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Hiraba H, Nishio K, Takeuchi Y, Ito T, Yamamori T, Kamimoto A. Application of one-piece endodontic crowns fabricated with CAD-CAM system to molars. JAPANESE DENTAL SCIENCE REVIEW 2024; 60:81-94. [PMID: 38303746 PMCID: PMC10830429 DOI: 10.1016/j.jdsr.2023.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 12/04/2023] [Accepted: 12/26/2023] [Indexed: 02/03/2024] Open
Abstract
Computer-aided design-computer-aided manufacturing (CAD-CAM) systems have been widely used as a fabrication method for restorations because of their high efficiency and accuracy, which significantly reduces fabrication time. However, molars with insufficient clearance or short clinical crown lengths require retention holes or grooves on the preparation, making it difficult to replicate the shapes with the CAM milling system. In these cases, restorations using the lost-wax method are selected. This article focuses on one-piece endodontic crowns (endocrowns) fabricated with a CAD-CAM system (CAD-CAM endocrowns), in which their posts and crowns are integrated. Articles from July 2012 to August 2023 were searched in PubMed with the keyword "endocrown". This review discusses the application of CAD-CAM endocrowns to molars from the viewpoint of model experiment (fracture resistance, adaptation) and clinical research. This technique, which allows margins and internal gaps to be set within the clinically acceptable range, is reported to be an effective way of restoring molars with high survival rates in clinical research.
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Affiliation(s)
- Haruto Hiraba
- Department of Dental Materials, Nihon University School of Dentistry, 1-8-13, Kanda-Surugadai, Chiyoda-ku, Tokyo 101-8310, Japan
- Division of Biomaterials Science, Dental Research Center, Nihon University School of Dentistry, 1-8-13 Kanda-Surugadai, Chiyoda-ku, Tokyo 101-8310, Japan
| | - Kensuke Nishio
- Department of Complete Denture Prosthodontics, Nihon University School of Dentistry, 1-8-13 Kanda-Surugadai, Chiyoda-ku, Tokyo 101-8310, Japan
| | - Yoshimasa Takeuchi
- Department of Comprehensive Dentistry and Clinical Education, Nihon University School of Dentistry, 1-8-13, Kanda-Surugadai, Chiyoda-ku, Tokyo 101-8310, Japan
| | - Takashi Ito
- Center of Innovative Clinical Medicine, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8525, Japan
| | - Tetsuo Yamamori
- Department of Prosthetic Dentistry, School of Dentistry, Ohu University School of Dentistry, 31-1 Misumido, Tomita, Koriyama, Fukushima 963-8611, Japan
| | - Atsushi Kamimoto
- Department of Comprehensive Dentistry and Clinical Education, Nihon University School of Dentistry, 1-8-13, Kanda-Surugadai, Chiyoda-ku, Tokyo 101-8310, Japan
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Alqutaibi AY, Alghauli MA, Dewedar K, AbdElaziz MH, Saker S. The influence of Zircos-E® etchant, silica coating, and alumina air-particle abrasion on the debonding resistance of endocrowns with three different preparation designs. Clin Exp Dent Res 2024; 10:e901. [PMID: 38770577 PMCID: PMC11106642 DOI: 10.1002/cre2.901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 04/25/2024] [Accepted: 05/06/2024] [Indexed: 05/22/2024] Open
Abstract
OBJECTIVES The study aimed to evaluate the debonding resistance of three different endocrown designs on molar teeth, using three different zirconia surface pretreatments. MATERIAL AND METHOD Ninety human mandibular first molars were divided into three main groups: endocrowns without ferrule, with 1 mm ferrule, and with 2 mm ferrule. The subgroups were defined by their surface pretreatment method used (n = 15): 50 μm alumina air-particle abrasion, silica coating using 30 μm Cojet™ particles, and Zircos-E® etching. The endocrowns were fabricated using multilayer zirconia ceramic, cemented with self-adhesive resin cement, and subjected to 5000 thermocycles (5-55°C) before debonding. The data obtained were analyzed using a two-way ANOVA. RESULTS All test specimens survived the thermocyclic aging. The results indicated that both the preparation design and the surface treatment had a significant impact on the resistance to debonding of the endocrowns (p < .001). The 2 mm ferrule followed by the 1 mm ferrule designs exhibited the highest debonding resistance, both were superior to the endocrown without ferrule. Zircos-E® etching and silica coating yielded comparable debonding resistance, which were significantly higher than alumina air-particle abrasion. All endocrowns demonstrated a favorable failure mode. CONCLUSIONS All designs and surface treatments showed high debonding resistance for a single restoration. However, ferrule designs with Zircos-E® etching or silica coating may represent better clinical options compared to the nonferrule design or alumina airborne-particle abrasion. Nonetheless, further research, including fatigue testing and evaluations with different luting agents is recommended.
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Affiliation(s)
- Ahmed Yaseen Alqutaibi
- Substitutive Dental Science Department, College of DentistryTaibah UniversityAl‐MadinahSaudi Arabia
- Department of Prosthodontics, Faculty of DentistryIbb UniversityIbbYemen
| | | | - Karim Dewedar
- Crown and Bridge Department, Faculty of Dental MedicineAl‐Azhar UniversityCairoEgypt
| | - Mohammed H. AbdElaziz
- Substitutive Dental Science Department, College of DentistryTaibah UniversityAl‐MadinahSaudi Arabia
- Crown and Bridge Department, Faculty of Dental MedicineAl‐Azhar UniversityCairoEgypt
| | - Samah Saker
- Fixed Prosthodontic Department, Faculty of DentistryMansoura UniversityMansouraEgypt
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Farghal A, Dewedar K, AbdElaziz MH, Saker S, Hassona M, Algabri R, Alqutaibi AY. Effect of ceramic materials and tooth preparation design on computer-aided design and computer-aided manufacturing endocrown adaptation and retentive strength: An in vitro study. Clin Exp Dent Res 2024; 10:e843. [PMID: 38345492 PMCID: PMC10828905 DOI: 10.1002/cre2.843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 11/23/2023] [Accepted: 01/04/2024] [Indexed: 02/15/2024] Open
Abstract
OBJECTIVES To evaluate how various tooth preparation designs impact the adaptation-both at the margins and internally-and the retentive strength of computer-aided design and computer-aided manufacturing (CAD/CAM) produced endocrowns. MATERIALS AND METHODS 60 extracted human mandibular first molars were endodontically treated and assigned into three groups (n = 20) according to the tooth preparation design: Group N: butt joint design, Group F and F1 received 1- and 2-mm circumferential ferrule preparation, respectively. Endocrowns were milled using either lithium disilicate glass-ceramic (IPS emax ceramic) or monolithic zirconia. The internal and marginal adaptation of the endocrowns were evaluated using the replica technique. After cementation, the endocrowns of all test groups were dislodged axially at 0.5 mm/min using a universal testing machine. A 2-way ANOVA and the independent samples t-test (α = .05) were performed to statistically analyze the data. RESULTS The effect of changing the design of the tooth preparation (butt joint, ferrule) on the marginal and internal gap was shown to be statistically significant (p < .05); the lower gap values were recorded at the axial followed by cervical, marginal, and pulpal floor walls in both ceramic groups regardless of the teeth preparation design. The ANOVA test revealed similar average removal forces and stresses for the two types of tested ceramic materials. CONCLUSION IPS emax ceramic adapted better than monolithic zirconia ceramic, regardless of the preparation design. Ferrule preparation design is more retentive than butt joint preparation, regardless of the type of ceramic material used.
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Affiliation(s)
- Ahmed Farghal
- Substitutive Dental Science, College of DentistryTaibah UniversityMadinahSaudi Arabia
| | - Karim Dewedar
- Crown and Bridge Department, Faculty of Dental MedicineAl‐Azhar UniversityCairoEgypt
| | - Mohammed H. AbdElaziz
- Substitutive Dental Science, College of DentistryTaibah UniversityMadinahSaudi Arabia
- Crown and Bridge Department, Faculty of Dental MedicineAl‐Azhar UniversityCairoEgypt
| | - Samah Saker
- Fixed Prosthodontics, Faculty of DentistryMansoura UniversityMansouraEgypt
| | - Mahy Hassona
- Fixed Prosthodontics, Faculty of DentistryMansoura UniversityMansouraEgypt
| | - Radwan Algabri
- Prosthodontic Department, Faculty of DentistryIbb UniversityIbbYemen
- Prosthodontic Department, Faculty of DentistryNational University, Ibb branchIbbYemen
| | - Ahmed Yaseen Alqutaibi
- Substitutive Dental Science, College of DentistryTaibah UniversityMadinahSaudi Arabia
- Prosthodontic Department, Faculty of DentistryIbb UniversityIbbYemen
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Lenz U, Bacchi A, Della Bona A. Biomechanical performance of endocrown and core-crown restorations: A systematic review. J ESTHET RESTOR DENT 2024; 36:303-323. [PMID: 37571973 DOI: 10.1111/jerd.13119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 07/26/2023] [Accepted: 07/29/2023] [Indexed: 08/13/2023]
Abstract
OBJECTIVE To assess and compare, through a systematic review of the literature, the biomechanical performance of endocrowns and traditional core-crowns (with and without intracanal post) for the rehabilitation of endodontically treated teeth with severe coronal structure damage. MATERIALS AND METHODS A systematic search was performed in MEDLINE/PubMed, Scopus, and Web of Science databases. In-vitro studies comparing endocrowns with (post-)core-crown restorations were selected and screened by two independent reviewers. The included studies were submitted to the risk of bias analysis using the RoBDEMAT tool and the biomechanical outcomes were collected for qualitative analysis. The extracted data were presented based on comparative analyses among the included studies. RESULTS Thirty-one studies were included: 9 studies evaluated restorations of molars, 14 for premolars, and 8 studies evaluated anterior restorations. For the majority of the studies, endocrowns showed either similar or greater survival rates under fatigue and monotonic load than (post-)core-crown restorations, irrespectively of the tooth. The endocrowns showed more favorable failure patterns than (post-)core-crowns, irrespectively of the tooth. Endocrowns produced lower stresses in the restorative material for molars and premolars and in the luting material for premolars than (post-)core-crown restorations. The included studies presented adequate information for most items of the RoBDEMAT risk of bias tool. CONCLUSION Endocrowns showed similar or greater biomechanical performance than the traditional (post-)core-crown restorations in most of the evaluated studies. CLINICAL SIGNIFICANCE This systematic review showed that endocrowns present either similar or greater biomechanical performance than core-crown restorations for anterior and posterior endodontically treated teeth with severe structural damage.
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Affiliation(s)
- Ulysses Lenz
- Postgraduate Program in Dentistry, University of Passo Fundo, Passo Fundo, Brazil
| | - Atais Bacchi
- Postgraduate Program in Dentistry, Paulo Picanço School of Dentistry, Fortaleza, Brazil
| | - Alvaro Della Bona
- Postgraduate Program in Dentistry, University of Passo Fundo, Passo Fundo, Brazil
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AlDabeeb DS, Alakeel NS, Al Jfshar RM, Alkhalid TK. Endocrowns: Indications, Preparation Techniques, and Material Selection. Cureus 2023; 15:e49947. [PMID: 38058523 PMCID: PMC10697178 DOI: 10.7759/cureus.49947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2023] [Indexed: 12/08/2023] Open
Abstract
Endodontic treatment is often necessary in the field of dentistry. As the tooth structure is lost during such treatment, the tooth may become weaker and lose some of its mechanical qualities. Endodontically treated posterior teeth require cuspal coverage because of their anatomical features. Endocrowns are regarded as a suitable choice for restoring teeth that have undergone endodontic treatment. These restorations are recommended when there is a substantial loss of tooth structure, restricted interocclusal space, or a short clinical crown. They are also contraindicated in case of severe loss of tooth structure where adhesion is not applicable. Endocrowns require a specific preparation design that is distinct from the conventional crown. They can be manufactured by two methods: heat pressing or computer-aided design/computer-aided manufacturing (CAD/CAM). Moreover, several materials have been used in fabricating endocrown restoration. Lithium disilicate glass-ceramic is the most recommended material as it possesses excellent mechanical properties and esthetic results with the ability to bond to tooth structure. In conclusion, several kinds of literature recommend using them for molars. Further research is needed to evaluate this technique for premolar and anterior teeth.
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Affiliation(s)
- Dalal S AlDabeeb
- Department of Restorative Dental Sciences, King Saud University, Riyadh, SAU
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Duraisamy P, Chander NG, Reddy JR, Balasubramanium M. The impact of extended pulp chamber preparations on the clinical performance of endocrowns in Indian patients: A 1-year observational study. J Oral Biol Craniofac Res 2023; 13:616-621. [PMID: 37576802 PMCID: PMC10416021 DOI: 10.1016/j.jobcr.2023.07.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 07/23/2023] [Accepted: 07/29/2023] [Indexed: 08/15/2023] Open
Abstract
Purpose The limitations of foundation restorations have been reduced with the advent of endocrowns. Despite their success, the extent of endocrowns tooth preparation into the pulp chamber has not been fully explored in the literature. The study aimed to evaluate the clinical performance of endocrowns with 5 mm extended pulp chamber tooth preparations in Indian patients over a 1- year period using modified USPHS criteria. Methods The observational study recruited 36 participants with definite criteria. Ceramic crown was planned for all the participants. Conventional endocrown tooth preparation was made with 5 mm pulpal extension. Clinical assessments were made at 0-, 6- and 12-months intervals using modified USPHS criteria. The data was statistically analyzed using Friedman test and Wilcoxon signed rank test. Results One patient (2.8%) experienced loss of retention, marginal adaptation, and loss of anatomical form during 1-year follow up period. The majority of the participants (97.3%) reported no discomfort and high satisfaction. (P < .05) No opposing tooth wear was observed at 0- and 6-months. The results showed statistical significance in the parameters of retention, marginal adaptation, loss of anatomical form, and patient satisfaction. (P < .05). Conclusion The clinical performance of endocrowns with extended pulp chamber preparation was satisfactory for a period of 12 months.
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Affiliation(s)
- Preethi Duraisamy
- Department of Prosthodontics, SRM Dental College, Ramapuram, Chennai, Tamilnadu, India
| | - Naveen Gopi Chander
- Department of Prosthodontics, SRM Dental College, Ramapuram, Chennai, Tamilnadu, India
| | - Jetty Ramesh Reddy
- Department of Prosthodontics, SRM Dental College, Ramapuram, Chennai, Tamilnadu, India
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Veselinova M, Diamantopoulou S, Paximada C, Papazoglou E. In-Vitro Comparison of Fracture Strength of Endocrowns and Overlays in Endodontically Treated Teeth Manufactured with Monolithic Lithium Disilicate and Zirconia. J Funct Biomater 2023; 14:422. [PMID: 37623666 PMCID: PMC10455451 DOI: 10.3390/jfb14080422] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/25/2023] [Accepted: 08/08/2023] [Indexed: 08/26/2023] Open
Abstract
To evaluate the fracture strength and the failure mode of endodontically treated molars restored with monolithic lithium disilicate and zirconia endocrowns and overlays. A total of 48 extracted mandibular molars were endodontically treated, decoronated 2 mm above the cementoenamel junction and divided into four 12-specimen groups. Group ELD: lithium disilicate endocrowns. Group EZ: monolithic zirconia endocrowns. Group OLD: lithium disilicate overlays. Group OZ: monolithic zirconia overlays. Overlays did not extend in the pulp chamber and endocrowns extended in the pulp chamber 2 mm. After adhesive bonding of the restorations, the specimens were subjected to thermocycling (×5000 cycles) and then to fracture resistance testing at lateral static loading (1 mm/min) at a universal testing machine. The failure mode of the specimens was qualitatively evaluated. Differences in means were compared using with t-tests for independent samples or Mann-Whitney test (p < 0.05). Weibull distribution analysis was also performed. Group ELD showed significantly higher fracture strength than all other groups (p = 0.001), and the highest Weibull modulus. Conclusions: Lithium disilicate endocrowns exhibit higher fracture strength and are more reliable compared to the other types of restorations examined. Endocrowns had more catastrophic failures compared to overlays.
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Affiliation(s)
| | | | | | - Efstratios Papazoglou
- Department of Operative Dentistry, National and Kapodistrian University of Athens, 11527 Athens, Greece; (M.V.); (S.D.); (C.P.)
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Lampl S, Gurunathan D, Krithikadatta J, Mehta D, Moodley D. Reasons for Failure of CAD/CAM Restorations in Clinical Studies: A Systematic Review and Meta-analysis. J Contemp Dent Pract 2023; 24:129-136. [PMID: 37272145 DOI: 10.5005/jp-journals-10024-3472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
AIM The systematic review presented herein was performed to descriptively analyze the causes for the failure of computer-aided design/computer-aided manufacture (CAD/CAM) restorations. The meta-analysis reported herein was performed to estimate long-term survival and success rates of CAD-CAM fabrications. MATERIALS AND METHODS Using the PICOS paradigm, a systematic search was carried out in the PubMed and Cochrane databases to identify randomized controlled trials (RCTs) and prospective observational studies reporting survival data for CAD/CAM restorations. After selecting studies with a predefined set of selection criteria, data from included prospective clinical studies and RCTs were used for a systematic review aimed at a descriptive analysis of factors associated with failure of CAD-CAM restorations. Data from the included prospective clinical studies were used for meta-analysis, wherein 5-year and 10-year survival and success rates were estimated using Poisson regression models. RESULTS The systematic review included data from 9 RCTs and 6 observational studies, which had a median follow-up of 36 months and 60 months, respectively. About 58 failures and 118 technical/ biological complications were noted in the included RCTs and 9 failures along with 58 technical/biological complications were noted in the prospective clinical studies. Poisson regression indicated an estimated 5-year and 10-year survival rates of 85.55-100 and 71-100, respectively. The estimated 5-year and 10-year success rates were 74.2-92.75 and 33.3-85.5, respectively. CONCLUSION Several technical and biological complications contribute to failure of CAD/CAM restorations. However, CAD/CAM restorations with routine chairside materials might have clinically meaningful success rates in the long term. CLINICAL SIGNIFICANCE The results presented herein indicate that optimal strategies for mitigation of biological and technical complications may augment the success of CAD/CAM fabrications in restorative dentistry. Studies aimed at identification of such strategies are needed to further enhance the long-term success rates of CAD/CAM restorations.
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Affiliation(s)
- Stephan Lampl
- Department of Paediatric Dentistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Deepa Gurunathan
- Department of Paediatric Dentistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India, Phone: +91 9994619386, e-mail:
| | - Jogikalmat Krithikadatta
- Department of Paediatric Dentistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Deepak Mehta
- Department of Conservative Dentistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, India; Department of Operative Dentistry, Tohoku University Graduate School of Dentistry, Tohoku University, Sendai, Japan
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Hassouneh L, Jum'ah A, Ferrari M, Wood DJ. A Micro-computed Tomography Analysis of Marginal and Internal Fit of Endocrowns Fabricated from Three CAD/CAM Materials. Oper Dent 2023; 48:79-89. [PMID: 36445975 DOI: 10.2341/21-105-l] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To assess the marginal and internal misfit of endocrowns fabricated from a resin matrix ceramic (CS), a partially crystallized (EMC), and a fully crystallized (ILS) lithium disilicate glass-ceramic. METHODS AND MATERIALS Thirty human premolar teeth restored with endocrowns were investigated. Three CAD/CAM materials were used (n=10 per group): CS, EMC, and ILS. Two-dimensional (2D) analysis of marginal and internal misfit was performed on micro-computed tomography scans before and after adhesive bonding. Further, three-dimensional (3D) analysis was performed to determine the total internal volume discrepancy. Surface roughness of the fitting surfaces of endocrowns was characterized using optical profilometry and scanning electron microscopy. RESULTS Adhesive bonding did not significantly affect marginal or internal misfit (p≥0.093). Differences in marginal misfit among the experimental groups were not statistically significant (p≥0.221). However, differences in 2D internal misfit were statistically significant; the CS group exhibited the largest internal misfit (p=0.001), while no significant difference was found between other groups (p=0.123). The largest discrepancies were observed at the pulpal floor and cervical region of all investigated specimens. No statistically significant difference was found in 3D misfit between ILS and EMC groups (p=0.711); however both exhibited statistically lower 3D misfit values compared to the CS group (p≤0.037). ILS endocrowns exhibited the smoothest and most homogenous fitting surface profile (p<0.001). However, there was no significant correlation between 2D internal misfit and the surface roughness (p≥0.082). CONCLUSIONS The choice of CAD/CAM material may influence the fitting accuracy of endocrowns. The investigated lithium disilicate glass-ceramics conferred superior internal fit for endocrowns compared to resin matrix ceramic.
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Affiliation(s)
- L Hassouneh
- Layla Hassouneh, PhD, MClinDent, BDS, University of Leeds, School of Dentistry, Division of Restorative Dentistry, Leeds, UK; and Department of Conservative Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - A Jum'ah
- *Ahmad Jum'ah, PhD, MRD(Pros.)RSCEd, RSCEd, JB, MSc, BDS, Department of Conservative Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan; and Faculty of Dentistry, Aqaba Medical Sciences University, Aqaba, Jordan
| | - M Ferrari
- Marco Ferrari, MD DDS, PhD, 1. University of Siena, Department of Medical Biotechnologies, Division of Fixed Prosthodontics, Siena, Italy 2. University of Leeds, School of Dentistry, Division of Restorative Dentistry, Leeds, UK
| | - D J Wood
- David J Wood, BSc, PhD, University of Leeds, School of Dentistry, Division of Oral Biology, Leeds, UK
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Mannocci F, Bitter K, Sauro S, Ferrari P, Austin R, Bhuva B. Present status and future directions: The restoration of root filled teeth. Int Endod J 2022; 55 Suppl 4:1059-1084. [PMID: 35808836 PMCID: PMC9796050 DOI: 10.1111/iej.13796] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 07/04/2022] [Accepted: 07/05/2022] [Indexed: 12/30/2022]
Abstract
This narrative review will focus on a number of contemporary considerations relating to the restoration of root filled teeth and future directions for research. Clinicians are now more than ever, aware of the interdependence of the endodontic and restorative aspects of managing root filled teeth, and how these aspects of treatment are fundamental to obtaining the best long-term survival. To obtain the optimal outcomes for patients, clinicians carrying out endodontic treatment should have a vested interest in the restorative phase of the treatment process, as well as an appreciation for the structural and biomechanical effects of endodontic-restorative procedures on restoration and tooth longevity. Furthermore, the currently available research, largely lacks appreciation of occlusal factors in the longevity of root filled teeth, despite surrogate outcomes demonstrating the considerable influence this variable has. Controversies regarding the clinical relevance of minimally invasive endodontic and restorative concepts are largely unanswered with respect to clinical data, and it is therefore, all too easy to dismiss these ideas due to the lack of scientific evidence. However, conceptually, minimally invasive endodontic-restorative philosophies appear to be valid, and therefore, in the pursuit of improved clinical outcomes, it is important that the efficacies of these treatment protocols are determined. Alongside an increased awareness of the preservation of tooth structure, developments in adhesive bonding, ceramic materials and the inevitable integration of digital dentistry, there is also a need to evaluate the efficacy of new treatment philosophies and techniques with well-designed prospective clinical studies.
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Affiliation(s)
- Francesco Mannocci
- Department of EndodonticsFaculty of Dentistry, Oral and Craniofacial SciencesKing's College LondonLondonUK
| | - Kerstin Bitter
- Department of Operative and Preventive DentistryCharité ‐ University Medicine BerlinBerlinGermany
| | - Salvatore Sauro
- Departamento de Odontología, Facultad de Ciencias de la SaludUniversidad CEU‐Cardenal Herrera ValenciaAlfara del PatriarcaSpain
| | - Paolo Ferrari
- Department of Operative DentistryUniversity of ParmaParmaItaly
| | - Rupert Austin
- Department of ProsthodonticsFaculty of Dentistry, Oral and Craniofacial SciencesKing's College LondonLondonUK
| | - Bhavin Bhuva
- Department of EndodonticsFaculty of Dentistry, Oral and Craniofacial SciencesKing's College LondonLondonUK
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Limones A, Celemín-Viñuela A, Romeo-Rubio M, Castillo-Oyagüe R, Gómez-Polo M, Martínez Vázquez de Parga JA. Outcome measurements and quality of randomized controlled clinical trials of tooth-supported fixed dental prostheses: A systematic review and qualitative analysis. J Prosthet Dent 2022:S0022-3913(22)00282-7. [PMID: 36109260 DOI: 10.1016/j.prosdent.2022.04.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 04/25/2022] [Accepted: 04/26/2022] [Indexed: 11/16/2022]
Abstract
STATEMENT OF PROBLEM The lack of consensus regarding a standardized set of outcome measurements and noncompliance with current reporting guidelines in clinical trials of tooth-supported fixed dental prostheses (FDPs) hamper interstudy comparability, compromise scientific evidence, and waste research effort and resources in prosthetic dentistry. PURPOSE The primary objective of this systematic review was to identify all primary and secondary outcome measurements assessed in randomized controlled trials (RCTs) of tooth-supported FDPs. Secondary objectives were to assess their methodological quality by using the Cochrane Collaboration's risk of bias tool (RoB, v2.0) and their reporting quality by means of a standardized 16-item CONSORT assessment tool through published reports. MATERIAL AND METHODS An electronic search was conducted in MEDLINE, EMBASE, and Cochrane library to identify all RCT-related articles published in the past 10 years. Differences in RoB were tested with the Pearson chi-square test, and those in CONSORT score with the Student t test. RESULTS A total of 64 RCTs from 79 publications were deemed eligible. The diversity of outcome measures used in the field is apparent. Twenty percent of the included studies had a low RoB, 79% showed some concerns, and 1% had a high RoB. The mean ±standard deviation CONSORT compliance score was 22.56 ±3.17. Trials adhered to the CONSORT statement reported lower RoB than those that did not adhere (P<.001). RCTs with a low RoB reported more comprehensive adherence to CONSORT guidelines than those with some concerns (MD 4 [95% CI 1.52-6.48]; P=.004). CONCLUSIONS A standardized core outcome reporting set in clinical research on tooth-supported FDPs remains evident. Adherence to the CONSORT statement continues to be low, with some RoB concerns that can be improved.
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Affiliation(s)
- Alvaro Limones
- Student, Assistant Professor, Department of Conservative & Prosthetic Dentistry, Faculty of Dentistry, Complutense University of Madrid (UCM), Madrid, Spain.
| | - Alicia Celemín-Viñuela
- Professor, Department of Conservative & Prosthetic Dentistry, Faculty of Dentistry, Complutense University of Madrid (UCM), Madrid, Spain
| | - Marta Romeo-Rubio
- Professor, Department of Conservative & Prosthetic Dentistry, Faculty of Dentistry, Complutense University of Madrid (UCM), Madrid, Spain
| | - Raquel Castillo-Oyagüe
- Cathedratic Professor, Department of Conservative & Prosthetic Dentistry, Faculty of Dentistry, Complutense University of Madrid (UCM), Madrid, Spain
| | - Miguel Gómez-Polo
- Professor, Department of Conservative & Prosthetic Dentistry, Faculty of Dentistry, Complutense University of Madrid (UCM), Madrid, Spain
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Aldesoki M, Bourauel C, Morsi T, El-Anwar MI, Aboelfadl AK, Elshazly TM. Biomechanical behavior of endodontically treated premolars restored with different endocrown designs: Finite element study. J Mech Behav Biomed Mater 2022; 133:105309. [DOI: 10.1016/j.jmbbm.2022.105309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 05/31/2022] [Accepted: 06/02/2022] [Indexed: 10/18/2022]
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