Pins in teeth

Not always contraindicated as they say in the textbooks. Pins can provide very favourable retention for restorations where bonding is less predictable or the tooth is very compromised. Indicated when a cusp is lost (as there will be reduced mechanical retention from tooth structure) and the pin will be inserted in the location of the lost cusp.

Location should be just inside the DEJ in dentine and care should be taken not to perforate the enamel wall or the pulp chamber. A good tip from Dr. L C is to place the drill tip in the sulcus and use that same angulation against the tooth structure to place your pin prep.

Today when removing a GIC in the access cavity to replace with a composite core i encountered a pin in the remaining composite. The decision came whether or not to remove this pin and it was
decided that removal was best. This was for 2 reasons:
1: the pin was solely in composite (the dentine may have been removed during endo access)
2: when completing the onlay prep, the puin will tend to vibrate, so we don't want anything compromising the integrity of the composite restoration (i.e forming microcracks) and although the pin would probably be removed during prep, it may weaken the final result. If the pin was showing after prep, it will not contribute to bonding