ENDOCROWNS AS AN ALTERNATIVE RESTORATION TO POST-RETAINED CROWNS ON ENDODONTIC TREATED TOOTH. A SYSTEMATIC REVIEW INTRODUCTION – The purpose of this systematic review is to evaluate the use of endocrowns, as a mean to restorative treatment on endodontically treated teeth. Based on the most recent publications, the following aspects of endocrowns are examined: 1. The manufacturing of the endocrown, including the preparation and material, 2. The advantages and disadvantages, in comparison to post and core crowns, 3. The evidence for endocrowns in in vivo studies.
MATERIALS AND METHOD – The search in PubMed identified 132 publications. Of which 36 studies were published prior to our defined 5-year limitation. Subsequently 96 studies were screened from title and abstract based on in- and exclusion criteria. In total 21 papers were included.
RESULTS – The outcome of the in vitro studies indicates, that endocrowns show higher fracture strength and a lower amount of catastrophic fractures with a 1 mm ferrule, a 2 mm extension in the pulp chamber, and no extension in the root canals. The preferred occlusal thickness of the endocrown depends on the chosen material. Zirkonia showed the best mechanical properties, compared to lithium disilicate and leucite based glass ceramic. The endocrown displays greater mechanical abilities, and low incidence of failures in the posterior region, compared to post and core crowns. While on the contrary post and core crowns are superior in the anterior region. The clinical studies indicate favorable clinical results and survival for endocrowns. Despite this, the studies are non randomized cohort studies and generally carry a high risk of bias, why the results are inconclusive.
CONCLUSION – The in vitro studies show that endocrowns may be an alternative restorative treatment to post and core crowns, with promising results in the posterior region. However, there is a lack of randomized, controlled studies that compares success- and survival rate of endocrowns with post and core crowns.