Comparative evaluation of incorporation of ferrule in premolars endocrown designs to check any alterations in their fracture resistance: A pilot study

Abstract

Introduction: Endocrown preparation of endodontically treated teeth as final restoration has been extensively studied for different teeth. Bindl et al. questioned the application of endocrowns for premolars due to the pulp chamber space’s smaller dimensions, which diminish bonding surface area. The addition of ferrule into the endocrown preparations of premolars has not been extensively studied. Aims and Study Design: Comparative evaluation of incorporation of the ferrule in premolars endocrown designs to check any alterations in their fracture resistance. Materials and Methods: The sample consisted of 40 maxillary first premolars without cracks or caries, extracted for orthodontic or periodontal purposes. The teeth were individually mounted with cold-cure acrylic resin. Group A: Composite endocrown without ferrule and Group B: Composite endocrown with ferrule. An endocrown former was prepared with elastomeric polyvinyl siloxane material (GC Exaclear). Endocrowns were then prepared with dual-cure core build-up composite-Core-x flow (Dentsply Maillefer, Switzerland) using the endocrown former so that morphologically, they all were almost identical. Endocrowns are cemented by dual-cure resin cement following manufacturer instructions. The fracture resistance of endocrowns with and without ferrule was evaluated and compared. Results and Observations: The data were tabulated in Microsoft Excel and analyzed with SPSS version 24 software. The variables were presented with mean, standard deviation, and independent t-test. The P ≤ 0.05 is considered statistically significant. Group B (with ferrule) showed higher fracture resistance (622.06 N) than Group A (537.59 N) (without ferrule). Independent t-test showed that the difference was statistically significant (P = 0.008). Conclusion: Comparing the failure load findings, it could be concluded that ferrule-containing endocrown needed greater loads than ordinary endocrown restorations for failure.