The Influence of Different Designs, Materials and Cements on the Success and Survival Rate of Endocrowns. A Systematic Review

The aim is to evaluate the success and survival rate of endocrowns and the influence of design, material and cements. A search of clinical trials of endocrowns was performed using three databases (Medline/PubMed, Scopus, CochraneLibrary), complemented by a manual search. The search resulted in 2,718 studies, six of which were included for analysis. The follow-up times were 2-12 years. Feldspathic porcelain was the material of choice cemented with different adhesive resin cement systems. Designs varied significantly. In total, the six studies represented 471 endocrowns. Thirty-six of these failed. Most common failures were loss of retention and fracture. Due to insufficient information on timing of events and drop-out, no statistical analysis was performed. No conclusive correlation between design, material, cement and success or survival of endocrowns could be established. Signs of differences in survival rates between molar and premolar endocrowns were noted, with a tendency towards higher survival rates for molar endocrowns. Feldspathic ceramic endocrowns with adhesive cementation demonstrate promising clinical performance. These conclusions are however based on a limited number of studies of comparatively low quality. Further studies are thus needed to verify the conclusions and to provide guidance in the clinical decision on best choice of materials, design and cements.