Dental pins, or dentin pins, for crowns and fillings
Dental pin use is way down with the widespread use of composite bonding. However, there is still a place that they can be useful.
Dental pins for crowns
This is probably the most common use today for dental pins. There are times when a tooth has almost no real structure left, yet there is still enough to put a crown on it. The tooth structure that is left is not the most ideal for bonding and is certainly fair worse than clean enamel. The patients that get these are often older patients that already a crown on the tooth that was lost. The advantage of old age in this case is we are far less likely to hit a pulp. Putting in a few dental pins can make an unrestorable tooth restorable again.
What about dentin pins for fillings?
Pins were far more popular in the days of amalgam fillings. Today few dentists will use a pin to place a filling. I imagine those dentists left that place very large amalgam fillings still use pins frequently, but their numbers are declining. Dentists also would use a pin to retain a front white filling. They seem to hold up well also.
How are dental pins different than dental posts?
Dental pins are much smaller and we insert them into the peripheral tooth structure. Whereas, dental posts are larger and dentists insert them into the central area of a tooth where the nerve was. We place dental posts in teeth with root canals. Pins can go in either teeth with or without root canals.
What is the dental code for dental pins?
There are 2 dental codes when using a dental pin. The most common dental code that dentists use that relates to dental pins is D2950. D2950 is a core buildup, including any pins that we require. The other dental code is D2951. That code is pin retention, is per tooth, and is in addition to the fillings itself.
Dental pin complications
The biggest complication we see is that the pin does not go where we want it to go. There are two spots where it can go that are not ideal. The first being into the pulp chamber. The likelihood of a root canal in the near future of a tooth like that is close to 100%. The second place is perfing out the side of the tooth. Amazingly most dentists have one or two of these in their practice and they are just fine. So while it is far from ideal, it it often not that serious for the tooth.
Another complication of pins is that they increase the likelihood of fracture in that area. We also call dental pins, retentive pins because they help retain the build up. However, while we do improve the retention rate we also increase the fracture rate. There is plenty of support to the widely held view that pins, although helpful in the retention of a large filling, act as a source of weakness within the restoration. Burke 2000 page 38
Alternative nomenclature for pins
There are other names that dental pins go by. The most common is dentin pin, because we place them in the dentin.