3. Introduction
Traditionally, the functional and esthetic recovery of endo-dontically
treated teeth with extensive coronal loss has been achieved
by fabricating total crowns supported on cast metal cores
But with the development of intraradicular posts made of glass fiber, and of
the technique of bonding to dentin, resulting from the development of resin
materials
The restoration of endodontically treated teeth became :
simpler
more economical
and biocompatible.
4. Introduction
with the advent. of adhesive dentistry and the new resources That may be used
to perform restorations of total crowns in endodontically treated teeth, as is the
case of
ENDOCROWNS .
5. What Is endo-crown !
• Definition
The endo-crown is an onlay restoration on endo-donticaly treated teeth ,
which is more conservative than traditional post and core system and uses
the adhesive resin with mono-block technique
6. What Is endo-crown !
• Concept
To engage the large pulpal chamber of root of treated molar teeth with ceramic
etched restoration which provides cuspal coverage.
7. What Is endo-crown !
• History
The first study published on endocrown restoration (oradhesive endodontic
restoration) was conducted by Pissis in 1995
In it,he described the ceramic Monoblock effect for teeth with extensive loss
of coronal structure.
it was Bindl and Mörmann who named this restorative procedure
“endocrown” in 1999 as adhesive endodontic crowns and characterized as
total porcelain crowns fixed to endodontically treated posterior teeth .
8. Endo-Crown
Indications
• Succesfully root treated molar.
Endo Crown :
Indications & Contra-indications
• Excessive loss of coronal dental tissue
and limited inter-occlusal space
10. Endo-Crown
Contra-indications
• Para Functional Habbits
Endo Crown :
Indications & Contra-indications
• Can’t obtain adequate isolation
From salive
• Depth of pulp chamber less than
3mm
• Cervical Margin less than 2 mm wide
• If adhesion can’t be assured
11. Endo-Crown
Advantages
• Less Complex , More practical and easier to perform
Endo Crown :
Advantages & Dis-advantages
• Allow minimal tooth wear thus strengthens the tooth
• Preparation design is conservative and biological width is minimal
• Allows re-entery to canals if required without post removal
• Reduce patient cost and chairside time
12. Endo-Crown
Dis-advantages
• Risk of debonding and root fracture In endo-crown
Endo Crown :
Advantages & Dis-advantages
• Limitation maybe restricted to the ceramic material which must be
acid etchable ceramics . Can’t be used in centrals and premolars
13. Endo-Crown
Preparation Method
• Occlusal Preparation
The goal in preparation is to achieve an overall reduction in the height of the occlusal
surface of at least 2 mm in the axial direction. This reduction can be achieved by
drilling 2-mm-deep grooves as guides , then using a green diamond wheel bur to
reduce the occlusal surface
Making the guide grooves in an isolated tooth and in situ
Endo Crown :
Preparation
14. Endo-Crown
Preparation Method
• Occlusal Preparation
The goal in preparation is to achieve an overall reduction in the height of the occlusal
surface of at least 2 mm in the axial direction. This reduction can be achieved by
drilling 2-mm-deep grooves as guides , then using a green diamond wheel bur to
reduce the occlusal surface
Preparation of the cervical margin or
“cervical sidewalk” using a wheel bur held
parallel to the occlusal plane.
Endo Crown :
Preparation
15. Endo-Crown
Preparation Method
• Axial Preparation
Involves eliminating undercuts in the access cavity.
A cylindrical-conical green diamond bur with a total occlusal convergence of 7° is used
to make the coronal pulp chamber and endodontic access cavity continuous
The depth of the cavity should be at least 3 mm.
Axial preparation using a cylindro-conical
drill to make the coronal pulp chamber
continuous with the access cavity
Endo Crown :
Preparation
16. Endo-Crown
Preparation Method
• Polishing The cervical band
The bur used in this step has the same taper as the one used in axial preparation, but
a larger diameter and a finer particle size. It should be guided around the entire
surface of the cervical band to remove micro-irregularities and produce a flat,
polished surface. The margin line should appear as a regular line with a sharp edge .
Cervical margin before (a) and after (b)
polishing.
Endo Crown :
Preparation
17. Endo-Crown
Preparation Method
• Preparation of the cavity floor
The entrance to the pulpal canal is opened. Gutta percha is removed to a depth not
exceeding 2 mm to take advantage of the saddle-like anatomy of the cavity floor. This
should be done with a nonabrasive instrument to maintain the integrity of the canals
entrance. No drilling of dentin is carried out.
• Cleaning of pulp chamber
Ultrasound is recommended to clean the pulp chamber and its floor thoroughly.
Abrasion is not indicated.
Endo Crown :
Preparation
18. Endo-Crown
Preparation Method
Endo Crown :
Preparation
• Bonding
Adhesives such as self-adhesive RelyX Unicem (3M, St. Paul, Minn.) or composites
such as Multilink (Ivoclar, Schaan, Liechtenstein) are used for bonding the endocrown
to the prepared tooth
Prepared tooth (a), endocrown (b) and final result after bonding (c).
19. Endo-Crown
Discussion
Endo Crown :
Discussion
• Longevity and Effectiveness
Several studies concluded that endocrowns were more resistant to compressive
forces than conventional crowns
More recently, finite element analysis highlighted the role of endocrowns in stress
distribution
• Choice of Materials
Glass-ceramic has the advantages of biocompatibility and biomimicry, and its wear
coefficient is close to that of the natural tooth. In addition, the single interface of a 1-
piece restoration enhances cohesion