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Fixed Prosth Midterm (Fall) > 7. Foundation Restorations for Vital Teeth II > Flashcards

7. Foundation Restorations for Vital Teeth II Flashcards

1
Q

What are the different retention and resistance features of foundation restoratiosn

A
  • Pins
  • Parallelism of walls of the prep
  • Proximal box form
  • Retention grooves in proximal line angles
  • Circumferential/partial grooves “slots”
  • Amalgam Pins
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2
Q

What are the three types of pins which ones do we use in clinic

A
  • Cemented
  • Friction-locked
  • Self-threading**
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3
Q

Which pin type has a pin hole diameter that is larger than the pin

A

cemented

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4
Q

How are friction locked pins placed compared to self threading pins

A

Friction locked
-taped into place with a mallet

Self threading
-Placed by hand wrench or a contra angle hand piece

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5
Q

Which pin type places the least internal stress on the tooth

A

cemented

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6
Q

Which pins are the most and least retentive

A 
Most= self-threading 
Least= Cemented
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7
Q

What are the four sizes of self-threading pins and which one is the most commonly used

A
  • Minuta
  • Minikin*
  • Minim**
  • Regular
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8
Q

About how much smaller is the pin hole diameter than the pin for self-threading pins

A

0.002 inches smaller

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9
Q

What color are the minikin and the minim pins

A

red= minikin and gray= minim

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10
Q

(Larger/smaller) diameter pins are more retentive

A

larger

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11
Q

Compare the pin depth for minikin and minim pins

A
  • minim= 2 mm

- minikin= 1.5 mm

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12
Q

Optimum depth into dentin for pins is…

A

2.0-3.0mm (2mm)

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13
Q

What are the benefits of a pin drill having a shoulder stop self-limiting feature

A
  • Depth reference
  • Reduces chance of perforation
  • Prevents the tip of the pin from putting stress on the dentin
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14
Q

What are the factors that need to be considered when deciding how many pins to place

A
  • Size of the pin
  • Amount of remaining tooth structure
  • Other mechanical R/R features employed
  • Anticipated occlusal forces on the final restoration
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15
Q

T/F Pins strengthen the tooth

A

f

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16
Q

1 pin should be used for per missing….

A
  • cusp
  • line angle
  • proximal surface
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17
Q

Incorporation of pins weakens composite or amalgam more

A

amalgam

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18
Q

Do pins weaken alloy-reinforced GI

A

no

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19
Q

Orienting the pins _ to the tensile stress is most favorable

A

parallel

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20
Q

As the number of pins increases the fracture resistance of amalgam (increases/decreases)

A

decreases

21
Q

Acid treatment of the pin surface will enhance the bond to what and results in improvement of…

A

composite… with improvement in fracture resistance

22
Q

Which has greater retention resin or amalgam cores retained with pins

A

no difference

23
Q

What is the max number of pins you should use per tooth and why

A

3 because you do not achieve significantly improved R/R with more than 3 pins

24
Q

How much space should be placed between pins

A
  • Depends on the size of the pin
  • Minim= 5 mm
  • Minikin= 3 mm
25
Q

pin placement should be _-_mm _ from the DEJ

A

0.5-1 mm pulpal

26
Q

If the pin is placed past the CEJ if should be placed at least _mm from the external root surface

A

1mm (allows space for the finishline)

27
Q

Where are the primary locations for pin placement and the unacceptable places

A 
Primary= line angles 
Unacceptable= furcations and concavities (maxillary first PM has a mesial concavity)
28
Q

What must oppose each pin you place

A

another retentive feature (could just be a vertical wall)

29
Q

The pin is placed - mm (outside/inside) the DEJ

A

0.5-1 mm inside

30
Q

The started hole is placed with the (fast/slow) speed handpeice with what bur

A

Slow with torque multiplier

-1/4 or a 1/2 round bur

31
Q

What is the name of the technique called to help you determine the angulation of the pin

A

Twist drill alignment- place the drill along the external surface of the tooth and use the angulation to place the pin

32
Q

How deep in the pin hole

A

2 mm

33
Q

The slow speed should be running in (forward/reverse) when the pin channel is made

A

forward

34
Q

What are the likely reasons why the drill may not be drilling

A
  • Dull drill
  • Flutes obstructed with debris
  • Drill is running in reverse
  • Drilling in enamel rather than dentin
35
Q

How many torque reducers are needed on the slow speed to make the pin channel and for pin placements

A

Pin channel
-Only one either the 10:1 latch or the torque multiplexer

Pin placement
-must use both

36
Q

What should you do if you placed your pin too close to a vertical wall in your prep and you can’t fit an amalgam condersor in there

A

reduce the wall back with a bur

37
Q

If you need to reduce the height of a pin down with a bur how is the bur angled relative to the pin

A

bur is at a right angle to the pin

38
Q

The pin is bent toward where to reduce its height and prevent prepping it

A

toward the center of the prep

39
Q

Horizontal pins are used to

A

reinforce a lone-standing cusp

40
Q

Horizontal pins should be placed where relative to the occlusal DEJ

A

1 mm below the occlusal DEJ

41
Q

The most likely explanation(s) for a loose pin is

A

the channel prep was not precise or cutting the pin improperly

42
Q

If you have a loose pin what can you do

A
  • Use a larger pin
  • Drill another channel (1.5 mm away)
  • Convert the loose channel into another retentive feature
43
Q

Cracks in the dentin can occur after pin placement as a result of what

A

the pin bottoms out in the channel

44
Q

How can you tell if you perforated

A
  • Sudden drop in drill
  • Pain
  • Blood
45
Q

How can pulpal perforations be avoided

A
  • Current X-ray and knowledge of pulp anatomy

- Avoid high risk areas

46
Q

With a pulp perforation with a pin what should you do for the following scenarios

  • Questionable pulp status
  • Indirect tx planned
  • Direct restoration
A
  • Questionable pulp status = RCT
  • Indirect tx planned = RCT
  • Direct restoration = Direct pulp cap
47
Q

What should you do if you perforated into the gingival sulcus

A
  • Cut the pin flush
  • Drop the finishline
  • Or condense amalgam internally and carve it externally
48
Q

What do you do if you perforate the periodontium with a pin past the epithelial attachement

A
  • Crown lengthening to access the pin or perforation
  • Seal the perforation with ….
    • MTA externally
    • Adhesive and resin internally

*Most complicated to handle

49
Q

What are the post op instructions for a person receiving a amalgam foundation restoration

A
  • Tooth should remain generally comfortable
  • Avoid heavy chewing pressure for 24 hrs
  • “occlusal awareness” requires adjustment
  • Report any issues or concerns

Fixed Prosth Midterm (Fall) (10 decks)

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