Aim: Endocrown restorations are commonly used to rehabilitate endodontically treated posterior teeth and their use is wellfounded in these cases. However, to date, there is little scientific evidence of their behavior in anterior teeth. The aim of this in vitro study was to evaluate the compressive strength of upper central incisors teeth, restored with glass-ceramic total crowns by the conventional anatomical core technique, and compare them to teeth restored with endocrowns with and without the presence of ferrule. Methods: Thirty teeth were randomly distributed into three groups: GE2 - endocrown group with 2 mm ferrule, GE0 - endocrown group without a ferrule, and GC - conventional crown with intraradicular post group. Crowns were cemented and teeth submitted to the 45o compression test until the fracture happened. Fractured specimens were analyzed to determine the fracture pattern. Descriptive analysis of the variables was performed and one-way analysis of variance was utilized to analyze the data for significant differences at p < 0.05. Results: The results of the control group (284.5 ± 201.05N) showed the highest fracture resistance value, followed by the 2mm group (274.54 ± 199.43N) and by the 0mm group (263.81 ± 80.05N). There was no statistically significant difference between all the groups (p = 0.964). Conclusions: The absence of a cervical enamel necklace favored a debonding of the pieces and endodontically treated anterior teeth could be restored with endocrown, which could be considered a conservative and viable treatment option.
Skupien JA, Opdam NJ, Winnen R, Bronkhorst EM, Kreulen CM, Pereira-Cenci T, et al. Survival of restored endodontically treated teeth in relation to periodontal status. Braz Dent J. 2016 Jan-Feb;27(1):37-40. doi: 10.1590/0103-6440201600495.
Santos Pantaleón D, Morrow BR, Cagna DR, Pameijer CH, Garcia-Godoy F. Influence of remaining coronal tooth structure on fracture resistance and failure mode of restored endodontically treated maxillary incisors. J Prosthet Dent. 2018 Mar;119(3):390-6. doi: 10.1016/j.prosdent.2017.05.007.
Gulec L, Ulusoy N. Effect of endocrown restorations with different CAD/CAM materials: 3D finite element and weibull analyses. Biomed Res Int. 2017;2017:5638683. doi: 10.1155/2017/5638683.
Dejak B, Mlotkowski A. Strength comparison of anterior teeth restored with ceramic endocrowns vs custom-made post and core. J Prosthet Dent. 2018 Apr;62(2):171-6. doi: 10.1016/j.jpor.2017.08.005.
Kanat-Ertürk B, Saridağ S, Köseler E, Helvacioğlu-Yiğit D, Avcu E, Yildiran-Avcu Y. Fracture strengths of endocrown restorations fabricated with different preparation depths and CAD/CAM materials. Dent Mater J. 2018 Mar;37(2):256-65. doi: 10.4012/dmj.2017-035.
Pereira JR, de Ornelas F, Conti PCR, do Valle AL. Effect of a crown ferrule on the fracture resistance of endodontically treated teeth restored with prefabricated posts. J Prosthet Dent. 2006 Jan;95(1):50-4. doi: 10.1016/j.prosdent.2005.10.019.
Bindl A, Richter B, Mörmann WH. Survival of ceramic computer-aided design/manufacturing crowns bonded to preparations with reduced macroretention geometry. Int J Prosthodont. 2005 May-Jun;18(3):219-24. doi: 10.1016/j.prosdent.2005.09.002.
Salameh Z, Sorrentino R, Ounsi HF, Sadig W, Atiyeh F, Ferrari M. The effect of different fullcoverage crown systems on fracture resistance and failure pattern of endodontically treated maxillary incisors restored with and without glass fiber posts. J Endod. 2008 Jul;34(7):842-6. doi: 10.1016/j.joen.2008.03.025.
Zarone F, Sorrentino R, Apicella D, Valentino B, Ferrari M, Aversa R, et al. Evaluation of the biomechanical behavior of maxillary central incisors restored by means of endocrowns compared to a natural tooth: A 3D static linear finite elements analysis. Dent Mat. 2006 Nov;22(11):1035-44. doi: 10.1016/j.dental.2005.11.034.
El-Badawy AA, El Aziz MH, Omar EA. Failure load of maxillary central incisor restored with CAD/CAM endocrown using different designs. Int J Dent Sci Res. 2019;7(1):5-9. doi: 10.12691/ijdsr-7-1-2.
El-Damanhoury HM, Haj-Ali RN, Platt JA, Fracture resistance and microleakage of endocrowns utilizing three CAD-CAM blocks. Oper Dent. 2015 Mar-Apr;40(2):201-10. doi: 10.2341/13-143-L.
Ramírez-Sebastià A, Bortolotto T, Cattani-Lorente M, Giner L, Roig M, Krejci I. Adhesive restoration of anterior endodontically treated teeth: influence of post length on fracture strength. Clin Oral Invest. 2014;18(2):545-54. doi: 10.1007/s00784-013-0978-3.
Ploumaki A, Bilkhair A, Tuna T, Stampf S, Strub JR. Sucess rates of prosthetic restorations on endodontically treated teeth: a systematic review after 6 years. J Oral Rehabil. 2013 Aug;40(8):618-30. doi: 10.1111/joor.12058.
Mannocci F, Bertelli E, Sherriff M, Watson TF, Pitt Ford TR. Three-year comparison of survival of endodontically teeth restores with full case coverage or with direct composite restoration. J Prosthet Dent. 2002 Sep;88(3):297-301. doi: 10.1067/mpr.2002.128492.
Clavijo VGR, Souza NC de, Kabbach W, Calixto LR, Andrade MF de, Susin AH. [Endocrown restorations: an approach for non-vital posterior teeth]. Clin Inter J Braz Dent. 2007;3(3):246-52. Portuguese.
Shin Y, Park S, Park JW, Kim KM, Park YB, Roh BD. Evaluation of the marginal and internal discrepancies of CAD-CAM endocrowns with different cavity depths: an in vitro study. J Prosthet Dent. 2017 Jan;117(1):109-15. doi: 10.1016/j.prosdent.2016.03.025.
Helal MA, Wang Z. Biomechanical assessment of restored mandibular molar by endocrown in comparison to a glass fiber post-retained conventional crown: 3d finite element analysis. J Prosthodont. 2019 Dec;28(9):988-96. doi: 10.1111/jopr.12690.
Bankoglu Gungor M, Turhan Bal B, Yilmaz H, Aydin C, Karakoca Nemli S. Fracture strength of CAD/CAM fabricated lithum disilicate and resin nano ceramic restorations used for endodocntically treated teeth. Dent Mat J. 2017 Mar;36(2):135-41. doi: 10.4012/dmj.2016-017.
Chang CY, Kuo JS, Lin YS, Chang YH. Fracture resistance and failure modes of CEREC endo-crowns and conventional post and core-supported CEREC crowns. J Dental Sci. 2009 Sep;4(3):110-7. doi: 10.1016/S1991-7902(09)60016-7.
Silva-Sousa AC, Moris ICM, Simões Barbosa AF, Corrêa Silva-Sousa YT, Sousa-Neto MD, Ferreira Pires CR, et al. Effect of restorative treatment with endocrown and ferrule on the mechanical behavior of anterior endodontically treated teeth: An in vitro analysis. J Mech Behav Biomed Mat. 2020 Dec;112:104019. doi: 10.1016/j.jmbbm.2020.104019.
Clausson C, Schroeder CC, Goloni PV, Farias FAR, Passos L, Zanetti RV. Fracture resistance of CAD/CAM lithium disilicate of endodontically treated mandibular damaged molars based on different preparation designs. Int J Biomater. 2019 May;2019:2475297. doi: 10.1155/2019/2475297.
Casagrande DDA. [Analysis of the compressive strength at 45° of full lithium disilicate crowns cemented in endodontically treated maxillary central incisors with 2mm and 4mm reconstruction (Buildup) with composite resin] [dissertation]. Campinas: São Leopoldo Mandic College; 2019. Portuguese.
Gresnigt MMM, Özcan M, van den Houten MLA, Schipper L, Cune MS. Fracture strength, failure type and Weibull characteristics of lithium disilicate and multiphase resin composite endocrowns under axial and lateral forces. Dent Mater. 2016 May;32(5):607-14. doi: 10.1016/j.dental.2016.01.004.
Qing H, Zhu Z, Chao Y, Zhang W. In vitro evaluation of the fracture resistance of anterior endodontically treated teeth restored with glass fiber and zircon posts. J Prosthet Dent. 2007 Feb;97(2):93-8. doi: 10.1016/j.prosdent.2006.12.008.
Tan PL, Aquilino SA, Gratton DG, Stanford CM, Tan SC, Johnson WT, et al. In vitro fracture resistance of endodontically treated central incisors with varying ferrule heights and configurations. J Prosthet Dent. 2005 Apr;93(4):331-6. doi: 10.1016/j.prosdent.2005.01.013.
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2022 Fernanda Angeloni de Souza, Catarina Borges da Fonseca Cumerlato, Pedro Paulo Feltrin, Ricardo Tatsuo Inoue, Raquel Virginia Zanetti