ENDOCROWN

PREPARED BY
SHEREEN MOHAMED EMAD EL-DIEN
DEMONSTRATOR OF THE FIXED PROSTHODONTICS DEPARTMENT AT NAHDA
UNIVERSITY
UNDER SUPERVISION
DR. MANAL RAFIE
LECTURER OF FIXED PROSTHODONTICS DEPARTMENT AT MINIA UNIVERSITY
1. DEFINITION
2. INDICATIONS
3. CONTRAINDICATIONS
4. ADVANTAGES
5. DISADVANTAGES
6. PREPARATION
7. IMPRESSION
8. MATERIAL OF CHOICE
9. TRY-IN
10. CEMENTATION
11. LONGEVITY AND
EFFECTIVENESS
12. RECENT STUDIES
13. REFERENCES
 The endocrown technique was proposed by Bindl
and Mörmann (1999) as an alternative to the
crown supported by post-and-core.
This technique consists of a monolithic crown
HISTORY retained inside the pulp cavity and supported by
the edges of the remaining tooth structure,
resulting in macro mechanical retention provided
by the pulp chamber walls, and micromechanical
retention through the adhesive bonding.
 Endocrown is an overlay with an extension into the pulp chamber. In other
words, it is a crown that extends to include the pulp chamber in
endodontically treated teeth, a crown with its core part as a single unit.
DEFINITION It is a large ceramic block that fills the pulp chamber and is adhesively
cemented to the dental substrate
INDICATIONS

1. Short clinical crown

2. Calcified – Curved – Short
roots
3. Limited interocclusal space
4. Where posts are impossible
5. Successfully treated tooth
6. Excessive coronal loss
7. Cavity depth at least 3mm and
cervical margin with 2 mm
width
CONTRAINDICATIONS
1. More than 50% of tooth
structure is missed
2. Adhesion can’t be assured
3. Pulp chamber depth less
than 3mm
4. Side-walk (cervical
margin) less than 2mm
5. Para functional habits
6. Can't obtain adequate
isolation
ADVANTAGES
1. Simple and easy to
perform
2. No preparation for root
dentin
3. No post
4. Conservative
preparation design
5. Reduce chairside time
DISADVANTAGES

1 2 3
Risk of debonding Risk of fracture (no Can’t use when a
(occlusal enough shoulder) large amount of
prematurity – bad coronal structure is
isolation) missing
 1. Occlusal reduction

 Wheel stone reduction of 2mm in the axial

PREPARATION direction // to occlusal plane.
Aim: to create a flat surface or (cervical sidewalk)
2. Axial preparation

 Depth of cut: 3-4mm.

By use of (Diamond bur)
Aim: to remove any
undercuts in the access
cavity
 Divergence of the
pulpal chamber with
approximate angulation
of six degrees leaving a
rim 2mm
 Rounded internal line
angles
3. Finishing & Cleaning

 Internal round with fine-

grained diamond points
 Rounding off occlusal-
axial angles
 Removal of micro-
irregularities and
producing a flat, polished
surface.
 Polishing is completed by
using specially shaped
abrasive rubber
STUDY (2017)
MATERIAL
Lithium Disilicate

CONCLUSION
Under the conditions of this study,
ferrule-containing endocrown
preparations demonstrated
significantly greater failure loads
than standard endocrown
restorations; However, calculated
failure stress based on the available
surface area for adhesive bonding
found no difference between the
groups
STUDY (2023)
CONCLUSION

In this FEM study, when endocrowns are chosen to restore

endodontically treated mandibular molars, under the oblique loading,
with the increase of defect on the mesial wall, the peak VM stress
values on the cement layer increased accordingly.
The model with mesial wall destruction at the level of CEJ was easier to
fail on the cervical dentin.
IMPRESSION

1. Conventional impression
technique

 One-step technique
 Two-step technique

Using addition silicon or

condensation silicon
 Two-step technique
The basis of the technique is to carry out a preliminary high-viscosity silicone
impression, in the fabrication of a custom tray, followed by washing out with
low-viscosity silicon.

 One-step technique
In this technique, the impression is performed with high and low-viscosity
silicon, simultaneously. The procedure is simpler, faster, and more
comfortable for the patient.
 2. Digital Impression
With a 3D intraoral scanner
MATERIAL OF CHOICE

1. Lithium disilicate (IPS E-max)

2. Zirconia-reinforced lithium silicate
( Celtra Duo, Suprinity, ZLS)
3. Polymer-infiltrated ceramics
(Enamic)
4. Nano fill Composite (Lava ultimate,
Cerasmart)
5. Translucent zirconia
6. Composite resin
STUDY (2019)
STUDY (2020)
MATERIAL

(1) Lithium disilicate

(IPS e.max Press)
(2) Polymer infiltrated
ceramic (Vita
Enamic)
(3) High translucency
zirconia (Ceramill
Zolid HT)
CONCLUSION

Within the limitation of this in vitro study, the following

conclusions could be drawn:
1. The endocrowns at conventional 2mm thickness fabricated from HTZ
displayed the highest fracture strength.
2. The LD ceramic was the second material of choice with marginally lesser
fracture resistance and showing 50% favorable failure modes. However, in
endodontically treated teeth with extensive occlusal deficiency, the
radicular extension should not be performed; the endocrowns could be
made up of LD possessing the highest fracture resistance or from PIC having
more favorable failure modes.
STUDY (2021)
MATERIALS
1. Zirconium lithium silicate (ZLS)
2. Translucent zirconia (Zr)

CONCLUSION
Zirconia seems to be an acceptable material for endocrown with
comparable internal and marginal adaptation to ZLS
STUDY (2023)
MATERIALS

The models represented extensively damaged molars restored by

endocrowns from the following materials:
1. Translucent zirconia
2. Zirconia-reinforced glass ceramic
3. Lithium disilicate glass-ceramic
4. Polymer-infiltrated ceramic network (PICN)
5. Resin nanoceramic
CONCLUSION

1. Resin nanoceramic caused high-stress concentration and displacement in

dental structures, which might not make it a suitable material for
endocrowns.
2. Translucent zirconia might be the best material for endocrowns to preserve
the tooth–restoration complex since it absorbed stresses and showed low
displacement within it and in the dental tissues.
3. Lithium disilicate ceramic and zirconia-reinforced lithium silicate could be
used to manufacture endocrowns as they offer an acceptable range of
stresses, Mohr–Coulomb ratio, and displacement in the endocrown and
dental structures.
 TRY-IN

Remove the temporary restoration then prophylaxis

with a prophylactic paste is carried out in order to
remove any debris or residual temporary cement.
The operatory field is isolated with a rubber dam.

The main advantage of try-in restoration

with absolute isolation is the visibility of the
margins and the dryness greatly facilitating
the assessment and adjustment of the
margins.
CEMENTATION
LONGEVITY AND EFFECTIVENESS
RESULTS
Out of the selected eight studies reported success rate of endocrown
restoration in molars varied from 72.7% to 99.57% and in premolars ranged
from 68.75% to 100% with a follow-up range of 3 to 19 years.

CONCLUSION
These findings showed similar success rates, and no difference in the rate of
endocrown failures between molars and premolars, thus suggesting that
premolars may be considered suitable candidates for endocrowns
RECENT STUDIES
STUDY (2023)
MATERIALS
1. Ultra-translucent zirconia 5Y-PSZ [KATANA UTML]
2. Lithium disilicate [IPS e.max-CAD]
CONCLUSION

Zirconia endocrowns showed better FFL than lithium disilicate

endocrowns, regardless of the number of remaining axis walls.
Lithium disilicate and 5Y-PSZ endocrowns showed FFL higher than
the normal masticatory loads.
STUDY (2023)
CONCLUSION
Based on the findings of this finite element analysis study; the following
conclusions were drawn:
1. Endocrown preparations for retaining a 3-unit ceramic FPD in lithium
disilicate should be a suitable alternative to the conventional
complete crown preparation.
2. The endocrown preparation on both abutments preserved more
tissue and decreased the risk of FPD fracture or debonding failure for
endodontically treated teeth.
REFERENCES
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. Bacchi, A. (2019). Comparison of endocrowns made of lithium disilicate glass-ceramic or
polymer-infiltrated ceramic networks and direct composite resin restorations: fatigue
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Biomechanical Assessment of Endodontically Treated Molars Restored by Endocrowns Made from
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THANK YOU