Assistant Professor and Consultant in Prosthodontics, Oral and Maxillofacial Rehabilitation Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.
J Prosthet Dent. 2021 Mar;125(3):415.e1-415.e9. doi: 10.1016/j.prosdent.2020.01.011. Epub 2020 Mar 18.
Endocrowns are a monoblock type of restoration that use the pulp chamber and remaining coronal tooth structure as a means of retention. However, data on their long-term survival and success rates as compared with conventional crowns are lacking.
The purpose of this systematic review and meta-analysis was to collate published work on endocrowns to assist clinicians in making decisions on when and whether they are an appropriate restorative option with a predictable outcome for extensively damaged endodontically treated teeth.
Databases such as PubMed (MEDLINE), Scopus, EMBASE, Cochrane library, and Google Scholar were searched up to June 2019 for clinical and in vitro studies on endocrown survival and success rates. For the meta-analysis, endocrown and conventional crown survival and success rates were compared, and the pooled effects were presented as relative risks and 95% confidence intervals using a random effects model.
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).
Additional well-designed clinical studies with long-term assessment are needed; however, endocrowns appear to be a promising conservative restorative option with acceptable long-term survival for endodontically treated posterior teeth in selected patients.
嵌体冠是一种整体式修复体，利用牙髓腔和剩余的牙冠结构作为固位体。然而，与传统冠相比，关于其长期存活率和成功率的数据尚缺乏。
本系统评价和荟萃分析的目的是整理发表的嵌体冠研究，以帮助临床医生在决定何时以及是否将其作为一种具有可预测结果的修复选择，用于广泛受损的牙髓治疗后牙齿。
截至 2019 年 6 月，检索了 PubMed（MEDLINE）、Scopus、EMBASE、Cochrane 图书馆和 Google Scholar 等数据库，以查找关于嵌体冠存活率和成功率的临床和体外研究。对于荟萃分析，比较了嵌体冠和传统冠的存活率和成功率，并使用随机效应模型呈现汇总效果作为相对风险和 95%置信区间。
10 项研究符合纳入标准（3 项临床研究和 7 项体外研究），并被纳入系统评价。临床研究的荟萃分析显示，嵌体冠的 5 年总体估计存活率为 91.4%，而传统冠为 98.3%。嵌体冠的 5 年总体成功率为 77.7%，而传统冠为 94%。评估的修复体之间在总体存活率或成功率方面没有显著差异（P>.05）。
需要更多设计良好的长期评估的临床研究；然而，对于选择的患者，嵌体冠似乎是一种有前途的保守修复选择，具有可接受的长期牙髓治疗后后牙存活率。
