Endocrowns: A systematic review

Area of Science:

• Restorative Dentistry
• Endodontics
• Dental Materials Science

Background:

• Restoring extensively damaged endodontically treated teeth presents significant clinical challenges.
• Traditional post-retained restorations may compromise tooth structure and lead to weakening.
• Alternative restorative solutions are needed for improved long-term outcomes.

Purpose of the Study:

• To systematically evaluate endocrowns as a viable alternative to post-retained restorations.
• To identify optimal preparation designs for endocrown fabrication.
• To determine the most suitable materials for endocrowns in extensively damaged endodontically treated teeth.

Main Methods:

• A comprehensive literature search was conducted in PubMed, Cochrane, and Scopus databases from 1995 to June 2018.
• Included were in vitro and clinical studies, excluding case reports.
• Manual bibliography searches supplemented the database search.

Main Results:

• Forty-one publications, including 8 clinical and 33 in vitro studies, were analyzed.
• Clinical studies focused on survival rates, failure modes, and clinical criteria.
• In vitro studies assessed fracture resistance, stress distribution, preparation criteria, and material performance.

Conclusions:

• Endocrowns demonstrate reliability as an alternative to post-retained restorations for molars, with promising potential for premolars.
• Specific preparation designs and strict adhesion protocols are essential for successful outcomes.
• Lithium disilicate glass-ceramic and nanofilled composite resin are recommended materials for endocrown fabrication.