Clinical Performance of Endocrowns in Molars: A Scoping Review

Background and Objectives: Endocrowns have emerged as a minimally invasive restorative option in dentistry, aiming to preserve as much of the original tooth structure as possible. This scoping review investigates the success rates, biomechanical performance, and material efficacy of endocrowns for restoring molars, in comparison to conventional post-and-core crowns. Materials and Methods: A comprehensive literature review was conducted to identify relevant studies using PubMed and Scopus databases. The search covered publications up to March 2025. All study types focusing on molar restorations were included, except for case reports. Data extraction and screening were performed independently by two reviewers. Results: A total of 37 studies fulfilled the eligibility criteria. Eleven systematic reviews examined comparisons between endocrowns and post-and-core crowns, as well as differences in material selection, survival and success rates, and outcomes between molars and premolars. The remaining 26 studies addressed the clinical performance and longevity of endocrowns, with an emphasis on preparation design, adhesive protocols, and mechanical behavior related to material selection. Conclusions: Endocrown restorations present a conservative and predictable alternative to post-and-core crowns for molars with extensive coronal damage. However, due to variability in reported outcomes, high-quality randomized clinical trials are crucial for confirming their clinical effectiveness. The development of novel, standardized treatment guidelines would provide clinicians with adequate information to effectively restore endodontically treated teeth (ETT).