Fehrenbach Julia, de Soares Jéssica Lopes Soares, do Nascimento Foly João Carlos Silva, Miotti Leonardo Lamberti, Münchow Eliseu Aldrighi
Graduate Program in Dentistry, School of Dentistry, Federal University of Rio Grande Do Sul, Porto Alegre, RS, Brazil.
Department of Conservative Dentistry, School of Dentistry, Federal University of Rio Grande Do Sul, Porto Alegre, RS, Brazil.
Dent Mater. 2025 Jan;41(1):28-41. doi: 10.1016/j.dental.2024.10.012. Epub 2024 Nov 2.
To conduct a systematic review and network meta-analysis (NMA) to answer whether endocrown restorations have similar mechanical behavior than other traditional core-crown systems with or without intracanal posts for the rehabilitation of anterior endodontically treated teeth.
The review followed the PRISMA Extension Statement for NMA. Studies were identified by a systematic search to select reports on endocrown restorations in anterior teeth. A search was performed in PubMed (MEDLINE), Scopus, Web of Science, Embase, SciELO, and LILACS databases. Articles evaluating mechanical performance through in vitro and finite element analysis (FEA) studies were selected and the risk of bias was assessed using the RoBDEMAT and ROBFEAD tools, respectively. The data were analyzed qualitatively and quantitatively through NMA using the MetaInsight tool.
Eleven articles were included (eight in vitro and three with FEA design). Six in vitro studies were evaluated using NMA. Composite resin endocrowns showed greater load-to-fracture and lower occurrence of catastrophic failures than traditional restorations. Combining glass fiber post with composite restoration also showed good strength behavior. Regarding FEA studies, two out of three studies showed a more homogeneous distribution of stress for the endocrown group.
Endocrowns performed similarly to or better than conventional restorative strategies, with composite resin being the most recommended material of choice. The rehabilitation of endodontically treated anterior teeth with extensive coronal destruction is typically challenging for the dentist, and there is still no consensus in the literature that provides conclusive answers for choosing the appropriate material and restorative strategy. Exploring new techniques and materials that make this procedure easier for the dentist and guarantee good results is paramount.
进行一项系统评价和网状Meta分析（NMA），以回答在修复牙髓治疗后的前牙时，嵌体冠修复与其他带或不带根管内桩的传统核冠系统相比，是否具有相似的力学性能。
本评价遵循NMA的PRISMA扩展声明。通过系统检索来识别研究，以选择关于前牙嵌体冠修复的报告。在PubMed（MEDLINE）、Scopus、科学网、Embase、SciELO和LILACS数据库中进行了检索。选择通过体外和有限元分析（FEA）研究评估力学性能的文章，并分别使用RoBDEMAT和ROBFEAD工具评估偏倚风险。使用MetaInsight工具通过NMA对数据进行定性和定量分析。
纳入了11篇文章（8篇体外研究和3篇FEA设计研究）。6篇体外研究使用NMA进行了评估。复合树脂嵌体冠比传统修复体表现出更高的断裂载荷和更低的灾难性失败发生率。将玻璃纤维桩与复合修复体结合也显示出良好的强度性能。关于FEA研究，三项研究中的两项显示嵌体冠组的应力分布更均匀。
嵌体冠的性能与传统修复策略相似或更好，复合树脂是最推荐的材料选择。对于牙髓治疗后的前牙，伴有广泛的冠部破坏，其修复对牙医来说通常具有挑战性，并且文献中仍然没有共识能为选择合适的材料和修复策略提供确凿答案。探索使牙医更容易进行此操作并保证良好效果的新技术和材料至关重要。
