Application of the palatogram technique to improve speech with complete-arch fixed implant-supported zirconia prostheses

While maxillary complete-arch fixed implant-supported prostheses are a popular treatment for patients with complete edentulism or with a terminal dentition, how speech is best optimized with this treatment is unclear. One popular method used in complete denture therapy for immediate improvement of speech, as well as to reduce the speech adaptation period for patients, is the use of a palatogram technique. Contemporary biomaterials such as zirconia used for complete-arch fixed implant-supported prosthesis are difficult to adjust and modify. Therefore, the purpose of this article was to describe the application of the palatogram technique during the evaluation stage of the maxillary screw-retained milled prototype prosthesis (interim acrylic resin prosthesis) to improve the palatal contours and optimize contact areas of the tongue with the palatal aspect of the prosthesis. The modified interim prosthesis can then be used for copy milling the definitive zirconia prosthesis. This technique is useful when other prosthodontic factors related to speech, such as the occlusal vertical dimension and tooth positions, have already been optimized.