Clinical and radiographic outcomes of endocrowns fabricated from two different CAD-CAM materials versus stainless steel crowns in restoring first permanent molars in children: a randomized clinical trial.

BACKGROUND

Restoring first permanent molars after endodontic treatment in children is challenging. Improved mechanical properties and adhesion of ceramic materials have led to the emergence of endocrown as a conservative and esthetic restorative option for endodontically treated molars in adults and offer dentists a restorative treatment for endodontically treated first permanent molars in children. The purpose of this study was clinical and radiographic evaluation of both endocrowns fabricated from 2 different materials and SSCs restoring endodontically treated first permenant molars in children over one year.

METHODS

Thirty children were selected (18 girls and 12 boys) with an age range of 10-13 years old, with an endodontically treated first molar. Children were randomly divided into 3 groups: PMC group (restored with preformed SSCs), EMX group (restored with litium disilicate endocrown), and COP group (restored with indirect reinforced composite endocrown) (n = 10). Evaluation was done in terms of parent satisfaction, radiograph (base line and 12 months), the restoration survival after 12 months, plaque index (PI), and gingival index (GI) at base line, 6 months, and 12 months.The data were analyzed using the Kruskal-Wallis H-test, which was used to compare an ordinal variable, and Friedman's test was used to compare an ordinal variable (P ≤.050).

RESULTS

Parent satisfaction showed statistically significant differences between PMC (mean rank = 7.5) and both EMX and COP (mean rank = 19.5) (P <.001), but not between the EMX and COP groups (P = 1.00). At 6 and 12 months, the PMC group's PI values were statistically significantly higher than those of the EMX and COP groups (P =.001 and P <.001, respectively). The GI values of the EMX and COP groups did not change significantly through different intervals (P = 1.000 and P =.135, respectively), whereas the GI values of the PMC group did (P =.050). At various intervals, it was found that there was no significant difference in the GI values between the three groups.

CONCLUSIONS

The survival rates of endorowns and SSCs were comparable. Compared to SSCs, endocrowns demonstrated a higher parental satisfaction, less plaque buildup, and improved gingival response.

TRIAL REGISTRATION

The study protocol was retrospectively registered on Clinical Trials under No. (NCT06432049-29/05/2024).