29 July 2022

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Endocrown VS Crown+Post: which is the best restoration for endodontically treated teeth?

Simona Chirico

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The restoration of endodontically treated teeth is still a discussed topic in dentistry. Today, the most common restoration for endodontically treated teeth involves post and crown, even if we know that posts increase the risk of root fractures and weaken the teeth.
 With progress in the development of adhesive techniques, the emergence of minimally invasive dentistry changed the conception of using post and crown in every situations. In recent years the use of endocrown, as a restoration for endodontically treated teeth, has been spreading more and more and it has recorded excellent results not only in “in vitro” studies, but also in “in vivo” ones.

So, which is the best restoration for endodontically treated teeth?  
 A recent review, published on the Journal of Prosthetic Dentistry by Govare and Contrepois, answered to this question and analyzed several aspects, but below we will report only a summary of the main data.  

Materials and methods
8 clinical studies were selected, in which they investigated: survival rate and failure modes .  

Results  
•    Survival rate:    
Endocrowns For molars: 90% from 6 months up to 10 years. Similar results for crowns.
                                              
Endocrowns For premolars: 68% and 75% at 55 months and 10 years. Instead for crowns 94%-95%.  

•    Failure modes:
For endocrowns: 53% loss of retention,
 14% periodontitis, 
14% chipping of endocrown 
                        
For crowns: 53% crown fracture, 
23% vertical root fracture,
 19% irreversible pulpitis.    

Conclusions
 For the restoration of extensively damaged endodontically treated molars, the results of clinical and in vitro studies agree that endocrowns are an excellent treatment solution in the short, medium and long terms.
 In case of premolars, the data aren’t as encouraging as the molars and it would be necessary to carry out other studies to deepen the issue.
In conclusion, the use of endocrown to restore endodontically treated molars guarantees to be less invasive and more conservative with the remaining dental structure.

For additional information: Endocrowns: A systematic review.