PIN RETAINED

RESTORATIONS
DR DRISHYA KISHORE
Any restoration which requires
the placement of pin/pins in the
dentin in order to provide
sufficient retention and
resistance form to the restoration.
 INDICATIONS

Badly broken teeth

Badly broken non-vital tooth requiring endodontic treatment
Extended preparations
Foundation for full coverage restoration
ADVANTAGES Conservation
of tooth
structure

Resistance and
retention form

Cost factor

Number of
appointments
 DISADVANTAGES

Tooth anatomy Dentin fracture

Strength of
Perforations Microleakage
amalgam
INTRODUCTION &
CLASSIFICATION

1958, Dr Miles Markley introduced stainless steel

pins

 Direct pins/nonparallel pins

• Cemented pins
• Friction locked pins
• Self-threading pins

 Indirect pins/parallel pins

 INDIRECT PINS

 Smaller in size than their pinholes

 Integral part of a cast restoration.
 Parallel pins - placed parallel to each other and also to the path of insertion of
the restoration

CAST GOLD PINS WROUGHT PRECIOUS METAL PINS

Smooth surface. Threaded or knurled patterns.

20 to 30 percent more retentive
 DIRECT PINS

CEMENTED PINS FRICTION LOCKED SELF-THREADING PINS

PINS
CEMENTED PINS

Introduced by Dr Merklay in 1958.

The pinholes should be 0.025 to 0.05 mm larger than the diameter
of the pin.
 Cemented with glass ionomer or zinc phosphate cement.

INDICATIONS

•Where least stresses or crazing is desired, e.g.

endodontically treated teeth
•When dentin has lost its elasticity because of
dehydration or sclerosis
•When bulk of dentin is less
•When pin has to be placed near the DEJ.
 TECHNIQUES

Dry the prepared pin channels.

Place the cement mix into the pin channel
Hold the pin in the forceps and coat with the cement
Insert the pin into the hole
Hold the pin in its position till it sets
Remove excess cement with an explorer.
 ADVANTAGES

Can be seated to the full depth of the hole

No stress on the surrounding dentin
Cement decreases the chances of microleakage
They can be cut or bent before placing in the pinholes.

DISADVANTAGES

Provide less retention

It is difficult to locate the pinhole after cement has been placed in it
for cementation
Can be dislodged while inserting filling material
Requires more time for the mixing and hardening of the cement.
FRICTION LOCKED PINS

Introduced by Goldstein in 1966.

Pins are 0.001” larger than their pinholes
Utilize the elasticity of dentin for retention.
2 to 3 times more retentive than the cemented pins.

INDICATIONS
• Vital teeth
• Periodontally sound teeth
• Direct access is possible
• When sufficient amount of dentin is available to
surround the pin.
 TECHNIQUES OF PIN PLACEMENT

Cut the pin to the desired length before insertion

Insert the pin into a pin setter and carry to the pinhole.
Apply force with mallet parallel to the long axis of the pin until pin
reaches the desired length
Bend the pin at a desirable angle with contouring pliers,if desired.
 ADVANTAGES

Cementing media not required

Pins attain stability from the moment they are inserted
Better retention than the cemented pins.

DISADVANTAGES

Sometimes the pins do not reach full depth of the channel

The length of the pin cannot be adjusted outside after insertion.
Bending or contouring of the pin after it has been inserted results in further
stresses
Microleakage occurs if the overlying restoration leaks
Stresses in dentin may result in form of cracks or craze lines.
 SELF-THREADING PIN

Introduced by Going in 1966.

Pins are 0.0015” to 0.004” larger than their pinholes.
Retained due to the mechanical grasp of the threads into the
dentin.
These are available in stainless steel or titanium but can be
gold plated to increase their passivity.
Most popular
3 to 6 times more retentive than the cemented pins.
The amount of stresses induced are also more with the
threaded pins.

INDICATIONS
 In vital teeth
 When maximum retention is desired
 When sufficient amount of dentin is available to
surround the pins.
 ADVANTAGES

 Ease of insertion
 Superior retention
 Require less depth for placement
 Require no cementing medium.

DISADVANTAGES

The pulpal stress is maximum when the pin is inserted perpendicular

to the pulp
Generate great stresses in dentin in form of craze or crack lines
Pins may fail to seat completely
If pin is forced into the pinhole it may strip the sides of the dentin
resulting in a loose fit
Microleakage is higher
Pins may need to be bent, cut or contoured after placement which
generate extra stress on the tooth or may loosen the pin.
 THREAD MATE SYSTEM (TMS)

Most widely used among self-threading pins.

DESIGNS
• Standard
• Self-shearing
• Two-in-one
• Link series
• Link plus series.
STANDARD PIN
Full length pin, i.e. 7 mm long which can be cut to the
required length after placement.
Flat head for engagement with the hand wrench or the
handpiece chuck.

SELF-SHEARING PIN
On reaching the bottom of the pinhole, the head
separates automatically at the shear line, leaving a portion of
it to project from the dentin.

TWO-IN-ONE DESIGN
In this, two pins join each other at a joint. This joint
marks the shear line for the peripheral pin.
One pin is peripheral pin and the second pin is wrench
attachment pin.
LINK SERIES
Plastic sheath/head designed to fit in a slow speed
contra-angle hand-piece.
When the pin reaches the bottom of the pinhole head
separates from the pin at the shear line.

LINK PLUS SERIES

Modifications from link series:
• Incorporation of sharper threads
• Tapered tip which readily fits in pinhole
• Shoulder stop.
 PRINCIPLES AND TECHNIQUES OF PIN PLACEMENT

Pin Size
Increase in diameter of pin offers more retention but more stresses in dentin

Number of Pins
One pin per missing cusp and one pin for each missing axial line angle

Interpin Distance
Interpin distance depends upon size and type of pins.
For cemented pins it is 2 mm, for friction lock it is 4 mm and for threaded pins it is 5
mm.

Length of Pin into Dentin and Amalgam

2 mm into dentin and amalgam provide maximum required retention.
Location of Pin Placement
Factors to be considered
Knowledge of normal pulp : At least 1 mm of dentin between pulp
and the pin
Avoid placing directly under occlusal loads
Pinholes should be located on a flat surface.
When more than two pinholes are planned, they should be placed at
different levels to prevent the stresses in same transverse plane of the tooth
Interpin distance
At least 1 mm of sound dentin around circumference of the pin
Intermittent radiographic monitoring
4. Technique of Preparation of Pinhole
i. Mark the point where pin is supposed to be placed.
ii. Pinholes are prepared using twist drills
iii. After pin preparation is complete, confirm the depth using omni-depth gauge
and take a radiograph.
5. Insertion of Pin
 Using conventional latch type contra-angle micromotor handpiece or using
TMS hand wrenches.
 Once the pin reaches bottom of pinhole, give quarter to half-turn rotation to pin
to minimize dentinal stresses.
7. Matrix Placement
8. Placement of Amalgam
9. Carving of Amalgam
10. Removal of the Matrix
11. Finishing and Polishing Procedure
FACTORS AFFECTING RETENTION OF PINS IN DENTIN AND AMALGAM

1. Pin Type
 Self-threaded pins > friction locked pins > cemented pins.
 Serrated pins are more retentive than smooth surface pins.
2. Pin Number
 Within limits, increase in number of pins increases the retention.
 Overuse of pins cause decrease in amount of dentin available, decrease amalgam
strength, and thus increase in fracture.
3. Interpin Distance
 Placing pins close to each other increases retention.
 If distance is lesser than 2 mm, pin retention is reduced
4. Pin Diameter
 Within limits, retention is directly proportional to diameter of pin.
 However, Overzealous increase in diameter may decrease amount
of dentin and thus weaken the tooth.
5. Pin Depth in Dentin
 Within limits, increasing the depth of pin in dentin increases the
retention .
 Overzealous increase of pin length in dentin may induce stresses in
dentin and may cause pulp exposure.
7. Surface Characteristics : Serrated pins are more retentive than
smooth pins.
8. Pin Orientation: Nonparallel orientation have more retention than
pins in parallel orientation.
9. Cementing Agents
Zinc phosphate and glass ionomer cement > ZOE.
10. Type of Dentin
Young resilient primary dentin>Secondary dentin > sclerosed dentin >
tertiary dentin
 COMPLICATIONS OF PIN-RETAINED
RESTORATIONS
1.Failure of Pin-retained Restorations
 Restoration may fracture because of improper condensation, trituration,
or manipulation.
 Pin fracture may occur because of improper pin placement technique.
 At pin-restoration interface: Restoration may pull away from pin because
of corrosion products at pin-restoration interface .
 Dentinal fracture can occur because of concentration of internal
stresses.

2. Broken drills
3. Loose Pins
Loose pins can occur in the following conditions:
•Repeated insertion and removal of drill during pin
preparation
•Pin drill is rotated more than required
•Pinhole is too large
•Manufacturer's discrepancy
•Stripped out or chipping of dentin or enamel.
To stabilize the pin, following can be done:
•Cement the existing pin in place
•Drill another hole of the same diameter 1.5 mm away from
the present hole and insert the same pin.
•.
6. Pulp and periodontal perforation
•Perforation is indicated by sudden bleeding while operating the drill.

5. Heat Generation
Excessive heat generation causes damage to pulp.

6. Microleakage
OTHER MEANS OF RETENTION IN COMPLEX AMALGAM RESTORATIONS

Slot
Slot is a groove which is placed in the horizontal plane in
dentin.
Slot is indicated especially in short teeth.
It has 1.0-1.5 mm of depth in occlusal or gingival floor.
Cove
Cove is prepared by using No. 1/4 bur.
Lock
Lock is a groove placed in longitudinal plane.
It is 0.2-0.3 mm wide and 0.5 mm deep into the dentin.
It is usually prepared with 169L tapered fissure bur in teeth
with sufficient crown height.
Amalgapin
• Amalgapins are vertical posts of amalgam anchored in
dentin.
• These are called "dentin chambers".
• Post formed by amalgam in dentin chamber is called
"amalgapin".
• Dentin chamber is prepared by using inverted cone bur
on gingival floor 0.5 mm in dentin with 1-2 mm depth and
0.5-1 mm width..
• Indications for Pin Amalgam Restorations
• Contraindications of Pin Amalgam Restorations
• Classification
• Principles and Techniques of Pin Placement
– Pin Size
– Number of Pins
– Interpin Distance
– Length of Pin into Dentin and Amalgam
– Location of Pin Placement
– Preparation of Pinhole
– Placement of Pin Amalgam Restorations
• Factors Affecting Retention of Pins in Tooth
Structure
• Failure of Pin Retained Restorations
• Alternatives to Pins for Additional Retention in
Amalgam Restoration