Endodontic crown: Difference between revisions
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'''Endodontic crown''' (aka: endocrown) is a single [[Dental prosthesis|prostheses]] fabricated from reinforced ceramics, indicated for [[Endodontics|endodontically]] treated [[Molar (tooth)|molar]] teeth that have significant loss of [[Glossary of dentistry|coronal]] structure.<ref> |
'''Endodontic crown''' (aka: endocrown) is a single [[Dental prosthesis|prostheses]] fabricated from reinforced ceramics, indicated for [[Endodontics|endodontically]] treated [[Molar (tooth)|molar]] teeth that have significant loss of [[Glossary of dentistry|coronal]] structure.<ref name=pmid24148141>{{cite journal |doi=10.1111/jerd.12065 }}</ref> Endocrowns are formed from a monoblock containing the coronal portion invaded in the apical projection that fills the pulp chamber space, and possibly the root canal entrances; they have the advantage of removing lower amounts of sound tissue compared to other techniques, and with much lower chair time needed. They are luted to the tooth structure by an adhesive material. The ceramic can be milled using [[CEREC|computer-aided techniques]]<ref name=pmid11725673>{{cite journal |pmid=11725673 }}</ref> or molded under pressure.<ref>{{cite conference |last1=Deesri |first1=W |last2=Kunzelmann |first2=KH |last3=Ilie |first3=N |last4=Hickel |first4=R |title=Fracture Strength and Weibull Evaluation of the Cerec® Endocrowns and Post-and-core-supported Conventional Cerec® Crowns |url=https://iadr.confex.com/iadr/2003Goteborg/techprogram/abstract_34536.htm |conference=81st General Session of the International Association for Dental Research |date=June 25−28, 2003 |location=Goteborg, Sweden }}</ref> Endocrowns can be an alternative to conventional [[Crown (dentistry)|crown restorations]]. |
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== History and classical approach == |
== History and classical approach == |
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It was Bindl and Mörmann<ref |
It was Bindl and Mörmann<ref name=pmid11725673/> who named this restorative procedure “endocrown” in 1999 defining it as a total porcelain crown fixed to a depulped posterior tooth, which is anchored to the internal portion of the pulp chamber and to the cavity margins, thus obtaining macromechanical retention (provided by the pulpal walls) for restoring endodontically treated teeth. |
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The classical approach is to build up the tooth with a [[post and core]], which have physical properties close to those of natural [[dentin]], utilizing adhesive procedures and placement of full-coverage crowns with a sufficient [[ferrule]], but it was found that excessive amount of teeth removal may cause fracture to the teeth |
The classical approach is to build up the tooth with a [[post and core]], which have physical properties close to those of natural [[dentin]], utilizing adhesive procedures and placement of full-coverage crowns with a sufficient [[ferrule]], but it was found that excessive amount of teeth removal may cause fracture to the teeth.<ref>{{cite journal |doi=10.2298/SGS0801054V }}</ref> The literature suggests that endocrowns may perform similarly or better than the conventional treatments using intraradicular posts, [[Dental composite|direct composite resin]] or [[Inlays and onlays|inlay/onlay]] restorations.<ref name=pmid27421989>{{cite journal |doi=10.1016/j.jdent.2016.07.005 }}</ref> |
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== Indications and contraindications == |
== Indications and contraindications == |
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Endocrowns are especially indicated in cases of [[Molar (tooth)|molar]] teeth with short, or fragile roots. They may also be used in situations of excessive loss of coronal dental tissue. Reinforced, acid etchable dental [[Dental porcelain|ceramics]] have been the materials of choice for the fabrication of endocrowns, because they guarantee the mechanical strength needed to withstand the forces exerted on the tooth, as well as the bond strength of the restoration to the cavity walls. |
Endocrowns are especially indicated in cases of [[Molar (tooth)|molar]] teeth with short, or fragile roots. They may also be used in situations of excessive loss of coronal dental tissue. Reinforced, acid etchable dental [[Dental porcelain|ceramics]] have been the materials of choice for the fabrication of endocrowns, because they guarantee the mechanical strength needed to withstand the forces exerted on the tooth, as well as the bond strength of the restoration to the cavity walls. |
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Using endocrowns for premolars is contraindicated as the tooth is more likely to be subjected to lateral forces during mastication than molars because of the steep cuspal incline. Therefore, premolars are prone to fracture after restoration<ref> |
Using endocrowns for premolars is contraindicated as the tooth is more likely to be subjected to lateral forces during mastication than molars because of the steep cuspal incline. Therefore, premolars are prone to fracture after restoration.<ref>{{cite journal |doi=10.1111/j.1600-9657.1987.tb00165.x }}</ref> |
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== Clinical trials and research == |
== Clinical trials and research == |
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A systemic review and meta-analysis showed a success rate of endocrowns varying from 94 to 100% |
A systemic review and meta-analysis showed a success rate of endocrowns varying from 94 to 100%.<ref name=pmid27421989/> Analysis in posterior and anterior teeth demonstrated that endocrowns had higher fracture strength than conventional treatments. Another study showed that an endodontic crown preparation appeared acceptable for molar crowns but inadequate for premolar crowns.<ref name=pmid24148141/> |
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The longest duration of survival is for molar endocrowns is a 5-year clinical follow-up period, with success rate of 87.1%. Root fracture is a very possible finding in premolar and anterior teeth.<ref> |
The longest duration of survival is for molar endocrowns is a 5-year clinical follow-up period, with success rate of 87.1%. Root fracture is a very possible finding in premolar and anterior teeth.<ref>{{cite journal |doi=10.1067/mpr.2002.122014 }}</ref><ref>{{cite journal |doi=10.14219/jada.archive.2005.0232 }}</ref> |
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==References== |
==References== |
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{{reflist}} |
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<references /> |
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[[Category:Restorative dentistry]] |
[[Category:Restorative dentistry]] |
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Revision as of 00:20, 11 June 2017
Endodontic crown (aka: endocrown) is a single prostheses fabricated from reinforced ceramics, indicated for endodontically treated molar teeth that have significant loss of coronal structure.[1] Endocrowns are formed from a monoblock containing the coronal portion invaded in the apical projection that fills the pulp chamber space, and possibly the root canal entrances; they have the advantage of removing lower amounts of sound tissue compared to other techniques, and with much lower chair time needed. They are luted to the tooth structure by an adhesive material. The ceramic can be milled using computer-aided techniques[2] or molded under pressure.[3] Endocrowns can be an alternative to conventional crown restorations.
History and classical approach
It was Bindl and Mörmann[2] who named this restorative procedure “endocrown” in 1999 defining it as a total porcelain crown fixed to a depulped posterior tooth, which is anchored to the internal portion of the pulp chamber and to the cavity margins, thus obtaining macromechanical retention (provided by the pulpal walls) for restoring endodontically treated teeth.
The classical approach is to build up the tooth with a post and core, which have physical properties close to those of natural dentin, utilizing adhesive procedures and placement of full-coverage crowns with a sufficient ferrule, but it was found that excessive amount of teeth removal may cause fracture to the teeth.[4] The literature suggests that endocrowns may perform similarly or better than the conventional treatments using intraradicular posts, direct composite resin or inlay/onlay restorations.[5]
Indications and contraindications
Endocrowns are especially indicated in cases of molar teeth with short, or fragile roots. They may also be used in situations of excessive loss of coronal dental tissue. Reinforced, acid etchable dental ceramics have been the materials of choice for the fabrication of endocrowns, because they guarantee the mechanical strength needed to withstand the forces exerted on the tooth, as well as the bond strength of the restoration to the cavity walls.
Using endocrowns for premolars is contraindicated as the tooth is more likely to be subjected to lateral forces during mastication than molars because of the steep cuspal incline. Therefore, premolars are prone to fracture after restoration.[6]
Clinical trials and research
A systemic review and meta-analysis showed a success rate of endocrowns varying from 94 to 100%.[5] Analysis in posterior and anterior teeth demonstrated that endocrowns had higher fracture strength than conventional treatments. Another study showed that an endodontic crown preparation appeared acceptable for molar crowns but inadequate for premolar crowns.[1]
The longest duration of survival is for molar endocrowns is a 5-year clinical follow-up period, with success rate of 87.1%. Root fracture is a very possible finding in premolar and anterior teeth.[7][8]
References
- ^ a b . doi:10.1111/jerd.12065.
{{cite journal}}: Cite journal requires|journal=(help); Missing or empty|title=(help) - ^ a b . PMID 11725673.
{{cite journal}}: Cite journal requires|journal=(help); Missing or empty|title=(help) - ^ Deesri, W; Kunzelmann, KH; Ilie, N; Hickel, R (June 25−28, 2003). Fracture Strength and Weibull Evaluation of the Cerec® Endocrowns and Post-and-core-supported Conventional Cerec® Crowns. 81st General Session of the International Association for Dental Research. Goteborg, Sweden.
{{cite conference}}: Check date values in:|date=(help) - ^ . doi:10.2298/SGS0801054V.
{{cite journal}}: Cite journal requires|journal=(help); Missing or empty|title=(help) - ^ a b . doi:10.1016/j.jdent.2016.07.005.
{{cite journal}}: Cite journal requires|journal=(help); Missing or empty|title=(help) - ^ . doi:10.1111/j.1600-9657.1987.tb00165.x.
{{cite journal}}: Cite journal requires|journal=(help); Missing or empty|title=(help) - ^ . doi:10.1067/mpr.2002.122014.
{{cite journal}}: Cite journal requires|journal=(help); Missing or empty|title=(help) - ^ . doi:10.14219/jada.archive.2005.0232.
{{cite journal}}: Cite journal requires|journal=(help); Missing or empty|title=(help)