ENDOCROWN: A SUBSTITUTE APPROACH TO POST AND CORE FOR REHABILITATION OF ENDODONTICALLY TREATED TOOTH

Abstract

Restoration of endodontically treated teeth (ETT) is distinct from root canal treatment although they are mutually dependent in planning, treatment and prognosis. The fabrication of full coverage crowns with or without the use of posts remains the long-established means of restoration of endodontically treated teeth. Despite all the clinical success achieved with intraradicular posts, they have been criticized for removal of sound tissue and risk of root perforation. With the amelioration of adhesive techniques and invention of newer materials, the concept of endocrown has been considered as an alternative and viable method for restoration of root canal treated molars. It is an indirect monoblock restoration aimed to achieve a bonded biomimetic reconstruction. The preparation is simple following minimally invasive principles of adhesive dentistry compared to conventional crowns with post and core. They have the advantage of removing lower amounts of sound tissue compared to other techniques, and with much lower chair time needed. Also, the masticatory stresses received at the tooth/ restoration interface are more properly dissipated along the overall restored tooth structure when endocrowns are placed. The rationale of the preparation was to use surface area available in the pulp chamber to gain stability and retention through adhesive cementation. The supragingival positioning of restorative margins prevents interferences with periodontal tissues. This article highlights a case report where a porcelain fused to metal endocrown is fabricated to effectively manage a grossly mutilated endodontically treated tooth and was followed up for one year.