Comparing endocrown restorations on permanent molars and premolars: a systematic review and meta-analysis

Abstract

Objectives: The objective of this systematic review was to evaluate the success of endocrown restorations on molars in comparison with endocrown restorations on premolars.Registration number: The methodology for this review is registered with the Prospero database (CRD42019149543).Data sources: MEDLINE, EMBASE, Dentistry and Oral Sciences source and The Cochrane CENTRAL were searched through January 2020 supplemented with hand searching of additional relevant journals.Data selection and Data extraction: Two independent reviewers screened studies against predefined inclusion criteria and extracted data. Data analysis: Narrative analysis was carried out and random effects meta-analysis was performed where possible.Results: Out of the selected eight studies reported success rate of endocrown restoration in molars varied from 72.7% to 99.57% and in premolars ranged from 68.75% to 100% with a follow-up range of 3 to 19 years. The pooled odds ratio and 95% confidence intervals for failure rates in molars compared to premolars in four studies selected for meta-analysis were 1.096 (95% CI:0.280, 4.292).Conclusions: These findings showed similar success rates, and no difference in the rate of endocrown failures between molars and premolars, thus suggesting that premolars may be considered suitable candidates for endocrowns. However, the findings should be interpreted with caution due to methodological limitations of the included studies. Further better quality and specifically designed controlled trials directly comparing the clinical performance of endocrowns on molars and premolars are required.

Lithium Disilicate Ceramic Endocrown Biomechanical Response According to Different Pulp Chamber Extension Angles and Filling Materials

“…According to a review [ 20 ] that evaluated the clinical behavior of endocrown restorations, the calculated success rate for molars ranged between 72.73% and 99.57%. In addition, the most common mode of failure was the restoration debonding [ 20 ].…”

“…According to a review [ 20 ] that evaluated the clinical behavior of endocrown restorations, the calculated success rate for molars ranged between 72.73% and 99.57%. In addition, the most common mode of failure was the restoration debonding [ 20 ]. From the present results, use of less rigid filling materials—e.g., bulk-fill flowable resin—can offer the patient a more reliable treatment option in terms of stress and adhesive failure risk.…”

“…With regards to the flattening of the pulp chamber floor, previous studies reported different filling materials, such as: resin cement [ 18 ], flowable composite resin [ 19 ], moldable composite resin [ 20 ], and glass ionomer cement [ 21 ]. However, the reason to choose the filling material used to flatten the pulp chamber restoration has never been justified before.…”

“…In the present study, the design criteria of the filling material layer were used based on previous in vitro [ 1 , 2 , 15 , 25 ] and in vivo [ 14 , 20 ] reports. Therefore, the concept is to fill the pulp chamber with the restorative material and then, to perform an adequate endocrown preparation [ 18 ].…”

“…When the pulp chamber floor is not completely flattened, the incidence of unfavorable failures can increase [ 17 ], and the preparation impression and the endocrown design can be compromised [ 14 ]. There are reports of different filling materials applied to seal the root canal and to flatten the pulp chamber, such as: resin cement [ 18 ], flowable composite resin [ 18 , 19 ], sculptable composite resin [ 20 ], and glass ionomer cement [ 21 ]. However, there is no study in the literature that has evaluated the effect of different biomaterials to flatten the pulp chamber and to support the endocrown restoration.…”