vibrating lines.
1	Alternative	Dentists have the knowledge on the location of the vibrating lines.
2	Null	Dentists do not mark the post-dam on the master cast.
2	Alternative	Dentists mark the post-dam on the master cast.
3	Null	Dentists do not carve the post-dam.
3	Alternative	Dentists carve the post-dam.
4	Null	Fear from denture failure and loss of retention is not the reason for dentists not marking and/or carving the post-dam.
4	Alternative	Fear from denture failure and loss of retention is the reason for dentists not marking and/or carving the post-dam.

Methods

This study was approved by the Committee for Ethics / College of Dentistry, University of Baghdad (project no. 357221, date: June 7, 2021) and was conducted from October 2022 to November 2022 in accordance with the Helsinki Declaration of Ethical Principles for Medical Research with Human Subjects. The consent form was distributed with the google form and gathered electronically. The consent form and the patient information sheet were written as recommended by the Committee for Ethics/College of Dentistry, University of Baghdad and the participants were aware of the aims of the research and the confidentiality of their personal information as they accepted to fill the google form questionnaire.

The questionnaire was shared as a google form online in different groups for Iraqi dentists with different academic degree on social media applications (WhatsApp and Telegram). The first part of the questionnaire consisted of the personal information for the participant including the age, sex, years of experience after graduation and academic degree; doctorate (Ph.D.), master's (M.Sc.), higher diploma (H.D.D.), and bachelor's (B.D.S). The second part consisted of four questions related to the study, as shown in Table 2. The data was analyzed by using IBM SPSS Statistics for Windows, Version 19.0. Armonk, NY: IBM Corp https://www.ibm.com/products/spss-statistics . for frequency distribution. In addition, a multinomial logistic regression analysis model was used to examine the association between the dentists' ability to detect the vibrating line, including age, years of experience after graduation, gender, and academic degree.

Table 2. The questions for the second part of the questionnaire sample that was used in this study as a google form and distributed randomly to Iraqi dentists.

1. Do you know how to locate the vibrating lines, anterior and posterior, during maxillary removable denture construction?

• Yes.
• No.

2. Who marks the post-dam on the master cast during maxillary removable denture construction?

• Dentist (You).
• Dental technician.

3. Who carves the post-dam on the master cast during maxillary removable denture construction?

• Dentist (You).
• Dental technician.

4. If you do not mark and/or carve on the master cast, then why? (Choose only the most appropriate reason) (one only)

• Fear from denture failure and loss of retention.
• Have no information about carving.
• Forget to carve before sending to dental laboratory.
• Difficult to carve.
• Depend on dental technician.

Results

The Iraqi dentists with different academic degree who participated in the survey were 118 in number. Among the participants, 86 were female and 32 were male with an age range between 22 to 46 years.

Most of the Iraqi dentists (90.7%) who participated in the survey stated that they know how to locate the vibrating lines, anterior and posterior, during maxillary removable denture construction and they answered by selecting “yes”, whereas 9.3% answered by selecting “No” ( Table 3).

Table 3. Frequency table of the knowledge of Iraqi dentist on the location of the vibrating lines, anterior and posterior, during maxillary removable denture construction.

	Frequency	Percent	Valid percent	Cumulative percent
Yes	107	90.7	90.7	90.7
No	11	9.3	9.3	100.0
Total	118	100.0	100.0

Most of the participants (84.7%) answered that they “dentist” mark the post-dam on the master cast during maxillary removable denture construction while (15.3%) stated that the “dental technician” marks it ( Table 4).

Table 4. Frequency table of who was responsible for the marking of the post-dam on the master cast during maxillary removable denture construction.

	Frequency	Percent	Valid percent	Cumulative percent
Yes	100	84.7	84.7	84.7
No	18	15.3	15.3	100.0
Total	118	100.0	100.0

More than half of the participants surveyed (52.5%) reported that they “dentist” carved the post-dam on the master cast during maxillary removable denture construction ( Table 5), while (47.5%) of the participates stated that the “dental technician” did it.

Table 5. Frequency table of who carves the post-dam on the master cast during maxillary removable denture construction.

	Frequency	Percent	Valid percent	Cumulative percent
Yes	62	52.5	52.5	52.5
No	56	47.5	47.5	100.0
Total	118	100.0	100.0

The percentage of participants who stated that they did not mark the post-dam on the master cast was 30.5% ( Table 6) and depend on the dental technician. While, the fear from denture failure and loss of retention was 25.4%, followed by 24.6% forget to carve before sending to dental laboratory, 10.2% have no information about carving, and 9.3% difficult to carve.

Table 6. Frequency table of the reasons why dentists don’t mark and/or carve the post-dam.

	Frequency	Percent	Valid percent	Cumulative percent
Depend on dental technician	36	30.5	30.5	30.5
Difficult to carve	11	9.3	9.3	39.8
Fear from denture failure and loss of retention	30	25.4	25.4	65.3
Forget to carve before sending to dental laboratory	29	24.6	24.6	89.8
Have no information about carving	12	10.2	10.2	100.0
Total	118	100.0	100.0

A multinomial logistic regression model was used to assess the understanding of Iraqi dentists' for locating the vibrating lines, whether they mark and/or carve the post-dam, and why the dentists did not record the post-dam themselves. However, only the academic degree showed a significant association. Age, experience after graduation, gender, and academic degree do not affect the participants' knowledge of locating the anterior and posterior vibrating lines during maxillary removable denture construction ( Table 7).

Table 7. Multinomial logistic regression to detect the association of locating the vibrating lines with age, gender, experience after graduation, and academic degree as predictable variables.

Who marks the post-dam on the master cast during maxillary removable denture construction?^a		B	Std. Error	df	Sig.
Dentist	Intercept	24.485	5.268	1	<.001
	Age	-.274	.235	1	.244
	Experience_after_graduation	.284	.225	1	.207
	[Gender=0] ^†	.800	.552	1	.147
	[Gender=1] ^†	0^b	.	0	.
	[Academic_degree=0] ^‡	-17.727	.734	1	<.001*
	[Academic_degree=1] ^‡	-19.041	1.459	1	<.001*
	[Academic_degree=2] ^‡	-17.390	.000	1	.
	[Academic_degree=3] ^‡	0^b	.	0	.

a The reference category is Dental technician.

b This parameter is set to zero because it is redundant.

c † 0 = female; 1 = male, ‡ 0 = bachelor's (B.D.S); 1= higher diploma (H.D.D.); 2= master's (M.Sc.); 3= doctorate (Ph.D.)

d * Indicates a significant difference between variables (P<0.05).

Being a B.D.S and a H.D.D dentist will reduce the chance of marking the post-dam on the master cast during maxillary removable denture construction by 18 and 19 units, respectively compared to dependence on the dental technician for this step ( Table 7).

Being a B.D.S and a H.D.D dentist will increase the chance of carving the post-dam on the master cast during maxillary removable denture construction by 19 units compared to dependence on the dental technician for this step ( Table 8).

Table 8. Multinomial logistic regression to detect the association of carving the vibrating lines with age, gender, experience after graduation, and academic degree as predictable variables.

Who scribes (carve) the post dam on the master cast during maxillary removable denture construction? ^a		B	Std. Error	df	Sig.
Dentist	Intercept	-22.979	4.501	1	<.001
	Age	.202	.203	1	.319
	Experience_after_graduation	-.168	.196	1	.389
	[Gender=0] ^†	-.400	.459	1	.384
	[Gender=1] ^†	0^b	.	0	.
	[Academic_degree=0] ^‡	18.892	.509	1	<.001*
	[Academic_degree=1] ^‡	19.195	1.337	1	<.001*
	[Academic_degree=2] ^‡	18.342	.000	1	.
	[Academic_degree=3] ^‡	0^b	.	0	.

a The reference category is Dental technician.

b This parameter is set to zero because it is redundant.

c † 0 = female; 1 = male, ‡ 0 = bachelor's (B.D.S); 1= higher diploma (H.D.D.); 2= master's (M.Sc.); 3= doctorate (Ph.D.)

d * Indicates a significant difference between variables (P<0.05).

Discussion

One of the essential steps in treatment of edentulous patients is the construction of an appropriate denture with esthetically, functionally, and biologically acceptable features. The retention of the prosthesis is crucial to achieve these goals and the PPS plays a significant role in obtaining these features.²

The step for introducing the PPS in the prosthesis should be done by the dentist and should not be imposed on the dental technician.¹^,¹³

This study’s results revealed that Iraqi dentists stated that they had the knowledge for the location of the vibrating line and they marked it in the patient’s mouth. However, most of those who didn’t mark and/or carve the post-dam most likely depended on the dental technician and fear from denture failure and loss of retention.

The first alternative hypothesis was accepted for this study. Results showed that the highest percentage (90.7%) of the Iraqi dentists stated that they had the knowledge on the location of the vibrating lines. This may be related to the fact that the position of the vibrating lines had been taught in detail during the study in Iraqi Colleges of Dentistry. This result agreed with finding of Sunil and Jain¹⁵ who stated that the practitioners had an acceptable amount of knowledge. In their study they found that over half of the participants surveyed (57%) stated that they had knowledge on how to locate the vibrating lines, while 43% stated that they had no knowledge.

The second null hypothesis was rejected and the alternative hypothesis was accepted. Most of the participants (84.7%) stated that they mark the post-dam on the master cast during maxillary complete denture construction. This could be due to the confidence and adequate knowledge they have for this step. In addition, this step is essential to transfer the vibrating lines form the patients mouth to the maxillary cast and was a mandatory step that the students must do when constructing a complete denture during the college study in the Iraqi Colleges of Dentistry. Adams¹⁸ findings showed contradictory results in which most of dentists didn’t mark the post-dam on the maxillary cast. Also, our finding regarding the dentist carving the post-dam also disagreed with Adams¹⁵ since almost half of the participants (52.5%) reported that the “dentist” carves the post-dam during maxillary removable denture construction. Therefore, the third null hypothesis was rejected and alternative hypothesis was accepted. Krysinski and Prylinski¹⁹ suggested that the shape and depth of the PPS was influenced by the clinical experience and the ability to evaluate the mucosal compressibility in the post-dam area, as well as the practitioner’s hand-carving abilities. These findings were in accordance with this study, in which 25.4% of the participant didn’t mark the post-dam on the master cast, may be due to fear of denture failure and loss of retention, while 10.2% of the participants had no information and 9.3% considered carving as a difficult procedure. Therefore, the fourth alternative hypothesis was accepted.

Since no available data is dedicated to the issue investigated in this study in the literature, studies with a larger number of participants will be required to corroborate these observations and whether these explanations are correct. Additionally, it is recommended to include more research, particularly for alternative methods of establishing the posterior palatal seal areas.

Within the limitations of this study, most dentists with different academic degree stated they were familiar with the location of the vibrating lines, and they marked the post-dam. However, carving the post-dam was still a matter of subjective experience and they depending on dental technicians for this step. The marking of the post-dam may be related to several different reasons and the most common reason was that they depended on the dental technician in marking and/or carving the post-dam on the master cast followed by the fear from denture failure and loss of retention.

Ethics and consent

This study was approved by the Committee for Ethics / College of Dentistry, University of Baghdad (project no. 357221, date: June 7, 2021) The consent form was distributed with the google form and gathered electronically. The consent form and the patient information sheet were written as recommended by the Committee for Ethics/College of Dentistry, University of Baghdad and the participants were aware of the aims of the research and the confidentiality of their personal information as they accepted to fill the google form questionnaire.

Data availability

Underlying data

The datasets generated by the survey study research during analysis the current study are available in the Zenodo repository. https://doi.org/10.5281/zenodo.13168769²⁰

This project contains following dataset:

1. 2024-8-2 with safe harbor method.csv

Data are available under the terms of the Creative Commons Attribution 4.0 International license (CC-BY 4.0).

Extended data

1. The datasets generated by the survey study research during analysis the current study are available in the Zenodo repository. https://doi.org/10.5281/zenodo.13299680²¹
This project contains following dataset:
2. Questionnaire of Iraqi Dentists.docx
Zenodo- Patient information sheet and Consent form. https://doi.org/10.5281/zenodo.13317785²²

This project contains following dataset:

• Patient information sheet and Consent form

Data are available under the terms of the Creative Commons Attribution 4.0 International license (CC-BY 4.0).

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Version 2

VERSION 2 PUBLISHED 04 Sep 2024

Author details Author details

¹ Department of Prosthodontics, University of Baghdad, College of Dentistry, Baghdad, Iraq
² Department of Prosthodontics, Mustansiriyah Unversity, College of Dentistry, Baghdad, Iraq

Shorouq M. Abass
Roles: Conceptualization, Data Curation, Formal Analysis, Methodology, Resources, Writing – Original Draft Preparation, Writing – Review & Editing

Bayan S. Khalaf
Roles: Conceptualization, Data Curation, Investigation, Methodology, Resources, Supervision, Writing – Original Draft Preparation, Writing – Review & Editing

Tameem K. Jassim
Roles: Data Curation, Investigation, Methodology, Resources, Software, Writing – Original Draft Preparation, Writing – Review & Editing

Aseel M. Al-Khafaji
Roles: Resources, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing

Competing interests

No competing interests were disclosed.

Grant information

The author(s) declared that no grants were involved in supporting this work.

Article Versions (2)

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Published: 29 Nov 2024, 13:1006

https://doi.org/10.12688/f1000research.154823.2

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https://doi.org/10.12688/f1000research.154823.1

© 2024 Abass SM et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Abass SM, Khalaf BS, Jassim TK and Al-Khafaji AM. Posterior palatal seal recording: fact and reasons among Iraqi dentists [version 2; peer review: 1 approved, 1 not approved]. F1000Research 2024, 13:1006 (https://doi.org/10.12688/f1000research.154823.2)

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PUBLISHED 29 Nov 2024

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Reviewer Report 09 Dec 2024

Khurshid Ahmed Mattoo, Jazan University, Jazan, Jazan, Saudi Arabia

Not Approved

https://doi.org/10.5256/f1000research.174983.r344392

This research has a serious flaw in methodology which has not been corrected. The measuring instrument which is a questionnaire is not reliable to measure four objectives stated by authors. The questionnaire itself has just four questions only which are measuring four to five objectives.
How did the authors assess the knowledge since they state that 90.7% of iraqi dentist had the knowledge about vibrating lines. These are just two boundaries of posterior palatal seal area. The assessment of knowledge is not valid. The question that has been stated in the questionnaire is that do you know how to locate the vibrating lines. This is a direct question and there is bias. For knowledge the authors have to frame at least 10 to 20 questions regarding posterior palatal seal and then accordingly score them on a scale.
Similar issue is with other objectives and their respective questions. All questions have different types of bias which include social desirability bias, demand characteristics bias, extreme responding bias and dissent bias.

Competing Interests: No competing interests were disclosed.

Reviewer Expertise: Prosthodontics that includes complete and partial removable prosthodontics, fixed partial prosthodontics including crown and bridge and implantology.

I confirm that I have read this submission and believe that I have an appropriate level of expertise to state that I do not consider it to be of an acceptable scientific standard, for reasons outlined above.

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Author Response 11 Sep 2025

Shorouq Abass, Department of Prosthodontics, University of Baghdad, College of Dentistry, Baghdad, Iraq

11 Sep 2025

Author Response

We sincerely thank the reviewer for their careful evaluation and insightful comments on our manuscript. We address the specific points raised as follows:

1. Reliability of the Questionnaire and ... Continue reading We sincerely thank the reviewer for their careful evaluation and insightful comments on our manuscript. We address the specific points raised as follows:

1. Reliability of the Questionnaire and Number of Items
We acknowledge the reviewer’s concern regarding the limited number of questions (four items) in our instrument. Our intention in designing a brief questionnaire was to maximize response rate and minimize participant fatigue, given that dentists in Iraq have limited available time for research participation. However, we agree that a more comprehensive set of items (10–20 questions) would increase construct validity and provide a more robust measure of knowledge. We will highlight this as a limitation in the revised manuscript and suggest that future studies adopt a broader and validated scale.

2. Assessment of Knowledge Regarding Vibrating Lines
The reviewer is correct that the item “Do you know how to locate the vibrating lines?” is a direct question and may not fully capture depth of knowledge. Our goal was to obtain a preliminary indication of awareness rather than a detailed knowledge assessment. We acknowledge that this approach carries potential for response bias and limited validity. In the revision, we will clarify this in the methodology and discussion sections, stating that the high percentage (90.7%) reflects self-reported awareness rather than objective assessment of knowledge.

3. Types of Bias in the Questionnaire
We appreciate the reviewer highlighting potential biases, including social desirability, demand characteristics, and extreme responding. We will explicitly acknowledge these as limitations of self-administered surveys in the discussion. Although such biases are common in questionnaire-based studies, we agree that more indirect questioning and multiple items per construct could reduce their impact.

4. Future Directions
We value the reviewer’s constructive suggestion regarding the development of a more comprehensive, validated instrument. For future studies, we intend to expand the questionnaire to cover multiple dimensions of knowledge and practice related to posterior palatal seal, ensuring content validity through expert consultation and pilot testing.

In summary, we acknowledge the limitations in our questionnaire design, particularly in terms of comprehensiveness and potential biases. We will revise the manuscript to clarify the scope of the study, acknowledge these limitations, and frame our findings as preliminary, thereby emphasizing the need for more rigorous future research.
We sincerely thank the reviewer for their careful evaluation and insightful comments on our manuscript. We address the specific points raised as follows:

1. Reliability of the Questionnaire and Number of Items
We acknowledge the reviewer’s concern regarding the limited number of questions (four items) in our instrument. Our intention in designing a brief questionnaire was to maximize response rate and minimize participant fatigue, given that dentists in Iraq have limited available time for research participation. However, we agree that a more comprehensive set of items (10–20 questions) would increase construct validity and provide a more robust measure of knowledge. We will highlight this as a limitation in the revised manuscript and suggest that future studies adopt a broader and validated scale.

2. Assessment of Knowledge Regarding Vibrating Lines
The reviewer is correct that the item “Do you know how to locate the vibrating lines?” is a direct question and may not fully capture depth of knowledge. Our goal was to obtain a preliminary indication of awareness rather than a detailed knowledge assessment. We acknowledge that this approach carries potential for response bias and limited validity. In the revision, we will clarify this in the methodology and discussion sections, stating that the high percentage (90.7%) reflects self-reported awareness rather than objective assessment of knowledge.

3. Types of Bias in the Questionnaire
We appreciate the reviewer highlighting potential biases, including social desirability, demand characteristics, and extreme responding. We will explicitly acknowledge these as limitations of self-administered surveys in the discussion. Although such biases are common in questionnaire-based studies, we agree that more indirect questioning and multiple items per construct could reduce their impact.

4. Future Directions
We value the reviewer’s constructive suggestion regarding the development of a more comprehensive, validated instrument. For future studies, we intend to expand the questionnaire to cover multiple dimensions of knowledge and practice related to posterior palatal seal, ensuring content validity through expert consultation and pilot testing.

In summary, we acknowledge the limitations in our questionnaire design, particularly in terms of comprehensiveness and potential biases. We will revise the manuscript to clarify the scope of the study, acknowledge these limitations, and frame our findings as preliminary, thereby emphasizing the need for more rigorous future research.
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Author Response 11 Sep 2025

Shorouq Abass, Department of Prosthodontics, University of Baghdad, College of Dentistry, Baghdad, Iraq

11 Sep 2025

Author Response

We sincerely thank the reviewer for their careful evaluation and insightful comments on our manuscript. We address the specific points raised as follows:

1. Reliability of the Questionnaire and ... Continue reading We sincerely thank the reviewer for their careful evaluation and insightful comments on our manuscript. We address the specific points raised as follows:

1. Reliability of the Questionnaire and Number of Items
We acknowledge the reviewer’s concern regarding the limited number of questions (four items) in our instrument. Our intention in designing a brief questionnaire was to maximize response rate and minimize participant fatigue, given that dentists in Iraq have limited available time for research participation. However, we agree that a more comprehensive set of items (10–20 questions) would increase construct validity and provide a more robust measure of knowledge. We will highlight this as a limitation in the revised manuscript and suggest that future studies adopt a broader and validated scale.

2. Assessment of Knowledge Regarding Vibrating Lines
The reviewer is correct that the item “Do you know how to locate the vibrating lines?” is a direct question and may not fully capture depth of knowledge. Our goal was to obtain a preliminary indication of awareness rather than a detailed knowledge assessment. We acknowledge that this approach carries potential for response bias and limited validity. In the revision, we will clarify this in the methodology and discussion sections, stating that the high percentage (90.7%) reflects self-reported awareness rather than objective assessment of knowledge.

3. Types of Bias in the Questionnaire
We appreciate the reviewer highlighting potential biases, including social desirability, demand characteristics, and extreme responding. We will explicitly acknowledge these as limitations of self-administered surveys in the discussion. Although such biases are common in questionnaire-based studies, we agree that more indirect questioning and multiple items per construct could reduce their impact.

4. Future Directions
We value the reviewer’s constructive suggestion regarding the development of a more comprehensive, validated instrument. For future studies, we intend to expand the questionnaire to cover multiple dimensions of knowledge and practice related to posterior palatal seal, ensuring content validity through expert consultation and pilot testing.

In summary, we acknowledge the limitations in our questionnaire design, particularly in terms of comprehensiveness and potential biases. We will revise the manuscript to clarify the scope of the study, acknowledge these limitations, and frame our findings as preliminary, thereby emphasizing the need for more rigorous future research.
We sincerely thank the reviewer for their careful evaluation and insightful comments on our manuscript. We address the specific points raised as follows:

1. Reliability of the Questionnaire and Number of Items
We acknowledge the reviewer’s concern regarding the limited number of questions (four items) in our instrument. Our intention in designing a brief questionnaire was to maximize response rate and minimize participant fatigue, given that dentists in Iraq have limited available time for research participation. However, we agree that a more comprehensive set of items (10–20 questions) would increase construct validity and provide a more robust measure of knowledge. We will highlight this as a limitation in the revised manuscript and suggest that future studies adopt a broader and validated scale.

2. Assessment of Knowledge Regarding Vibrating Lines
The reviewer is correct that the item “Do you know how to locate the vibrating lines?” is a direct question and may not fully capture depth of knowledge. Our goal was to obtain a preliminary indication of awareness rather than a detailed knowledge assessment. We acknowledge that this approach carries potential for response bias and limited validity. In the revision, we will clarify this in the methodology and discussion sections, stating that the high percentage (90.7%) reflects self-reported awareness rather than objective assessment of knowledge.

3. Types of Bias in the Questionnaire
We appreciate the reviewer highlighting potential biases, including social desirability, demand characteristics, and extreme responding. We will explicitly acknowledge these as limitations of self-administered surveys in the discussion. Although such biases are common in questionnaire-based studies, we agree that more indirect questioning and multiple items per construct could reduce their impact.

4. Future Directions
We value the reviewer’s constructive suggestion regarding the development of a more comprehensive, validated instrument. For future studies, we intend to expand the questionnaire to cover multiple dimensions of knowledge and practice related to posterior palatal seal, ensuring content validity through expert consultation and pilot testing.

In summary, we acknowledge the limitations in our questionnaire design, particularly in terms of comprehensiveness and potential biases. We will revise the manuscript to clarify the scope of the study, acknowledge these limitations, and frame our findings as preliminary, thereby emphasizing the need for more rigorous future research.
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Reviewer Report 02 Dec 2024

Zena Wally, university of Kofa, Kofa, Iraq

Approved

https://doi.org/10.5256/f1000research.174983.r344391

Dear Editor,

The authors have ... Continue reading

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Reviewer Report 11 Nov 2024

Zena Wally, university of Kofa, Kofa, Iraq

Approved with Reservations

https://doi.org/10.5256/f1000research.169899.r333838

This study assesses Iraqi dentists' understanding and use of post-dam in maxillary complete dentures. Although the research holds substantial merit, some concerns require further attention.

Proofreading: The entire manuscript would benefit from a thorough proofreading to

This study assesses Iraqi dentists' understanding and use of post-dam in maxillary complete dentures. Although the research holds substantial merit, some concerns require further attention.

Proofreading: The entire manuscript would benefit from a thorough proofreading to correct grammatical errors and improve overall readability.
Introduction: The introduction should include a review of existing research on the posterior palatal seal (PPS), emphasizing its significance and the commonly used methods for recording and carving the PPS. It should also address the challenges and variability in PPS recording and carving among practitioners, providing readers with a comprehensive and informed understanding of the topic.
Discussion: The discussion section should critically evaluate the limitations of the study, which is an essential part of any research discussion. For example, the sample size and the reliance on self-reported data could be potential limitations, as dentists might overstate their knowledge or practices. Additionally, the generalizability of the findings to all Iraqi dentists or other regions should be addressed. The authors should clearly identify limitations that could affect the interpretation of the results.
Rationale for the Study: The rationale for the study should justify why this research is important and its potential impact on the field of dentistry. It should explain the value of understanding the practices of Iraqi dentists and discuss how the findings could contribute to improving denture retention practices in Iraq and potentially in similar regions.
Future Prospects: The authors should highlight the future potential for improving clinical education and patient outcomes, particularly through enhanced training in PPS techniques.
References: Consider including more recent and relevant references published within the last 3-5 years to strengthen the manuscript and provide up-to-date insights.

Is the work clearly and accurately presented and does it cite the current literature?

Partly
Is the study design appropriate and is the work technically sound?

Yes
Are sufficient details of methods and analysis provided to allow replication by others?

Yes
If applicable, is the statistical analysis and its interpretation appropriate?

Yes
Are all the source data underlying the results available to ensure full reproducibility?

Yes
Are the conclusions drawn adequately supported by the results?

Partly

Competing Interests: No competing interests were disclosed.

Reviewer Expertise: Biomaterials in Dentistry

I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above.

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Author Response 23 Nov 2024

Shorouq Abass, Department of Prosthodontics, University of Baghdad, College of Dentistry, Baghdad, Iraq

23 Nov 2024

Author Response

Thank you for your insightful recommendations on our manuscript. Therefore, we will proceed to revise based on the details you have provided.
Competing Interests: No competing interests were disclosed.
Thank you for your insightful recommendations on our manuscript. Therefore, we will proceed to revise based on the details you have provided.
Thank you for your insightful recommendations on our manuscript. Therefore, we will proceed to revise based on the details you have provided.
Competing Interests: No competing interests were disclosed. Close
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Author Response 23 Nov 2024

Shorouq Abass, Department of Prosthodontics, University of Baghdad, College of Dentistry, Baghdad, Iraq

23 Nov 2024

Author Response

Thank you for your insightful recommendations on our manuscript. Therefore, we will proceed to revise based on the details you have provided.
Competing Interests: No competing interests were disclosed.
Thank you for your insightful recommendations on our manuscript. Therefore, we will proceed to revise based on the details you have provided.
Thank you for your insightful recommendations on our manuscript. Therefore, we will proceed to revise based on the details you have provided.
Competing Interests: No competing interests were disclosed. Close
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Reviewer Report 11 Nov 2024

Khurshid Ahmed Mattoo, Jazan University, Jazan, Jazan, Saudi Arabia

Not Approved

https://doi.org/10.5256/f1000research.169899.r333845

I have reviewed the paper thoroughly up to the methodology section. The methodology section is fundamentally inadequate, incorrect and completely unreliable. The authors have generated four different hypotheses at the beginning and to test that they have used one questionnaire which comprised just four questions. The authors have put their own questions in the measuring tool and have not found the reliability and validity of such questions. The introduction section is on average not related to the purpose of this study. The authors have failed to provide a context to their study in terms of what the posterior palatal seal area is, what it is comprised of and why its recording is relevant. There is no research related literature that has been referred by the authors. The referred literature is inappropriate and inadequate without reference to the concerned studies.

Is the work clearly and accurately presented and does it cite the current literature?

No
Is the study design appropriate and is the work technically sound?

No
Are sufficient details of methods and analysis provided to allow replication by others?

No
If applicable, is the statistical analysis and its interpretation appropriate?

No
Are all the source data underlying the results available to ensure full reproducibility?

No
Are the conclusions drawn adequately supported by the results?

No

Competing Interests: No competing interests were disclosed.

Reviewer Expertise: Prosthodontics that includes complete and partial removable prosthodontics, fixed partial prosthodontics including crown and bridge and implantology.

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Version 2

VERSION 2 PUBLISHED 04 Sep 2024

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Khurshid Ahmed Mattoo, Jazan University, Jazan, Saudi Arabia
Zena Wally, university of Kofa, Kofa, Iraq

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8 Views

09 Dec 2024 | for Version 2

Khurshid Ahmed Mattoo, Jazan University, Jazan, Jazan, Saudi Arabia

8 Views Cite this report Responses(1)

Not Approved

Competing Interests

No competing interests were disclosed.

Reviewer Expertise

Prosthodontics that includes complete and partial removable prosthodontics, fixed partial prosthodontics including crown and bridge and implantology.

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Author Response

11 Sep 2025

Shorouq Abass, Department of Prosthodontics, University of Baghdad, College of Dentistry, Baghdad, Iraq

We sincerely thank the reviewer for their careful evaluation and insightful comments on our manuscript. We address the specific points raised as follows:

1. Reliability of the Questionnaire and Number of Items
We acknowledge the reviewer’s concern regarding the limited number of questions (four items) in our instrument. Our intention in designing a brief questionnaire was to maximize response rate and minimize participant fatigue, given that dentists in Iraq have limited available time for research participation. However, we agree that a more comprehensive set of items (10–20 questions) would increase construct validity and provide a more robust measure of knowledge. We will highlight this as a limitation in the revised manuscript and suggest that future studies adopt a broader and validated scale.

2. Assessment of Knowledge Regarding Vibrating Lines
The reviewer is correct that the item “Do you know how to locate the vibrating lines?” is a direct question and may not fully capture depth of knowledge. Our goal was to obtain a preliminary indication of awareness rather than a detailed knowledge assessment. We acknowledge that this approach carries potential for response bias and limited validity. In the revision, we will clarify this in the methodology and discussion sections, stating that the high percentage (90.7%) reflects self-reported awareness rather than objective assessment of knowledge.

3. Types of Bias in the Questionnaire
We appreciate the reviewer highlighting potential biases, including social desirability, demand characteristics, and extreme responding. We will explicitly acknowledge these as limitations of self-administered surveys in the discussion. Although such biases are common in questionnaire-based studies, we agree that more indirect questioning and multiple items per construct could reduce their impact.

4. Future Directions
We value the reviewer’s constructive suggestion regarding the development of a more comprehensive, validated instrument. For future studies, we intend to expand the questionnaire to cover multiple dimensions of knowledge and practice related to posterior palatal seal, ensuring content validity through expert consultation and pilot testing.

In summary, we acknowledge the limitations in our questionnaire design, particularly in terms of comprehensiveness and potential biases. We will revise the manuscript to clarify the scope of the study, acknowledge these limitations, and frame our findings as preliminary, thereby emphasizing the need for more rigorous future research.

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Non

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6 Views

02 Dec 2024 | for Version 2

Zena Wally, university of Kofa, Kofa, Iraq

6 Views Cite this report Responses(0)

Approved

Dear Editor,

The authors have adequately addressed the raised comments, and I recommend accepting the manuscript.

Competing Interests

No competing interests were disclosed.

Reviewer Expertise

Biomaterials in Dentistry

I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard.

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19 Views

11 Nov 2024 | for Version 1

Zena Wally, university of Kofa, Kofa, Iraq

19 Views Cite this report Responses(1)

Approved With Reservations

This study assesses Iraqi dentists' understanding and use of post-dam in maxillary complete dentures. Although the research holds substantial merit, some concerns require further attention.

Proofreading: The entire manuscript would benefit from a thorough proofreading to correct grammatical errors and improve overall readability.
Introduction: The introduction should include a review of existing research on the posterior palatal seal (PPS), emphasizing its significance and the commonly used methods for recording and carving the PPS. It should also address the challenges and variability in PPS recording and carving among practitioners, providing readers with a comprehensive and informed understanding of the topic.
Discussion: The discussion section should critically evaluate the limitations of the study, which is an essential part of any research discussion. For example, the sample size and the reliance on self-reported data could be potential limitations, as dentists might overstate their knowledge or practices. Additionally, the generalizability of the findings to all Iraqi dentists or other regions should be addressed. The authors should clearly identify limitations that could affect the interpretation of the results.
Rationale for the Study: The rationale for the study should justify why this research is important and its potential impact on the field of dentistry. It should explain the value of understanding the practices of Iraqi dentists and discuss how the findings could contribute to improving denture retention practices in Iraq and potentially in similar regions.
Future Prospects: The authors should highlight the future potential for improving clinical education and patient outcomes, particularly through enhanced training in PPS techniques.
References: Consider including more recent and relevant references published within the last 3-5 years to strengthen the manuscript and provide up-to-date insights.

Is the work clearly and accurately presented and does it cite the current literature?

Partly
Is the study design appropriate and is the work technically sound?

Yes
Are sufficient details of methods and analysis provided to allow replication by others?

Yes
If applicable, is the statistical analysis and its interpretation appropriate?

Yes
Are all the source data underlying the results available to ensure full reproducibility?

Yes
Are the conclusions drawn adequately supported by the results?

Partly

Competing Interests

No competing interests were disclosed.

Reviewer Expertise

Biomaterials in Dentistry

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10 Views

11 Nov 2024 | for Version 1

Khurshid Ahmed Mattoo, Jazan University, Jazan, Jazan, Saudi Arabia

10 Views Cite this report Responses(0)

Not Approved

Is the work clearly and accurately presented and does it cite the current literature?

No
Is the study design appropriate and is the work technically sound?

No
Are sufficient details of methods and analysis provided to allow replication by others?

No
If applicable, is the statistical analysis and its interpretation appropriate?

No
Are all the source data underlying the results available to ensure full reproducibility?

No
Are the conclusions drawn adequately supported by the results?

No

Competing Interests

No competing interests were disclosed.

Reviewer Expertise

Prosthodontics that includes complete and partial removable prosthodontics, fixed partial prosthodontics including crown and bridge and implantology.

Respond to this report

Responses (0)

Alongside their report, reviewers assign a status to the article:

Approved - the paper is scientifically sound in its current form and only minor, if any, improvements are suggested

Approved with reservations - A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit.

Not approved - fundamental flaws in the paper seriously undermine the findings and conclusions

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[9] 9. Winland RD, Young JM: Maxillary complete denture posterior palatal seal: variations in size, shape, and location. J. Prosthet. Dent. 1973 Mar; 29(3): 256–261. PubMed Abstract | Publisher Full Text

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[11] 11. Techapiroontong S, Limpuangthip N, Prawatvatchara W, et al.: Workflows and Laboratory Cost for Removable Digital Complete Denture: Two Case Reports with and without Existing Denture. Case Rep. Dent. 2024; 2024: 1564153. PubMed Abstract | Publisher Full Text | Free Full Text

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[14] 14. Goyal S, Goyal MK, Balkrishanan D, et al.: The posterior palatal seal: Its rationale and importance: An overview. Eur. J. Prosthodont. 2014; 2(2): 41. Publisher Full Text

[15] 15. Sunil NSBA, Jain AR: Knowledge, Attitude and Perception of Methods and Materials Used for Recording Posterior Palatal Seal among Dental Practitioners and Dental Students. Biomed. Pharmacol. J. 2018; 11(1): 539–551. Publisher Full Text

[16] 16. Ansari IH: Establishing the posterior palatal seal during the final impression stage. J. Prosthet. Dent. 1997; 78(3): 324–326. Publisher Full Text

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[18] 18. Adams M: A comparison of posterior palatal seal creation in complete dentures by students at the University of Pretoria and private practitioners 2015 MChD. School of Dentistry, University of Pretoria, South Africa.

[19] 19. Krysinski ZJ, Prylinski M: Carving of a master cast to obtain a posterior palatal seal of a complete maxillary denture as performed by four prosthodontists: A pilot study. J. Oral Sci. 2007; 49(2): 129–132. PubMed Abstract | Publisher Full Text

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Posterior palatal seal recording: fact and reasons among Iraqi dentists

Abstract

Abstract

Backgrounds

Methods

Results

Conclusions

Keywords

Revised Amendments from Version 1

Introduction

Table 1. The null and the alternative hypotheses for the study.

Methods

Table 2. The questions for the second part of the questionnaire sample that was used in this study as a google form and distributed randomly to Iraqi dentists.

Results

Table 3. Frequency table of the knowledge of Iraqi dentist on the location of the vibrating lines, anterior and posterior, during maxillary removable denture construction.

Table 4. Frequency table of who was responsible for the marking of the post-dam on the master cast during maxillary removable denture construction.

Table 5. Frequency table of who carves the post-dam on the master cast during maxillary removable denture construction.

Table 6. Frequency table of the reasons why dentists don’t mark and/or carve the post-dam.

Table 7. Multinomial logistic regression to detect the association of locating the vibrating lines with age, gender, experience after graduation, and academic degree as predictable variables.

Table 8. Multinomial logistic regression to detect the association of carving the vibrating lines with age, gender, experience after graduation, and academic degree as predictable variables.

Discussion

Ethics and consent

Data availability

Underlying data

Extended data

References

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