Endocrown restorations: A systematic review and meta-analysis

A systematic review was conducted to evaluate clinical (survival) and in vitro (fracture strength) studies of endocrown restorations compared to conventional treatments (intraradicular posts, direct composite resin, inlay/onlay).

This report followed the PRISMA Statement. A total of 8 studies were included in this review.

Two reviewers performed a literature search up to February 2016 in seven databases: PubMed, Web of Science, Scopus, BBO, SciELO, LILACS and IBECS.

Only clinical trials and in vitro studies that evaluated endocrowns were included. Case reports, case series, pilot studies, reviews and in vitro studies that evaluated properties other than fracture strength of endocrowns were excluded. From the 103 eligible articles, 8 remained in the qualitative analysis (3 clinical trials and 5 in vitro studies), and the meta-analysis was performed for the 5 in vitro studies. A global comparison was performed with random-effects models at a significance level of p<0.05.

Clinical trials showed a success rate of endocrowns varying from 94 to 100%. The global analysis in posterior and anterior teeth demonstrated that endocrowns had higher fracture strength than conventional treatments (p=0.03). However, when comparing endocrowns to conventional treatments only in posterior teeth (subgroup analyses), no statistically significant differences were found between treatments (p=0.07; I(2)=62%).

The literature suggests that endocrowns may perform similarly or better than the conventional treatments using intraradicular posts, direct composite resin or inlay/onlay restorations.

Although further studies are still necessary to confirm the present findings, endocrowns show potential application for the rehabilitation of severely compromised, endodontically treated teeth.