Skip to main content
Top
Published in: Trials 1/2019

Open Access 01-12-2019 | Dental Restoration | Study protocol

Clinical efficacy of different marginal forms of endocrowns: study protocol for a randomized controlled trial

Authors: Jieli Sun, Wenhao Ruan, Jiahui He, Xiaoyu Lin, Bowen Ci, Siye Yin, Wenjuan Yan

Published in: Trials | Issue 1/2019

Login to get access

Abstract

Background

After root canal treatment, most tooth defects need to be restored. Onlay restoration is widely used to restore dental defects. Endocrown is a new type of onlay; however, dentists have yet to obtain a full understanding of the clinical effects of marginal forms of endocrowns. Here, we present a multicenter protocol to compare the clinical efficacy of two marginal forms (flat and 90-degree shoulder) for tooth restoration. The efficacy will be evaluated by marginal fit, marginal discoloration, and integrity of restoration.

Methods

The proposed flat and 90-degree shoulder marginal endocrown assessment trial is an open-label, parallel-group, multicenter randomized controlled trial involving two hospitals. A total of 200 patients will be included in this trial, and the following patient inclusion criteria will be applied: good oral hygiene habits, no periodontal diseases, receipt of standard root canal treatment, and need for endocrown restoration. Patients will be enrolled after providing signed informed consent and will be divided into two groups (flat and 90-degree shoulder endocrown) in accordance with a random number table. Treatment allocation will be balanced (1:1). Endocrowns will be cemented by dual-cured luting composite. Clinical evaluations will be performed at baseline and at 24 months after treatment in accordance with modified US Public Health Service criteria by two independent evaluators. The primary outcome will be marginal fit; secondary outcome measures will include debonding, marginal discoloration, and integrity of restoration. All acquired data will be analyzed by an independent statistician. Wilcoxon one-sample tests will be used for intra-group comparisons, and Wilcoxon two-sample tests will be used for inter-group comparisons. The Bonferroni method will be used to correct for multiple comparisons, and hierarchical logistic regression will be applied to determine central effects.

Discussion

The results of this trial will provide a clinical basis for clinicians to restore teeth by endocrowns and to improve long-term restoration for patients.

Trial registration

ClinicalTrials.gov identifier: NCT03398395. Registered on 12 January 2018.
Appendix
Available only for authorised users
Literature
1.
go back to reference Skupien JA, Cenci MS, Opdam NJ, Kreulen CM, Huysmans MC, Pereira-Cenci T. Crown vs. composite for post-retained restorations: a randomized clinical trial. J Dent. 2016;48:34–9.CrossRef Skupien JA, Cenci MS, Opdam NJ, Kreulen CM, Huysmans MC, Pereira-Cenci T. Crown vs. composite for post-retained restorations: a randomized clinical trial. J Dent. 2016;48:34–9.CrossRef
2.
go back to reference Schwartz RS, Robbins JW. Post placement and restoration of endodontically treated teeth: a literature review. J Endod. 2004;30:289–301 [PubMed].CrossRef Schwartz RS, Robbins JW. Post placement and restoration of endodontically treated teeth: a literature review. J Endod. 2004;30:289–301 [PubMed].CrossRef
3.
go back to reference Rocca GT, Krejci I. Crown and post-free adhesive restorations for endodontically treated posterior teeth: from direct composite to endocrowns. Eur J Esthet Dent. 2013;8:156–79 [PubMed].PubMed Rocca GT, Krejci I. Crown and post-free adhesive restorations for endodontically treated posterior teeth: from direct composite to endocrowns. Eur J Esthet Dent. 2013;8:156–79 [PubMed].PubMed
4.
go back to reference Yamanel K, Caglar A, Gülsahi K, Ozden UA. Effects of different ceramic and composite materials on stress distribution in inlay and onlay cavities: 3-D finite element analysis. Dent Mater J. 2009;28:661–70.CrossRef Yamanel K, Caglar A, Gülsahi K, Ozden UA. Effects of different ceramic and composite materials on stress distribution in inlay and onlay cavities: 3-D finite element analysis. Dent Mater J. 2009;28:661–70.CrossRef
5.
go back to reference Ozyoney G, Yan Koğlu F, Tağtekin D, Hayran O. The efficacy of glass-ceramic onlays in the restoration of morphologically compromised and endodontically treated molars. Int J Prosthodont. 2013;26:230–4.CrossRef Ozyoney G, Yan Koğlu F, Tağtekin D, Hayran O. The efficacy of glass-ceramic onlays in the restoration of morphologically compromised and endodontically treated molars. Int J Prosthodont. 2013;26:230–4.CrossRef
6.
go back to reference Leonard DL. Commentary: the endocrown: an alternative approach for restoring extensively damaged molars. J Esthet Restor Dent. 2013;25:391.CrossRef Leonard DL. Commentary: the endocrown: an alternative approach for restoring extensively damaged molars. J Esthet Restor Dent. 2013;25:391.CrossRef
7.
go back to reference Fages M, Bennasar B. The endocrown: a different type of all-ceramic reconstruction for molars. J Can Dent Assoc. 2013;79:d140 [PubMed].PubMed Fages M, Bennasar B. The endocrown: a different type of all-ceramic reconstruction for molars. J Can Dent Assoc. 2013;79:d140 [PubMed].PubMed
8.
go back to reference Lander E, Dietschi D. Endocrowns: a clinical report. Quintessence Int. 2008;39:99–106 [PubMed].PubMed Lander E, Dietschi D. Endocrowns: a clinical report. Quintessence Int. 2008;39:99–106 [PubMed].PubMed
9.
go back to reference Sevimli G, Cengiz S, Oruc MS. Endocrowns: review. J Istanb Univ Fac Dent. 2015;49:57–63.CrossRef Sevimli G, Cengiz S, Oruc MS. Endocrowns: review. J Istanb Univ Fac Dent. 2015;49:57–63.CrossRef
10.
go back to reference Biacchi GR, Basting RT. Comparison of fracture strength of endocrowns and glass fiber post-retained conventional crowns. Oper Dent. 2012;37:130–6.CrossRef Biacchi GR, Basting RT. Comparison of fracture strength of endocrowns and glass fiber post-retained conventional crowns. Oper Dent. 2012;37:130–6.CrossRef
11.
go back to reference Mohammadi N, Kahnamoii MA, Yeganeh PK, Navimipour EJ. Effect of fiber post and cusp coverage on fracture resistance of endodontically treated maxillary premolars directly restored with composite resin. J Endod. 2009;35:1428–32.CrossRef Mohammadi N, Kahnamoii MA, Yeganeh PK, Navimipour EJ. Effect of fiber post and cusp coverage on fracture resistance of endodontically treated maxillary premolars directly restored with composite resin. J Endod. 2009;35:1428–32.CrossRef
12.
go back to reference Dejak B, Młotkowski A. 3D-Finite element analysis of molars restored with endocrowns and posts during masticatory simulation. Dent Mater. 2013;29:e309–17.CrossRef Dejak B, Młotkowski A. 3D-Finite element analysis of molars restored with endocrowns and posts during masticatory simulation. Dent Mater. 2013;29:e309–17.CrossRef
13.
go back to reference Dietschi D, Duc O, Krejci I, Sadan A. Biomechanical considerations for the restoration of endodontically treated teeth: a systematic review of the literature--Part 1. Composition and micro- and macrostructure alterations. Quintessence Int. 2007;38:733–43 [PubMed].PubMed Dietschi D, Duc O, Krejci I, Sadan A. Biomechanical considerations for the restoration of endodontically treated teeth: a systematic review of the literature--Part 1. Composition and micro- and macrostructure alterations. Quintessence Int. 2007;38:733–43 [PubMed].PubMed
14.
go back to reference Lin CL, Chang YH, Pa CA. Estimation of the risk of failure for an endodontically treated maxillary premolar with MODP preparation and CAD/CAM ceramic restorations. J Endod. 2009;35:1391–5.CrossRef Lin CL, Chang YH, Pa CA. Estimation of the risk of failure for an endodontically treated maxillary premolar with MODP preparation and CAD/CAM ceramic restorations. J Endod. 2009;35:1391–5.CrossRef
15.
go back to reference Lin CL, Chang YH, Chang CY, Pai CA, Huang SF. Finite element and Weibull analyses to estimate failure risks in the ceramic endocrown and classical crown for endodontically treated maxillary premolar. Eur J Oral Sci. 2010;118:87–93.CrossRef Lin CL, Chang YH, Chang CY, Pai CA, Huang SF. Finite element and Weibull analyses to estimate failure risks in the ceramic endocrown and classical crown for endodontically treated maxillary premolar. Eur J Oral Sci. 2010;118:87–93.CrossRef
16.
go back to reference Guo J, Wang Z, Li X, Sun C, Gao E, Li H. A comparison of the fracture resistances of endodontically treated mandibular premolars restored with endocrowns and glass fiber post-core retained conventional crowns. J Adv Prosthodont. 2016;8:489–93.CrossRef Guo J, Wang Z, Li X, Sun C, Gao E, Li H. A comparison of the fracture resistances of endodontically treated mandibular premolars restored with endocrowns and glass fiber post-core retained conventional crowns. J Adv Prosthodont. 2016;8:489–93.CrossRef
17.
go back to reference Sedrez-Porto JA, Rosa WL, da Silva AF, Münchow EA, Pereira-Cenci T. Endocrown restorations: a systematic review and meta-analysis. J Dent. 2016;52:8–14.CrossRef Sedrez-Porto JA, Rosa WL, da Silva AF, Münchow EA, Pereira-Cenci T. Endocrown restorations: a systematic review and meta-analysis. J Dent. 2016;52:8–14.CrossRef
18.
go back to reference Kierklo A, Tribiłło R, Walendziuk A, Stokowska W. The influence of cervical lesion on the stress state and strength of tooth with occlusal restoration: a numerical model study. Rocz Akad Med Bialymst. 2002;47:95–104 [PubMed].PubMed Kierklo A, Tribiłło R, Walendziuk A, Stokowska W. The influence of cervical lesion on the stress state and strength of tooth with occlusal restoration: a numerical model study. Rocz Akad Med Bialymst. 2002;47:95–104 [PubMed].PubMed
19.
go back to reference Juloski J, Radovic I, Goracci C, Vulicevic ZR, Ferrari M. Ferrule effect: a literature review. J Endod. 2012;38:11–9 [PubMed].CrossRef Juloski J, Radovic I, Goracci C, Vulicevic ZR, Ferrari M. Ferrule effect: a literature review. J Endod. 2012;38:11–9 [PubMed].CrossRef
20.
go back to reference Pierrisnard L, Bohin F, Renault P, Barquins M. Corono-radicular reconstruction of pulpless teeth: a mechanical study using finite element analysis. J Prosthet Dent. 2002;88:442–8.CrossRef Pierrisnard L, Bohin F, Renault P, Barquins M. Corono-radicular reconstruction of pulpless teeth: a mechanical study using finite element analysis. J Prosthet Dent. 2002;88:442–8.CrossRef
21.
go back to reference Taha D, Spintzyk S, Schille C, Sabet A, Wahsh M, Salah T, et al. Fracture resistance and failure modes of polymer infiltrated ceramic endocrown restorations with variations in margin design and occlusal thickness. J Prosthodont Res. 2018;62:293–7 [PubMed].CrossRef Taha D, Spintzyk S, Schille C, Sabet A, Wahsh M, Salah T, et al. Fracture resistance and failure modes of polymer infiltrated ceramic endocrown restorations with variations in margin design and occlusal thickness. J Prosthodont Res. 2018;62:293–7 [PubMed].CrossRef
22.
go back to reference Vianna A, Prado C, Bicalho AA, Pereira R, Neves F, Soares CJ. Effect of cavity preparation design and ceramic type on the stress distribution, strain and fracture resistance of CAD/CAM onlays in molars. J Appl Oral Sci. 2018;26:e20180004 [PubMed].CrossRef Vianna A, Prado C, Bicalho AA, Pereira R, Neves F, Soares CJ. Effect of cavity preparation design and ceramic type on the stress distribution, strain and fracture resistance of CAD/CAM onlays in molars. J Appl Oral Sci. 2018;26:e20180004 [PubMed].CrossRef
23.
go back to reference Otto T, Mörmann WH. Clinical performance of chairside CAD/CAM feldspathic ceramic posterior shoulder crowns and endocrowns up to 12 years. Int J Comput Dent. 2015;18:147–61 [PubMed].PubMed Otto T, Mörmann WH. Clinical performance of chairside CAD/CAM feldspathic ceramic posterior shoulder crowns and endocrowns up to 12 years. Int J Comput Dent. 2015;18:147–61 [PubMed].PubMed
24.
go back to reference Bernhart J, Bräuning A, Altenburger MJ, Wrbas KT. Cerec3D endocrowns--two-year clinical examination of CAD/CAM crowns for restoring endodontically treated molars. Int J Comput Dent. 2010;13:141–54 [PubMed].PubMed Bernhart J, Bräuning A, Altenburger MJ, Wrbas KT. Cerec3D endocrowns--two-year clinical examination of CAD/CAM crowns for restoring endodontically treated molars. Int J Comput Dent. 2010;13:141–54 [PubMed].PubMed
25.
go back to reference Van Noort R. The future of dental devices is digital [J]. Dent Mater. 2012;28:3–12.CrossRef Van Noort R. The future of dental devices is digital [J]. Dent Mater. 2012;28:3–12.CrossRef
26.
go back to reference Gracis S, Thompson VP, Ferencz JL, Silva NR, Bonfante EA. A new classification system for all-ceramic and ceramic-like restorative materials. Int J Prosthodont. 2015;28:227–35.CrossRef Gracis S, Thompson VP, Ferencz JL, Silva NR, Bonfante EA. A new classification system for all-ceramic and ceramic-like restorative materials. Int J Prosthodont. 2015;28:227–35.CrossRef
27.
go back to reference El-Damanhoury HM, Haj-Ali RN, Platt JA. Fracture resistance and microleakage of endocrowns utilizing three CAD-CAM blocks. Oper Dent. 2015;40:201–10.CrossRef El-Damanhoury HM, Haj-Ali RN, Platt JA. Fracture resistance and microleakage of endocrowns utilizing three CAD-CAM blocks. Oper Dent. 2015;40:201–10.CrossRef
28.
go back to reference Höland W, Rheinberger V, Apel E, Hoen CV. Principles and phenomena of bioengineering with glass-ceramics for dental restoration. J Eur Ceram Soc. 2007;27:1521–6.CrossRef Höland W, Rheinberger V, Apel E, Hoen CV. Principles and phenomena of bioengineering with glass-ceramics for dental restoration. J Eur Ceram Soc. 2007;27:1521–6.CrossRef
29.
go back to reference Elsaka SE, Elnaghy AM. Mechanical properties of zirconia reinforced lithium silicate glass-ceramic. Dent Mater. 2016;32:908–14.CrossRef Elsaka SE, Elnaghy AM. Mechanical properties of zirconia reinforced lithium silicate glass-ceramic. Dent Mater. 2016;32:908–14.CrossRef
30.
go back to reference Kolassa JE. A comparison of size and power calculations for the Wilcoxon statistic for ordered categorical data. Stat Med. 1995;14:1577–81 [PubMed].CrossRef Kolassa JE. A comparison of size and power calculations for the Wilcoxon statistic for ordered categorical data. Stat Med. 1995;14:1577–81 [PubMed].CrossRef
31.
go back to reference Priyadarshini BI, Jayaprakash T, Nagesh B, Sunil CR, Sujana V, Deepa VL. One-year comparative evaluation of Ketac Nano with resin-modified glass ionomer cement and Giomer in noncarious cervical lesions: a randomized clinical trial. J Conserv Dent. 2017;20:204–9.CrossRef Priyadarshini BI, Jayaprakash T, Nagesh B, Sunil CR, Sujana V, Deepa VL. One-year comparative evaluation of Ketac Nano with resin-modified glass ionomer cement and Giomer in noncarious cervical lesions: a randomized clinical trial. J Conserv Dent. 2017;20:204–9.CrossRef
32.
go back to reference Heymann HO, Sturdevant JR, Brunson WD, Wilder AD, Sluder TB, Bayne SC. Twelve-month clinical study of dentinal adhesives in class V cervical lesions. J Am Dent Assoc. 1988;116:179–83.CrossRef Heymann HO, Sturdevant JR, Brunson WD, Wilder AD, Sluder TB, Bayne SC. Twelve-month clinical study of dentinal adhesives in class V cervical lesions. J Am Dent Assoc. 1988;116:179–83.CrossRef
33.
go back to reference Barnes DM, Blank LW, Gingell JC, Gilner PP. A clinical evaluation of a resin-modified. Glass ionomer restorative material. J Am Dent Assoc. 1995;126:1245–53.CrossRef Barnes DM, Blank LW, Gingell JC, Gilner PP. A clinical evaluation of a resin-modified. Glass ionomer restorative material. J Am Dent Assoc. 1995;126:1245–53.CrossRef
34.
go back to reference Cvar JF, Ryge G. Reprint of criteria for the clinical evaluation of dental restorative materials. 1971. Clin Oral Investig. 2005;9:215–32.CrossRef Cvar JF, Ryge G. Reprint of criteria for the clinical evaluation of dental restorative materials. 1971. Clin Oral Investig. 2005;9:215–32.CrossRef
Metadata
Title
Clinical efficacy of different marginal forms of endocrowns: study protocol for a randomized controlled trial
Authors
Jieli Sun
Wenhao Ruan
Jiahui He
Xiaoyu Lin
Bowen Ci
Siye Yin
Wenjuan Yan
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Trials / Issue 1/2019
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/s13063-019-3530-1

Other articles of this Issue 1/2019

Trials 1/2019 Go to the issue