Comparison of clinical efficacy of CAD CAM Endocrowns made of feldspathic ceramic, zirconia lithium silicate, and lithium disilicate: A two-year mixed cohort study

J Dent. 2024 Oct:149:105019. doi: 10.1016/j.jdent.2024.105019. Epub 2024 Apr 24.

Abstract

Objective: Endocrowns can be fabricated from various materials as a treatment option for endodontically treated teeth. This mixed cohort study aimed to demonstrate the clinical efficacy of Endocrowns made of feldspathic, zirconia lithium silicate, and lithium disilicate ceramics using a chairside CAD/CAM system.

Methods: The present study compared the clinical outcomes of 141 Endocrown restorations in posterior teeth of 85 patients in a two-year follow-up. The efficacy of restorations was evaluated in three aspects: esthetics, biological response, and function, with the aid of the FDI guideline, and presented as descriptive analyses. Additionally, the data were analyzed using Chi-square and Spearman correlation tests. The significance level was set at p = 0.05.

Results: The study findings revealed that the type of restorations (feldspathic ceramic, zirconia lithium silicate, and lithium disilicate) (p > 0.05) and underlying teeth (molars and premolars) (p > 0.05) play no part in restorations' failure. Caries' recurrence is primarily responsible for the failure of the endocrowns. Secondary caries and radiolucency were observed in four teeth (2.83 %). The clinical efficacy of 126 restorations (89.36 %) fell into the category of "clinically excellent" and "clinically good." Ten restorations (7.09 %) were classified as "clinically sufficient/satisfactory," and only five restorations (3.54 %) needed replacement due to having "clinically unsatisfactory" and "clinically poor" quality.

Conclusions: Endocrowns showed a high success rate and durability in the short term, therefore can be considered a safe choice for restoring endodontically treated teeth. It is worth noting that caries were the most common reason for the failure of the restorations.

Clinical significance: Endocrowns made of different ceramics have been proven reliable restorations for endodontically treated molars and premolars.

Keywords: CAD-CAM; Dental restoration outcome; Endocrown; Follow-up study.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aluminum Silicates / chemistry
  • Bicuspid
  • Ceramics* / chemistry
  • Cohort Studies
  • Computer-Aided Design*
  • Crowns
  • Dental Caries / therapy
  • Dental Materials / chemistry
  • Dental Porcelain* / chemistry
  • Dental Prosthesis Design
  • Dental Restoration Failure
  • Esthetics, Dental
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Molar
  • Potassium Compounds / chemistry
  • Potassium Compounds / therapeutic use
  • Silicates / therapeutic use
  • Tooth, Nonvital / therapy
  • Treatment Outcome
  • Young Adult
  • Zirconium* / chemistry

Substances

  • Zirconium
  • Dental Porcelain
  • zirconium oxide
  • lithia disilicate
  • Aluminum Silicates
  • Silicates
  • Dental Materials
  • Potassium Compounds
  • feldspar