Postgraduate Program in Dentistry, University of Passo Fundo, Passo Fundo, Brazil.
Postgraduate Program in Dentistry, Paulo Picanço School of Dentistry, Fortaleza, Brazil.
J Esthet Restor Dent. 2024 Feb;36(2):303-323. doi: 10.1111/jerd.13119. Epub 2023 Aug 12.
To assess and compare, through a systematic review of the literature, the biomechanical performance of endocrowns and traditional core-crowns (with and without intracanal post) for the rehabilitation of endodontically treated teeth with severe coronal structure damage.
A systematic search was performed in MEDLINE/PubMed, Scopus, and Web of Science databases. In-vitro studies comparing endocrowns with (post-)core-crown restorations were selected and screened by two independent reviewers. The included studies were submitted to the risk of bias analysis using the RoBDEMAT tool and the biomechanical outcomes were collected for qualitative analysis. The extracted data were presented based on comparative analyses among the included studies.
Thirty-one studies were included: 9 studies evaluated restorations of molars, 14 for premolars, and 8 studies evaluated anterior restorations. For the majority of the studies, endocrowns showed either similar or greater survival rates under fatigue and monotonic load than (post-)core-crown restorations, irrespectively of the tooth. The endocrowns showed more favorable failure patterns than (post-)core-crowns, irrespectively of the tooth. Endocrowns produced lower stresses in the restorative material for molars and premolars and in the luting material for premolars than (post-)core-crown restorations. The included studies presented adequate information for most items of the RoBDEMAT risk of bias tool.
Endocrowns showed similar or greater biomechanical performance than the traditional (post-)core-crown restorations in most of the evaluated studies.
This systematic review showed that endocrowns present either similar or greater biomechanical performance than core-crown restorations for anterior and posterior endodontically treated teeth with severe structural damage.
通过对文献的系统回顾，评估和比较根管内全瓷冠和传统核-冠修复（有或无根管内桩）治疗牙体严重结构破坏的牙髓病牙的生物力学性能。
在 MEDLINE/PubMed、Scopus 和 Web of Science 数据库中进行了系统检索。选择并由两名独立评审员筛选了比较根管内全瓷冠和（桩）核-冠修复的体外研究。使用 RoBDEMAT 工具对纳入的研究进行偏倚风险分析，并收集生物力学结果进行定性分析。提取的数据根据纳入研究的比较分析进行呈现。
共纳入 31 项研究：9 项研究评估磨牙修复，14 项研究评估前磨牙修复，8 项研究评估前牙修复。对于大多数研究，根管内全瓷冠在疲劳和单调载荷下的存活率与（桩）核-冠修复相似或更高，与牙齿无关。根管内全瓷冠的失效模式比（桩）核-冠修复更有利，与牙齿无关。根管内全瓷冠在磨牙和前磨牙的修复材料中以及前磨牙的粘结材料中产生的应力低于（桩）核-冠修复。纳入的研究为 RoBDEMAT 偏倚风险工具的大多数项目提供了足够的信息。
在大多数评估的研究中，根管内全瓷冠的生物力学性能与传统的（桩）核-冠修复相似或更高。
本系统评价表明，对于牙体严重结构破坏的牙髓病前牙和后牙，根管内全瓷冠在生物力学性能方面与核-冠修复相似或更高。
