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Direct Restoration > Complex Pin Amalgam > Flashcards

Complex Pin Amalgam Flashcards

1
Q

When to use pins:

A

Slots, locks and undercuts aren’t enough for retention

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2
Q

Indications for cpa:

A

One or more cusps need capping, definitive final restoration, foundation resto, control resto in teeth that have a questionable pulpal and pd px, control resto in teeth w a uterus or sever caries

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3
Q

Give added support to pins, if needed

A

Slots, box-like forms, coves, grooves

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4
Q

Advantages of cpa:

A

Conservative, 1 appt., resistant a and retention ban be increased w pins and slots, inexpensive compared to crown

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5
Q

Disadv of cpa:

A

Occlusal contact/ anatomy, resistance form difficult to develop than for cusp-only onlay, internal pins can make craze lines in dentin

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6
Q

Ideal preparation design for cpa’s:

A

None, we use what is left

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7
Q

Tooth preparation for cpa:

A

90’ cs margin angle in all areas

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8
Q

Reduce cusp in this situation:

A

F-L extension is more than 2/3 distance from primary groove toward cusp tip

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9
Q

When to use depth cuts:

A

When the cusp is intact/ normal height

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10
Q

Burs to use for depth cuts on cusps:

A

556, 169L (side)

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11
Q

Depth of retentive groove for functional and nonfunctional cusps:

A

2-2.5, min 1.5

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12
Q

Min amal for functional and non functional cusps

A

2mm, 1.5mm

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13
Q

Sharp internal corners are removed to:

A

Resistance to fracture from occlusal forces, reduce stress concentration in amal

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14
Q

Cusp reduction should extend to here:

A

Just past F/L groove, vertical wall against the adjacent in reduced cusp, try to have 2 opposing walls that converge, if possible

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15
Q

Provide retention for class 1 and2 restos:

A

Convergence of opposing walls

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16
Q

Vertical retentive grooves should be placed with:

A

1/4 round, 169L

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17
Q

Vertical retentive groove is aka:

A

Vertical retentive lock

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18
Q

Bur to use to make the sentinel slots:

A

330

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19
Q

Where to make slots:

A

1mm deep and 0.5-1mm inside DEJ

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20
Q

Bur to make coves:

A

1/4 round bur

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21
Q

Coves are prepared on his plane

A

Horizontal

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22
Q

Slots and pins are placed in this plane:

A

Vertical

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23
Q

Slots are placed along:

A

Gingival floor, axial to DEJ

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24
Q

Which to place first, retentive grooves or pins?

A

Grooves

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25
Q

Types of pins:

A

Cemented, friction locked (undersized channels), self threaded

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26
Q

How to place friction locked pin:

A

Mallet into undersized channel

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27
Q

Pin types, shortest to longest:

A

Self-threading, cemented, friction-locked

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28
Q

Cemented pins:

A

Miles Markley, 1958, stainless steel, threads or serrations, less internal stress, least retentive, rarely used, 0.025 pin in 0.027 hole in dentin, 3-4mm hole depth, 2mm projects above hole, zinc phosphate cement

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29
Q

Instrument to push cement into pin holes:

A

Lentulo spiral instrument

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30
Q

Cut pin w:

A

Wire cutting pliers

31
Q

When to use rotating carborundum disc on pin:

A

To round end

32
Q

How to bend pin:

A

2 pairs of pliers

33
Q

Friction locked:

A

Goldstein, 1966, 0.022 inch (typo?) tapped into 0.021 inch hole, takes advantage of elasticity of dentin, 2-3mm depth, 3mm above hole pin, 2-3 X more retentive than cemented, more internal stress than cemented

34
Q

Most used pin system:

A

Self threading

35
Q

Self threading pin system:

A

1966, Going, diameter: 0.0015-0.004in smaller than diameter of pin, dentin elasticity permits insertion, depth: 2mm, 2mm above hole, 3-6 X more retentive than cemented, dentinal stress during insertion causing craze lines

36
Q

TMS

A

Thread mate systems, most widely used, many sizes, color coded, great retention, (pin, wrench, drill in set), gold plated stainless steel or titanium

37
Q

Types of hand wrenches:

A

Metallic or plastic

38
Q

4 sizes and diameters of TMS pins:

A

Regular: gold, minim: silver, minikin: red, minuta: pink (largest to smallest)

39
Q

2 types of twist drills:

A

Depth limiting 2mm, standard 5mm

40
Q

2 factors in choosing pin:

A

Amount of dentin, amount of retention desired

41
Q

For posterior teeth:

A

Minikin pins (0.019), reduce dentinal crazing, pulpal penetration, and potential penetration, minim back up if hole is over prepared

42
Q

Minuta:

A

Least retention. Can’t use for posterior teeth

43
Q

The larger the pin,

A

The greater the retention

44
Q

5 designs of TMS pins:

A

Standard, self-shearing, 2-in-1, link series, link plus

45
Q

Standard:

A

1

46
Q

Self-shearing:

A

Top portion shears off once the bottom is hit, plastic sleeve discarded

47
Q

2 in 1:

A

Shears in half, one half in handpiece, can place in another pinhole, each is shorter than standard pin

48
Q

Link series:

A

Available in all sizes,

49
Q

Link plus

A

Shorter stalk at 2mm, single and 2 in 1 design, 2.7mm length extends out of dentin, self shearing, color coded, plastic sleeve

50
Q

Minuta hand wrench shank:

A

Not straight

51
Q

Minim wrench:

A

Banded

52
Q

Non banded wrench:

A

Regular and minikin

53
Q

Standard can only be used w, all others an be used w:

A

Hand wrench, latch type contrangle w approp chuck

54
Q

Hand wrenches must use:

A

Dental tape/ floss around upper portion

55
Q

If rubber dam can’t be used with patient, what should you do?

A

Cotton gauze to shield throat

56
Q

Location for pin placement:

A

Need 2mm amal, 1mm sound dentin around pin channel, 0.5-1m from DEJ or 1-1.5mm from external surface of tooth, whichever is greater

57
Q

Pin channel placement:

A

Parallel to external tooth surface, perpendicular to direction of pin channel, prevents perforation

58
Q

Lager pins:

A

Greater retention, rarely used, create crazing/ cracking, risk of exposing pulp chamber

59
Q

Can pins be placed directly next to walls?

A

No, need access to condense amalgam around pin

60
Q

What to do if there is not adequate space to condense around a pin?

A

Create a cove around the pin, 169L or 245 bur

61
Q

Purpose of pilot hole

A

Accurate pin placement/ twist drill placement, prevent crawling if drill during rotation

62
Q

Bur to make pilot hole:

A

1/4 round

63
Q

What can we use to insert the depth limiting twist drill

A

Plastic hand piece or slow speed

64
Q

Why we add slow gear onto slow speed for pin placement

A

Increases torque, tactic sense, reduces risk of stripping threads in dentin when pin is in place

65
Q

Drill system we are using:

A

Link plus system

66
Q

Speed for pin placement of drill

A

Very low speed

67
Q

How many hand movements for pin placement

A

2 max, don’t angle either, should always vessels rotating

68
Q

Pins should not be bent for these reasons:

A

To make parallel with other pins, to increase pin retention

69
Q

When to bend pin

A

To allow condensation, with pin bender tool, firm, even pressure

70
Q

Why not to use black spoon excavator to bend pin

A

Risk of slipping, less control while bending, bend pin at orifice, increases risk of crazing/ cracking dentin, cracking pin, pin bending tool places fulcrum of bend above the point of insertion into dentin

71
Q

How to close open space of Tofflemire system when doing large prep:

A

Insert cut piece of matrix band between band and adjacent tooth

72
Q

Alternate system to create proper contour of large resto:

A

Auto matrix system, 360’ coverage

73
Q

How to shorten pins after placement

A

1/4 round bur

Direct Restoration (23 decks)

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