endocrown

2. Endocrown
(ADHESIVE ENDODONTIC CROWN)

3. “This chapter offers a rational and practical
approach to the challenge.”

4. The objectives of post endodontic restoration are:
1- Prevent bacterial micro-leakage.
2- Protect the residual tooth structure,
3- Restore form, function and aesthetics,
4- Ensure periodontal health,
5- Prevent the abrasion of the antagonistic teeth.
6- Should commence as soon as possible after RCT.

5. Special techniques are used for restoration of
ETT, two factors influence the choice of a
technique,
 The tooth type.
 The amount of remaining tooth structure which is
the most important factor for determining the
prognosis.

6.  Endocrown restoration was Proposed in 1999
by Bindl and Mörmann as an alternative to the
post-and-core supported crown.
 It consists of
 a circumferential
1.0 to 1.2 mm butt margin
 and a central retention cavity inside the pulp
chamber , a ‘monobloc’.

7.  stability and retention of the restoration
depends on adhesive bonding.
.

8. History
Pissis in 1995 “the monoblock porcelain technique.”
In 1999, Bindl and Mörmann used the term
“endocrown” to describe a ceramic crown which
extends into the pulp chamber or the root canal
orifices of an endodontically treated tooth in order to
gain retention.
 The first clinical endocrown report was published in
2008 by Lander and Dietschi.

9. Preparation
The endocrown preparation consists of a circular
shoulder margin (1- 1.2 mm) and a central retention
cavity inside the pulp chamber.

10. Indications
1- As an alternative to readymade post, core and crown.

11. 2- whenever post and core cannot be made.

12. 3- In case of limited inter occlusal space.
4- In case of no remaining coronal tooth structure (no
clinical crown).

13. Steps of preparation
OCCLUSAL REDUCTION

14. Preparation pulp chamber and pulpal Floor
Gutta percha is removed to a depth not exceeding 2 mm to
take advantage of the saddle-like anatomy of the cavity floor.
 No drilling of dentin is carried out.

15. Techniques of fabrication
Pressable or CADCAM

16. Material selection
1- lithium disilicate based glass-
matrix ceramics

17. 2- Resin-matrix ceramics
1- Resin nanoceramics
2- Hybrid ceramics

18. 3- BIO HPP (PEEK)

24. Cementation
Must use adhesive cementation, conventional
cementation is contraindicated

25. Advantages of endocrowns when compared
to post-core and crown
o No need for further reduction of sound tooth
structure.
o Decrease number of visits.
o Decrease chances of root perforation.
o Indicated in curved roots.
o Cost.
o no need for crown lengthening in case of short
clinical crown.
o retreatment is easier.

26. Failure and management
Fiber reinforcement of
compromised ETT

32. Disadvanatages
 No sufficient studies supporting its use for
premolars and incisors.
 Cannot be used in case of
1. parafunctional habits.
2. Pulp chamber less than 3mm.
3. Peripheral enamel less than 1mm.

38. BEFORE AFTER