Pinned amalgam

Today , you are going to make a pin retained amalgam. So what is pinned amalgam?
A pin retained restoration may be defined as any restoration requiring the placement
of one or more pins in the dentin to provide adequate retention and resistant / forms.

And I think it may be the only chance you can practice pinned amalgam in your
career. For me, I only practice pinned amalgam no more than 3 times after I finished
my undergraduate programme. And some students gave me some feedback they
don’t want to waste time to practice amalgam. But you are just year 2 students, you
will have plenty of composite training in the future and from my point of view it more
important to learn tooth reduction/ preparation, so they are the same. And if you
could make a good tooth preparation for amalgam restoration, defenitly you can
make a good tooth preparation for composite prep for composite.

It is first used by Dr. Miles Markley in 1958 and was once very popular owing to good
retention, but laterstudies showed that pins increased retention in amalgams, but
decreased strength. So you need to bear in mind this treatment has some problems.

When you look at these 2 pics, you know why the tooth prep should be as
conservative as possible. If it is too wide, the walls and cusps are very easy to
fracture.
Pins are used whenever adequate retention forms cannot be established with slots,
locks, or undercuts only. The pin-retained amalgam is an important adjunct in the
restoration of teeth with extensive caries or fractures.

Because of effective bonding to enamel and dentin, the need for pins has virtually
been eliminated. Proper use of bonding technique and selectively placed retention
features usually provide adequate retention for composite restorations. The use of
pins may be considered for a tooth that insufficient remaining tooth structure for
adequate retention features. Ideally, such a tooth should be restored with an esthetic
crown. However, economics or time constraints may dictate the placement of a
pinned amalgam restoration.

That ‘s what we will use. The pin and twist drill should be both placed in a latch-type
contra-angle low speed handpiece

The most frequently used pin type is the small self-threading pin. Friction-locked and
cemented pins, although still available, are rarely used). The diameter of the
prepared pinhole is 0.0015 inch to 0.004 inch smaller than the diameter of the pin.
The elasticity (resiliency) of the dentin permits insertion of a threaded pin into a hole
of smaller diameter.

For selfthreading pins, retention is not increased significantly when the depth of the
pin into dentin exceeds 2 mm. so as a general rule, pinhole depth is 2 mm. so that’s
the reason why the twist drill is designed as a depth-limiting drill. And you can see
the working end the drill tip is 2 mm.

Therefore pin extension into dentin and amalgam greate rthan 2 mm is unnecessary
for pin retention and is contraindicatedto preserve the strength of the dentin and
the amalgam. a pin oriented vertically and positioned directly below an occlusal load
weakens the amalgam significantly' Occlusal clearance should be sufficient to
provide 2 mm of amalgam over the pin.

operator should carefully probe the gingival crevice to determine if any abnormal
contours exist that would predispose the tooth to an external perforation. As a
rule, the pinhole should be parallel to the adjacent external surface of the tooth.

Therefore it may be necessary to prepare first a recess in the vertical wall with the No. 245 bur to permit proper
pinhole preparation, as well as to provide a minimum of 0.5 mm clearance around pin for adequate condensation
of amalgam

The position of a pinhole must not result in the pin being so close to a vertical wall of
tooth structure that condensation of amalgam against the pin or wall is
jeopardized.

Pinholes should be prepared on a flat surface that is perpendicular to the proposed

direction of the pinhole. Otherwise, the drill tip may slip or "crawl," and a depth-
limiting drill cannot prepare the hole as deeply as intended

1. c

2. e

3. a

4. b

5. c

6. c

7. a

8. e
 9. a

10. b

11. d

12. c

13. d

14. a

15. e

16. d

17. c
18. b

19. c

20. d

21. a

22. c

23. d

24. d

25. e

26. a

27. c

28. b

29. e

30. a

31. e

32. a

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