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<p><b>Introduction</b> Endocrowns are increasingly used as alternatives to traditional post-and-core crowns due to their bonding and aesthetic advantages. However, inconsistent clinical outcomes and varying materials and protocols create uncertainty regarding their optimal use, necessitating a systematic review to clarify their properties.</p><p><b>Purpose</b> This review assesses the mechanical properties of anterior endocrown restorations compared to traditional crowns with intracanal posts, such as zirconia and fibre posts. It evaluates different endocrown designs regarding material and ferrule effect, focusing on fracture resistance, marginal adaptation, and pull-out bond strength to inform clinical decision-making.</p><p><b>Methods and materials</b> Following PRISMA guidelines, a comprehensive search of PubMed, Cochrane Library for Cochrane Reviews, Web of Science, Scopus, and Google Scholar was conducted. Studies were included if they assessed the biomechanical behaviour of anterior endocrowns with or without post-and-core comparators. Posterior teeth studies, finite element analyses, animal studies, reviews, and clinical trials were excluded. Of 72 studies identified, 16 met the inclusion criteria. Data were extracted using a standardised form, and risk of bias was assessed with the ROBINS-I tool.</p><p><b>Results</b> In total, 16 <i>in vitro</i> studies were analysed. Most studies indicated that endocrowns demonstrate comparable fracture resistance to post-and-core systems, although marginal adaptation varied. A 2 mm ferrule significantly improved the prognosis.</p><p><b>Conclusion</b> Endocrown restorations for anterior teeth may serve as a viable alternative to post-and-core treatments. Further clinical studies are needed to clarify discrepancies in fracture strength and adaptation and assess long-term success.</p>

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Fracture resistance and microleakage of anterior endocrowns: a systematic review of in vitro studies

  • 期刊论文

  • 发表日期：

    2025年10月21日

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  • AmirTaher Mirmortazavi,
  • Nazanin Salmani,
  • Iman Shiezadeh,
  • Ghazal Asadi,
  • Mina Ahmadi

摘要

Introduction Endocrowns are increasingly used as alternatives to traditional post-and-core crowns due to their bonding and aesthetic advantages. However, inconsistent clinical outcomes and varying materials and protocols create uncertainty regarding their optimal use, necessitating a systematic review to clarify their properties.

Purpose This review assesses the mechanical properties of anterior endocrown restorations compared to traditional crowns with intracanal posts, such as zirconia and fibre posts. It evaluates different endocrown designs regarding material and ferrule effect, focusing on fracture resistance, marginal adaptation, and pull-out bond strength to inform clinical decision-making.

Methods and materials Following PRISMA guidelines, a comprehensive search of PubMed, Cochrane Library for Cochrane Reviews, Web of Science, Scopus, and Google Scholar was conducted. Studies were included if they assessed the biomechanical behaviour of anterior endocrowns with or without post-and-core comparators. Posterior teeth studies, finite element analyses, animal studies, reviews, and clinical trials were excluded. Of 72 studies identified, 16 met the inclusion criteria. Data were extracted using a standardised form, and risk of bias was assessed with the ROBINS-I tool.

Results In total, 16 in vitro studies were analysed. Most studies indicated that endocrowns demonstrate comparable fracture resistance to post-and-core systems, although marginal adaptation varied. A 2 mm ferrule significantly improved the prognosis.

Conclusion Endocrown restorations for anterior teeth may serve as a viable alternative to post-and-core treatments. Further clinical studies are needed to clarify discrepancies in fracture strength and adaptation and assess long-term success.