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D2 Fall - Operative III > Accessory Retention > Flashcards

Accessory Retention Flashcards

1
Q

When is accessory retention used with?

A

LARGE restorations and less than ideal supporting tooth structure

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2
Q

What material are pins commonly used with?

A

amalgam (because it relies on mechanical retention)

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3
Q

What are indications for pins?

A
  • Improve retention as a last resort
  • Large restorative that are missing cusp(s)
  • Prognosis of tooth is uncertain (unstable perio)
  • Unable to access pulp canals (sclerosed tooth) for needed
    additional retention
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4
Q

What are contraindications for pins?

A
  • Severe loss of tooth structure
  • Endodontically treated teeth (11)
    o Teeth are too brittle
    o Alternatively use post or amalgam core
  • Large pulp canals (children)
  • Difficult access for placement
  • Tooth serves as abutment for RPD
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5
Q

How big is the pin hole in a self threading pin?

A

Pin hole is 0.002” smaller than pin

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6
Q

How does a self-threading pin work?

A

Self-threads into dentin (with hand wrench or latch grip on slow speed)

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7
Q

Where is a self-threading pin located?

A

2mm in dentin
2mm outside of dentin

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8
Q

Self threading pins are _________ times more retentive as cemented pin

A

5-6x

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9
Q

Do self-threading pins create stress?

A

Yes; high crestal and apical stresses; crazing and microleakage

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10
Q

Where do self-threading pins give the most stress to?

A

Dentin

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11
Q

What is a cool feature of self-threading pins?

A

Self-shearing
- break off on their own as you turn them

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12
Q

Where should pins be placed?

A

In dentin
- should be at least 1mm of dentin around pin hole

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13
Q

How far apart should pins be placed from eachother?

A

5mm apart (minimum of 3mm)

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14
Q

How far should a pin be placed from the wall of a prep?

A

1mm (minimum of 0.5mm)

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15
Q

Where should a pin be placed relative to the DEJ?

A

1mm inside DEJ (minimum of 0.5mm)

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16
Q

Why could you increase the pin placement from 1mm inside DEJ to 1.5mm inside DEJ?

A

If planning to crow tooth to avoid exposure upon crown prep

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17
Q

How far should a pin be placed from any wall?

A

0.5mm to allow room for condensation of amalgam around pin

18
Q

Where exactly should a pin be placed relative to the tooth itself?

A

In line angle

19
Q

How deep should a pin be placed into dentin?

A

2mm deep

20
Q

What axis should a pin be placed in relation to?

A

Long axis of tooth
If using multiple, angle in slightly different directions

21
Q

Should you bend pins?

A

AVOID

22
Q

What are the different twist drill sizes?

A

Regular 0.027 (gold)
Minim 0.021 (silver)- Most frequently used
Minikin 0.017 (red)
Minutia 0.0135 (pink)

23
Q

What are the types of twist drills?

A
  1. Standard
  2. Self limiting (drill stops itself from drilling too deep of a pilot hole)
24
Q

What part of the drill acts as a heat absorber?

A

Aluminum shank

25
Q

What kind of size drill has a built in wobble?

A

Minuta and Minikin

26
Q

What is the function of the wobble that a minuta or minikin size drill have?

A

Minimize dentin crazing and drill breakage

27
Q

When should you discard a drill?

A

After 20 uses

28
Q

How do you know if the pin is the correct height?

A

2mm of amalgam must be over top of the pin

29
Q

What do you do if the pin is too tall?

A

educe with handpiece stabilized by forceps to cut perpendicular to pin or bend slightly with pin bender

30
Q

Where should you not place a pin?

A

Near the pulp
Concavities of the tooth

31
Q

Where should you not place a pin to avoid a concavity?

A
  1. Mesial concavity over maxillary 1st premolar
  2. Distal mand molars and max lingual of molars
  3. Mid-F, Mid-M, and Mid-D furcations of Max 1st/2nd molars
32
Q

Where should you not place a pin to avoid a concavity?

A
  • mesial concavity over max 1st premolar
  • lingual and facial of mandibular molars
  • facial, mesial, and distal fucation of maxillary molars
33
Q

What stress can pins introduce?

A

Introduces stress into dentin which can lead to fracture

34
Q

What strength do pins reduce?

A

Pins reduce the compressive and transverse strength of amalgam

35
Q

What exposures are preferred in terms of pins?

A

Pulp exposure preferred to PDL exposure

36
Q

How to deal with pulp exposure from a pin?

A

Direct pulp cap with calcium hydroxide or RCT

37
Q

What does a PDL exposure result in?

A

Abscess

38
Q

How to deal with a PDL exposure from a pin?

A

Treated by removing pin that is perforating tooth and plugging with amalgam

39
Q

Does a pulpal or PDL exposure have a less predictable prognosis?

A

PDL

40
Q

Where can there be microleakage with a pin?

A

Around it

41
Q

Does adding a pin make it more or less difficult to restore and carve anatomy?

A

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D2 Fall - Operative III (11 decks)

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