Comparison of Clinical Efficacy of CAD/CAM Endocrowns Made of Feldspathic, Zirconia Lithium Silicate, and Lithium Disilicate: A Two-year Mixed Cohort Study

Abstract

Endocrowns can be fabricated from various materials as a treatment option for endodontically treated teeth. This mixed cohort study aimed to demonstrate the clinical efficacy of endocrowns made of feldspathic, zirconia lithium silicate, and lithium disilicate ceramics using a chairside CAD/CAM system. The present study compared the clinical outcomes of 141 endocrown restorations in posterior teeth of 85 patients in a two-year follow-up. The efficacy of restorations was evaluated in three aspects: esthetics, biological response, and function, with the aid of the FDI guideline, and presented as descriptive analyses. Additionally, the data were analyzed using Chi-square and Spearman correlation tests. The significance level was set at p = 0.05. The study findings revealed that the type of restorations (feldspathic, zirconia lithium silicate, and lithium disilicate) (p > 0.05) and underlying teeth (molars and premolars) (p > 0.05) play no part in restorations' failure. Caries' recurrence is primarily responsible for the failure of the endocrowns. Secondary caries and radiolucency were observed in four teeth (2.83%). The clinical efficacy of 126 restorations (89.36%) fell into the category of "clinically excellent" and "clinically good." Ten restorations (7.09%) were classified as "clinically sufficient/satisfactory," and only five restorations (3.54%) needed replacement due to having "clinically unsatisfactory" and "clinically poor" quality. With endocrowns made of the mentioned ceramics showing a high success rate and durability in the short term, they can be considered a safe choice for restoring endodontically treated teeth. It is worth noting that caries were the most common reason for the failure of the restorations. Endocrowns made of different ceramics have been proven reliable restorations for endodontically treated molars and premolars.