jcda
ca
ESSENTIAL DENTAL KNOWLEDGE
The following is a summary of an article recently published in the Clinical Dentistry
The Canadian Dental Association
section of the JCDA website. For the full version, see jcda.ca.
Published by
jadc
Clinical
Summaries
DES CONNAISSANCES
DENTAIRES INDISPENSABLES
Clinical Reports
Publié par
l’Association dentaire canadienne
The Endocrown: A Different Type of All-Ceramic Reconstruction for
Molars
Michel Fages, DDS, PhD; Bertrand Bennasar, DDS
Abstract
The endocrown is indicated for the endodontic restoration of severely damaged
molars. This monolithic, ceramic adhesive restoration requires specific preparation
techniques to satisfy criteria that are primarily biomechanical in nature: a cervical
margin in the form of a butt joint and a preparation of the pulp chamber that
does not extend into the root canals. The remaining tooth substance is thus more
robust, resulting in increased longevity. This simple and efficient concept is compatible with the philosophy of biointegrated prostheses. This type of reconstruction, which is still uncommon, should be more widely known and used.
T
he purpose of this paper is to describe the preparation and insertion of endocrowns
as well as the materials used to achieve a reliable and durable result. The main
objective is to dispense with metal and achieve an all-ceramic bonded reconstruction
that is minimally invasive of root canals, as the use of root canals for anchoring has
been cited as an important factor in weakening the tooth.8-11 Thus, the preparation for
endocrowns is different from that for conventional complete crowns.12,13
An endocrown machined using
computer-aided design and
computer-aided manufacture (top).
The prepared tooth (middle) and the
final result after bonding (bottom).
More online
Complete case report and
additional photos at:
jcda.ca/article/d140
The endocrown is described as a monolithic (one-piece) ceramic bonded construction14-18 characterized by a supra-cervical19butt joint, retaining maximum enamel to
improve adhesion. The endocrown invades the pulpal chamber, but not the root canals. It is milled using computer-aided techniques16,18 or by molding ceramic materials
under pressure.20,21 New generations of ceramics and adhesives may lead to a view of
this therapeutic device as an alternative to conventional crown-root anchored restorations.22,23 The specific preparation and bonding result in a particularly favourable
reconstruction in terms of biomechanics.5,24,25
The preparation for endocrowns is simple and can be performed quickly. Root canals
are not involved in the process, and the procedure is less traumatic than alternatives.
The supragingival position of the cervical margin preserves the marginal periodontium, facilitates impression taking and maintains the solid substance of the remaining tooth. The endocrown fits perfectly with the concept of biointegration and belongs
among the restorative options for posterior endodontically treated and badly damaged molars. a
Cite this as: J Can Dent Assoc 2013;79:d140
jcda
ca | 2014 | Vol. 80, No. 1 |
ESSENTIAL DENTAL KNOWLEDGE
Published by
The Canadian Dental Association
jcdaf
ca
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