Pin Retained Restoration

Retentive Pins
Dr. Miles Markley(1958)- introduced stainless steel pins to provide retention and resistance form. Pins retain the restoration in the prepared tooth structure together and secondly, reinforce the tooth by cross-splinting of weakened cusp.

Indications:
y Grossly mutilated teeth- large restorations may

be fracture of may be lost due to occlusal loading

y Extended preparations-pin placement is

recommended if the large interproximal restoration, restoration of cusp shapes or of cavity extended beyond the lines angles, is to be done.
y Cores for full coverage restoration- by pin-

supported amalgam, core can be placed in less time and expense.

Indications:
y Extensive Class V restoration- pin placement

tends to reinforce the restoration.

y Time period and economic factors- no chance for

second appointment or economic problem regarding cast gold restoration, pin- retained amalgam restoration can be the restoration of choice.

Advantages:
y Conservation of tooth material y Number of appointments 1 appointment is

required for pin retainer

y Resistance and retention form y Economic- inexpensive

Disadvantages:
y Pulpectomized and pulpectomized teeth- increase y y y y y

chances of fracture of dentin due to dehydration Dentinal microfractures Microleakage Strength of amalgam Perforation due to misdirection of care Tooth Anatomy- some cases it is not possible to achieve proper contours and occlusal contact with pin retained restoration

Types of Pin
y Self-threading pins y Cemented pins y Friction-locked pins

Self-Threading Pins
y Most retentive y Pinholes are slightly smaller in

diameter (0.038 to 0.1mm) than the pin diameter y Pin retained due to mechanical grasp y Viscoelastic property of the dentin allows insertion of a threaded pin into a hole of a smaller diameter

Self-Threading Pins
Advantages: y Superior retention y Less depth y No cementing medium Disadvantages: y Maximum pulpal stress- pin is inserted perpendicular to the pulp y Maximum dentin stress

Cemented Pins
y Least retentive y Pinholes should be 0.025 to

0.05mm larger than the diameter of the pin y Depth hole in dentin should be 3 to 4mm

Friction-Locked Pins
y Intermediate retention y Diameter of the pinhole is

0.025mm smaller than the diameter of pinhole pin y Retained due to resiliency of dentin

Number of Pins
y Extensive number of pins should be avoided y One pin must be placed for each missing cusp

and one pin for each missing proximal surface y ** Certain factors may alter this rule, due to esthetic consideration. **

Length of Pin into Dentin and Amalgam

y Pin extension of 2mm into dentin and amalgam

provide maximum required retention y ** Pin extension greater than 2mm is contraindicated. **

Cavity Preparation for Pin Retained Amalgam Restorations

y Cavity preparation y Excavation of carious dentin y Rim-preparation (should finish) y Placement of amalgam matrix y Base/Liner application (after final preparation) y Pinholes are made y Placement of pins y Coves preparation in axial wall y Condensation of amalgam around pins y Polishing after 24 hours

PINHOLE PREPARATION:
No.bur used to prepare a pilot hole (dimple) y To permit more accurate placement of the twist drill y Prevent the drill from crawling once it has began to rotate y Optimal depth of the pinhole into the dentin is 2mm

PINHOLE PREPARATION:
y The hole should be prepared

on flat surface and the drill perpendicular to it. y Place flat thin-bladed hand instrument into the crevice and against the external surface of the tooth To indicate the proper angulations for the drill

PINHOLE PREPARATION:
y Place the drill tip in its proper position y Hand piece rotating at very low speed y Apply pressure to the drill y Prepare pinhole in one or two movement y until the depth-limiting portion is reached y Remove the drill from pinhole

Failure of Pin Retained Restoration

y Fracture may occur
y Improper condensation or improper trituration y Pin retained restoration failure

y Separation at interface of the pin and restorative

material y Broken pins and drills y Enlarge pinholes y Pulpal penetration and periodontal perforation

Pre-operative View

Preparation after Pin Placement

Restoration immediately after Completion

Restoration after 5 years

Reference
y Textbook of Operative Dentistry by Chandra y http://www.pdfebooksdownloads.com

Salamat po..