Evaluation of the clinical performance of endocrown and overlay restorations: A 4-year retrospective study

IF 4.8 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of dentistry Pub Date : 2025-06-02 DOI:10.1016/j.jdent.2025.105874

Mustafa Ayata , Esen Küçükömeroğlu Oktay , Haydar Albayrak , Melis Çakar , Mutlu Özcan

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引用次数: 0

Abstract

Objectives

This retrospective study aimed to evaluate and compare the clinical performance, plaque indices, and cemented surface areas of feldspathic ceramic endocrown and overlay restorations in endodontically treated premolars and molars over a 2- to 4-year follow-up.

Methods

Fifty-one restorations (24 endocrowns, 27 overlays) delivered between January 2019 and September 2022 were examined. All were fabricated in a single session using CEREC system (Omnicam AC scanner, CEREC Software v3.85, and MCXL milling unit; Sirona Dental Systems GmbH, Bensheim, Germany) from feldspathic ceramic blocks (CEREC Blok PC; Sirona Dental Systems GmbH, Bensheim, Germany) and cemented with a dual-cure adhesive resin cement (G-CEM LinkForce; GC Corporation, Tokyo, Japan). Clinical performance was assessed using modified FDI criteria, including esthetic, functional, and biological parameters. Plaque index was recorded, and cemented surface area was measured using archived STL files. Statistical analyses included the Mann-Whitney U test, chi-square test, Fisher’s exact test, and two-way ANOVA (p < 0.05).

Results

All endocrown and overlay restorations showed a 100 % survival rate, with no failures. No significant differences were found in esthetic, functional, or biological performance (p > 0.05). Plaque index scores were similar (p = 0.253), but a strong negative correlation was observed between plaque accumulation and periodontal response (Spearman’s rho = -0.846, p < 0.001). Endocrowns had a significantly larger cemented surface area than overlays (p = 0.020), but this did not impact clinical success.

Conclusions

Endocrowns and overlays provided reliable, minimally invasive treatment options for endodontically treated premolars and molars, ensuring high survival rates. Although endocrowns presented a larger cemented surface area, overlays showed similar success, supporting a conservative approach. Periodontal health was not significantly affected by restoration type, but clinical success was influenced by patient hygiene (clinicaltrials.gov ID: NCT06734806).

Clinical Significance

Endocrowns and overlay restorations fabricated from feldspathic and cemented with a dual-polymerized resin cement used with a bonding agent can be safely applied in a single session for endodontically treated posterior teeth.

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评价内冠和覆盖修复体的临床性能：一项4年回顾性研究。

目的：本回顾性研究旨在评估和比较长石陶瓷内冠和覆盖修复体在根管治疗的前磨牙和磨牙中的临床表现、菌斑指数和胶结表面积，随访时间为2- 4年。方法：对2019年1月至2022年9月间交付的51个修复体（24个内冠，27个覆盖层）进行检查。所有这些都是使用CEREC系统（Omnicam AC扫描仪，CEREC软件v3.85， MCXL铣削单元）在一次加工中完成的；Sirona Dental Systems GmbH, Bensheim, Germany)生产长石陶瓷块(CEREC block PC；Sirona Dental Systems GmbH, Bensheim, Germany)，并用双固化胶粘剂树脂水泥(G-CEM LinkForce；GC公司，东京，日本)。临床表现采用改良的FDI标准进行评估，包括美学、功能和生物学参数。记录斑块指数，并使用存档的STL文件测量胶结表面积。统计分析采用Mann-Whitney U检验、卡方检验、Fisher精确检验和双因素方差分析（p < 0.05）。结果：内冠和覆盖修复体成活率均为100%，无失败病例。在美学、功能或生物学性能方面没有发现显著差异（p < 0.05）。牙菌斑指数得分相似（p = 0.253），但牙菌斑积累与牙周反应呈显著负相关（Spearman’s rho = -0.846,p < 0.001）。内冠的胶结表面积明显大于覆盖层（p = 0.020），但这并不影响临床成功。结论：牙髓冠和覆盖层为牙髓治疗的前磨牙和磨牙提供了可靠的微创治疗选择，确保了较高的存活率。虽然内冠具有更大的胶结表面积，但覆盖也取得了类似的成功，支持保守方法。牙周健康不受修复类型的显著影响，但临床成功受患者卫生的影响（clinicaltrials.gov ID: NCT06734806）。临床意义：由长石制成的内冠和覆盖修复体，用双聚合树脂胶结剂粘接，可以安全地在一次治疗中应用于根管治疗的后牙。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of dentistry 医学-牙科与口腔外科

CiteScore

7.30

自引率

11.40%

发文量

349

审稿时长

35 days

期刊介绍： The Journal of Dentistry has an open access mirror journal The Journal of Dentistry: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. The Journal of Dentistry is the leading international dental journal within the field of Restorative Dentistry. Placing an emphasis on publishing novel and high-quality research papers, the Journal aims to influence the practice of dentistry at clinician, research, industry and policy-maker level on an international basis. Topics covered include the management of dental disease, periodontology, endodontology, operative dentistry, fixed and removable prosthodontics, dental biomaterials science, long-term clinical trials including epidemiology and oral health, technology transfer of new scientific instrumentation or procedures, as well as clinically relevant oral biology and translational research. The Journal of Dentistry will publish original scientific research papers including short communications. It is also interested in publishing review articles and leaders in themed areas which will be linked to new scientific research. Conference proceedings are also welcome and expressions of interest should be communicated to the Editor.