Conservative management of extensively damaged endodontically treated tooth using computer-aided design and computer-aided manufacturing-based hybrid-ceramic endocrown: A clinical report

Roughness analysis on porcelain sectional surface of porcelain fused to Co-Cr alloy endocrowns

This study aims to compare the roughness between the central and edge points on the porcelain sectional surface of porcelain fused to Co-Cr alloy endocrowns. Utilizing anatomical data from average molar dimensions, a simplified model for the endocrowns was created. Eight porcelain fused to Co-Cr alloy endocrowns were fabricated with an edge thickness of 0.3 mm. Following casting, firing, cutting, and polishing procedures, the roughness on porcelain sectional surface at both the central and edge points of the inner crown was assessed using an atomic force microscope (AFM). The roughness measurement (Sq value) for the central point on porcelain sectional surface was (10.46 ± 3.37 nm), and for the edge point, it was (10.50 ± 1.99 nm). There was no statistically significant distinction between the central and edge points in terms of roughness. Despite the uneven thickness of the inner crown in porcelain fused to Co-Cr alloy endocrowns, it was observed that this disparity had negligible impact on the internal microstructure of the porcelain. Therefore, its application in dental clinical settings could be deemed viable.

Clinical performance of computer-aided design/computer-aided manufacture lithium disilicate ceramic endocrown restorations: A 2-year study

Context

Optimal restoration methods for endodontically treated teeth (ETTs) have always remained an ongoing discussion among physicians in this day and age. ETTs have a tendency to fracture when chewing, compared to initial teeth. From the perspective of biology, preserving and restoring tooth structure is critical to maintaining biomechanical, functional, and esthetic harmony. Dental bonding techniques have lessened the necessity for post-and-core restorations in ETTs with severe substance loss. A minimally invasive endodontic restoration technique called "endocrown" was initially introduced by Bindl and Mörmann in 1999.

Aims

The aim of the study was to clinically evaluate all-ceramic mandibular molar endocrowns made using computer-aided design/computer-aided manufacturing (CAD/CAM) following 2 years of follow-up.

Subjects and Methods

This unblinded study contains 56 patients with 56 mandibular molars, which had severe substance loss. After teeth preparation, lithium disilicate ceramic endocrowns were manufactured with the CEREC CAD/CAM system, and cementation was performed using a composite luting agent. The endocrowns were assessed using the modified United States Public Health Service criteria at baseline, 6 months, 1 year, and 2 years following placement. Patient satisfaction was evaluated using a questionnaire.

Statistical Analysis Used

This study used descriptive statistics, including mean, standard deviation, and 95% confidence intervals. Data were processed using STATA version 14.0 (StataCorp LLC, USA).

Results

Two endocrowns (3.6%) failed throughout the period of observation. The high clinical rating criteria (96.4%, count of 54) and the increased satisfaction percentage (94.6%, count of 53) remained practically stable during the follow-up assessments at 6 months and after 1-2 years.

Conclusions

Endocrown offers a less invasive treatment option that may be a better method for endodontically treated mandibular molars. With contemporary CAD/CAM technology and new materials, time in the chair and esthetics optimally improved, bringing satisfaction to the patient.