Clinical Evaluation of Endocrown and Overlay Restorations

Overview

Observational Study The goal of this observational study is to evaluate the clinical performance and patient satisfaction of endodontically treated teeth restored with endocrown and overlay restorations using feldspathic ceramic blocks over a 2 to 4-year period. The main questions this study aims to answer are: What are the survival rates of endocrown and overlay restorations in posterior teeth after 2 to 4 years? Are there differences in biological and mechanical failure rates between endocrown and overlay restorations? How do the cemented surface areas correlate with clinical outcomes? Participants who previously received endocrown or overlay restorations will undergo a clinical evaluation, including radiographic imaging, to assess secondary caries and restoration integrity. They will also rate their satisfaction with their restorations through a standardized survey. Retrospective STL file analysis will be used to measure cemented surface areas of the restorations.

This retrospective observational study aims to evaluate the clinical performance and patient satisfaction of endocrowns and overlay restorations fabricated from feldspathic ceramic CAD/CAM blocks over a period of 2 to 4 years. The study involves patients treated exclusively at the Private Ortoperio Dental Clinic in Kayseri, Turkey. Endocrowns and overlays are widely used for restoring structurally compromised teeth. Endocrowns provide macro-retention by utilizing the pulp chamber and micro-retention through adhesive cementation, making them particularly suitable for endodontically treated teeth with limited crown height or narrow interocclusal spaces. Overlays, on the other hand, provide minimally invasive coverage while preserving the underlying tooth structure. Despite their popularity, long-term clinical data for these restorations remain limited. The study will include 39 patients, aged between 18 and 75, who previously received endocrown or overlay restorations. Eligible participants must have functioning restorations placed at least 2 years prior, with records of digital impressions (STL files) archived at the clinic. Restorations will be evaluated using modified FDI criteria to assess aesthetic, functional, and biological outcomes. The criteria for failure include ceramic fractures, loosening, dislodgment, secondary caries, and periodontal issues. Patient satisfaction will also be measured using a Likert scale questionnaire. Digital impressions of the cemented teeth will be analyzed using Materialise 3-matic software to calculate cemented surface areas. Additionally, the oral hygiene of participants will be assessed using the plaque index, and the mean plaque index score will be calculated for each patient. Statistical analyses will be conducted to determine potential factors affecting clinical outcomes, with methods to be determined based on data characteristics. This study seeks to fill gaps in the literature by providing robust data on the survival rates and failure mechanisms of feldspathic ceramic endocrown and overlay restorations. Results are expected to guide clinicians in material selection and application techniques for achieving optimal outcomes in similar cases.