Errors and complications during the preparation and filling of atypical cavities, use of the pin constructions
If you can not find a place to pin between the pulp and marginal periodontium, we can expect the development of severe complications. Hence it is quite natural to fear the doctor a second manipulation of the pin canal. In this case, the fear of opening the pulp with a doctor, especially a beginner, much prevails, although perforation in the gum is actually more dangerous. Create pin canal without anesthesia is always painful procedure.
Table 1.
| Character of complications | Cause | Methods of correction and prevention |
| Painfulness | The result of local overheating of dentin. | Work with the air-water cooling |
| Perforations in the bottom of the cavity of the tooth and its walls. | Does not include topographic and anatomical features of tooth. | The perforation treated with 30 % silver nitrate solution, close with the glass ionomer cement and continues treatment of tooth. With careful work based on random perforations should be favorable. Sterile pin in this case will serve as a medical bandage. Thus he is hermetically separates the pulp from the environment. |
| Opening of the periodontum. | When this error is to create a risk of pathological gingival pockets in the area of perforation. | Artificial canal can be sealed zinc-phosphate cement, silver amalgam, the introduction of a ping to the level of perforation or sealing of zinc phosphate cement and smooth stainless steel wire with a polish finish. Describes the intervention tilting gingival flap opening perforation and operational alignment on the root surface of the material or pins and suturing. Some recommend leaving any empty flume. Unfortunately, none of the options can not be guaranteed to prevent the development of progressive parodontitis. |
| Fracture of drills or pins | Not made convenient access to the mouths canals. Or poor quality of instrument. | Removing of benches in canals. It should not be enter it into the pin canal or put out it non-rotating. Working only with qualitative instruments. |
| The drill does not cut. | 1) drill rotates in the wrong direction, 2) drill dull, 3) drill rests on the enamel. | Working only with qualitative instruments. Enamel layer should first pass a small carbide or diamond drill. |
| Pin-wide canal. | Discrepancy between the sizes of instrument and diameters of the canal. Careless investigation in the canal. | To provide retention pin, you must: 1) to cement it or 2) use a thicker drill and appropriate thick pin. |
CONTROL QUESTIONS:
1. Classification of atypical cavities.
2. Preparation of the vital and pulpless teeth.
3. Preparation of atypical cavities.
4. What materials are using for filling of atypical cavities.
5. Rules for filling the cavities with atypical localization.
6. Types of parapulpar and intracanal pins constructions. Indications for use.
7. Errors and complications during the preparation and filling of atypical cavities, use of the pin constructions.
HOMEWORK:
Independent out-of-class work
1. To write out the classification of atypical cavities.
Tests for self-monitoring and self-correction the original level of knowledge:
1. There are three main types of systems pins:
A. Cemented, friction and screwed
B. Rotating, cemented and friction
C. Replacement, cemented and screwed
D. Frictioned, rotary and screwed
E Stabilized, cemented and rotating
2. To pins construction classified by material include all of the above, except:
A. cemented,
B. steel,
C. silver,
D. synthetic fiber,
E. ceramic.
3. To pins construction classified by form include all of the above, except:
A. conic-cylindrical,
B. conic,
C. cylindrical,
D. synthetic.
4. The system includes the following pins 4 elements:
A. Cavities, pin, drill and filling material,
B. The tip of a pin, dentin and filling material,
C. A tip drill, pin and dentin,
D. Cavities, pin, drill and dentin,
E. Drill, pin, dentin and filling material.
5. Atypical cavities include all of the above, except:
A. Secondary caries,
B. Caries of cement,
C. Circular caries,
D. Caries of fissures,
E. Caries tuber of chewing teeth.
6. Parapulpar pins are installed in the hard tissues of the tooth:
A. out of pulp cavity,
B. on top of the pulp cavity,
C. into the pulp cavity,
D. covering the pulp cavity.