SYSTEMATIC REVIEW
Endocrowns: A systematic review Nicolas Govare, DDSa and Mathieu Contrepois, DDSb The restoration of extensively ABSTRACT damaged endodontically treated Statement of problem. The restoration of extensively damaged endodontically treated teeth teeth remains a challenge. Their remains a challenge. The use of post-retained restorations has been questioned because of biomechanical deterioration impotential tooth weakening. pacts the tooth’s long-term Purpose. The purpose of this systematic review was to determine whether endocrowns are a prognosis.1,2 The most reliable alternative to post-retained restorations for extensively damaged endodontically treated commonly used restoration for teeth and to determine which preparation design is most appropriate and which materials are these teeth still involves a postbest adapted for fabricating endocrowns. retained foundation restoration Material and methods. The literature that was analyzed covered endocrowns from 1995 to June and a crown.2-5 The only 2018. A search was conducted for in vitro and clinical studies in English in 3 research databases advantage of inserting a post (PubMed, Cochrane, and Scopus), and this was complemented by a manual search in the is to increase the retention of bibliographies of the studies found. Case reports were excluded. the core foundation. Conversely, Results. A total of 41 publications consisting of 8 clinical studies and 33 in vitro studies were intracanal retention weakens the included in this systematic review. Several analysis parameters were identified: for the clinical tooth structure and increases the studies, survival rate, failure modes, and clinical criteria; for the in vitro studies, fracture risk of root fractures.6-10 In resistance, stress distribution, preparation criteria, and materials used. the event of failure, in addition to Conclusions. Endocrowns are a reliable alternative to post-retained restorations for molars and exposing the tooth to irreversible seem promising for premolars. A certain preparation design and a rigorous adhesion protocol fractures, the invasive nature of must be respected. Among the available materials, lithium disilicate glass-ceramic and nanofilled this type of restoration often excomposite resin stand out. (J Prosthet Dent 2019;-:---) cludes the possibility of further intervention.11 endodontically treated teeth and to determine which With progress in the development of adhesive techmaterials are best for fabricating endocrowns and what niques, the emergence of minimally invasive dentistry preparation criteria should be used. without a post or crown is challenging the post-andcrown concept.12 First described in 1995 by Pissis,13 the MATERIAL AND METHODS monoblock technique was the forerunner of the endocrown. The term endocrown was first used by Bindl and The review was established in accordance with the Mormann in 1999.14 They described an adhesive Preferred Reporting Items for Systematic Reviews and monolithic ceramic restoration anchored in the pulp Meta-analyses (PRISMA) guidelines. An electronic chamber, exploiting the micromechanical retention search in PubMed, Scopus, and the Cochrane Library of properties of the pulp-chamber walls (Fig. 1). articles published from January 1995 to June 2018 was The purpose of this systematic review was to deterconducted by using combinations of the following search mine whether endocrowns are a reliable alternative to terms: (endocrown OR endocrowns OR endo crown OR post-retained restorations for extensively damaged endo-crown) AND (computer aided design OR post and
a
Private practice, Bordeaux, France. Lecturer, Department of Prosthodontics, Faculty of Dentistry, University of Bordeaux, Bordeaux, France; and Private practice, Bordeaux, France.
b
THE JOURNAL OF PROSTHETIC DENTISTRY
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