The endocrown: an alternative approach for restoring extensively damaged molars

Abstract

Endocrown-type restorations are single prostheses fabricated from reinforced ceramics that can be acid etched, indicated for endodontically treated molar teeth that have significant loss of coronal structure. Endocrowns are formed from a monoblock containing the coronal portion integrated into the apical projection that fills the pulp chamber space, and possibly the root canal entrances. In this study, the proposal was to discuss the indication and use of the endocrown to replace single crowns with intraradicular retention, and to present a clinical case report on the 3-year follow-up of an endocrown-type restoration, fabricated from injected lithium disilicate ceramic (IPS e.Max Press/Ivoclar Vivadent) in a mandibular first molar with extensive coronal destruction from fracture. It was found that endocrown restorations could be made following the development of reinforced ceramics that can be acid etched, that have aggregate strength and esthetics, that bond to the dental structure, and that have developed from broader knowledge of the biomechanical behavior of depulped teeth restored with and without intraradicular posts. Clinical studies have shown that the endocrown has functional longevity, and has become a promising alternative in the esthetic and functional recovery of endodontically treated molar teeth.

Clinical significance: It should be borne in mind that endocrowns offer advantages for the restoration of depulped molar teeth, insofar as they promote adequate function and offer adequate esthetics, and also maintain the biomechanical integrity of the compromised structure of non-vital posterior teeth. By eliminating the use of a post and filling core, the number of adhesive bond interfaces is reduced, thus making the restoration less susceptible to the adverse effects of degradation of the hybrid layer. In this clinical case, the 3-year survival of the endocrown restoration may be considered successful.