07 July 2021

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A systematic review and meta-analysis on endocrowns

Co-author: Claudia Mazzitelli

Lorenzo Breschi

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As a matter of facts, endodontically treated teeth (ETT) long-term success depends on the type and quality of the coronal restoration. Different restoration designs have been proposed over time, especially since when adhesive techniques have been introduced. Among them, endocrowns have been used to restore severely damaged ETT instead of conventional buildup-crown systems. However, data on their long-term survival and success rates as compared with conventional crowns are lacking. In this context, Raghad A. Al-Dabbagh et al. performed a systematic review and meta-analysis to compare survival and success of endocrowns to those of conventional crowns.

Materials and Methods
Two investigators searched scientific Databases (PubMed, Scopus, EMBASE, Cochrane Library, Google Scholar) up to June 2019 for both clinical and in-vitro studies on the topic. Clinical studies were considered suitable with a follow-up of at least 3 years and the presence of a control group. Authors also selected in-vitro studies without metal alloy restorations, that measured as outcome fracture strength, survival, catastrophic failure, and marginal adaptation. Survival rate was defined as when endo-crowns or conventional crowns were present in the oral cavity but with biological and/or technical complications. Success rate was defined as restorations not associated with any of these complications. Regarding the meta-analysis, survival and success rates were compared (p<0.05) using a random effects model (Review Manager software 5.2). 

Results
Authors initially selected 2584 potential records. After an initial selection, 48 articles were critically evaluated. Ten studies fulfilled the inclusion criteria (3 clinical and 7 in vitro) and were included in the systematic review. The meta-analysis of the clinical studies showed an estimated overall 5-year survival rate of 91.4% for endocrowns and 98.3% for conventional crowns. The estimated overall 5-year success rates were 77.7% for endocrowns and 94% for conventional crowns. There were no significant differences in overall survival or success estimates between the assessed restorations (P>.05).

Conclusions
From the results obtained by the research group, it can be concluded that endocrowns appear to be a promising conservative restorative option with acceptable long-term survival for ETT. However, additional well-designed clinical studies with long-term assessment are needed. 

For more information: Survival and success of endocrowns: A systematic review and meta-analysis