One-piece endodontic crowns in posterior teeth: An overview of systematic reviews.

IF 4.3 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Journal of Prosthetic Dentistry Pub Date : 2024-10-08 DOI:10.1016/j.prosdent.2024.09.001
Susana Morimoto, Yuri Arakaki, Daniela P Raggio, Mutlu Özcan
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Abstract

Statement of problem: The outcome of posterior nonvital teeth depends not only on endodontic factors but also on the effectiveness of the restoration. The growing trend in minimally invasive dentistry has led to increasing interest in 1-piece endodontic crowns as an alternative restoration. Nevertheless, their indications and longevity lack extensive exploration, thereby limiting their widespread acceptance in dental practice.

Purpose: The purpose of this overview was to synthesize the available evidence from systematic reviews (SRs) about 1-piece endodontic crowns and to identify clinical outcomes such as survival, success rates, and patient-reported outcome measures (PROMs).

Material and methods: A systematic search was performed in the electronic databases MEDLINE/PubMed, Cochrane, Web of Science, and OpenGrey, as well as a manual search, up to June 2024, with no language or time restriction. SRs that addressed clinical studies related to 1-piece endodontic crowns or endocrowns were included. The risk of bias and methodological quality was measured using the ROBIS and AMSTAR-2 tools, respectively.

Results: The search identified 468 articles, of which 9 SRs were included. The best evidence reported in the SRs was that survival or success rates for ceramic and indirect resin 1-piece endodontic crowns were high at 5 years, similar to those for conventional crowns. Loss of retention was the main cause of failure with similar failure rates for molars and premolars. Evidence for the use of zirconia and metal 1-piece endodontic crowns is limited, and no SR was found that addressed PROMs. Methodological quality was considered low or critically low in most SRs. However, the risk of bias was low for 2 of the 3 SRs that provided the best evidence in the meta-analysis for ceramic and indirect resin 1-piece endodontic crowns. Overlap in the included studies was very high.

Conclusions: Although the evidence generated by multiple RS only determined that ceramic and indirect resin 1-piece endodontic crowns can be a suitable and reliable option for restoring endodontically treated premolars and molars, with high success and survival rates comparable with those of complete crowns with posts, this overview concluded that it was not possible to provide firm conclusions regarding the outcomes of 1-piece endodontic crowns because of the lack of adequate high-quality primary studies with different materials, heterogenicity of the studies, variations in follow-up, preparation, and operative steps, and very high overlap of studies. Thus, additional well-designed clinical trials are necessary rather than SRs to strengthen the evidence in this area.

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后牙的一片式根管治疗冠:系统回顾综述。
问题陈述:后牙非重要牙齿的治疗效果不仅取决于牙髓病因素,还取决于修复的有效性。随着微创牙科技术的不断发展,单件式牙髓修复冠作为一种替代修复方法越来越受到人们的关注。目的:本综述的目的是综合系统综述(SR)中关于一片式牙髓冠的现有证据,并确定临床结果,如存活率、成功率和患者报告的结果测量(PROMs):在电子数据库 MEDLINE/PubMed、Cochrane、Web of Science 和 OpenGrey 中进行了系统检索,并在 2024 年 6 月前进行了人工检索,没有语言或时间限制。涉及与一片式根管治疗冠或根管治疗冠相关的临床研究的 SR 均被纳入。分别使用 ROBIS 和 AMSTAR-2 工具测量了偏倚风险和方法学质量:结果:此次检索共发现 468 篇文章,其中纳入了 9 篇参考文献。研究报告中报告的最佳证据是陶瓷和间接树脂单件式牙髓冠在 5 年后的存活率或成功率较高,与传统牙冠的存活率或成功率相似。固位丧失是失败的主要原因,臼齿和前臼齿的失败率相似。使用氧化锆和金属单件式牙髓冠的证据有限,而且没有发现针对PROMs的研究结果。大多数研究的方法学质量被认为较低或极低。然而,在荟萃分析中为陶瓷和间接树脂单件式根管治疗冠提供最佳证据的 3 项研究中,有 2 项研究的偏倚风险较低。纳入研究的重叠率非常高:尽管由多个RS产生的证据仅确定陶瓷和间接树脂一片式牙髓冠可以作为修复牙髓治疗的前磨牙和磨牙的一种合适而可靠的选择,其成功率和存活率都很高,可与带桩的全冠相媲美,但本综述认为,由于缺乏足够的使用不同材料的高质量原始研究,研究的异质性,随访、准备和手术步骤的差异,以及研究的高度重叠,因此不可能就一片式牙髓冠的结果给出确定的结论。因此,有必要进行更多设计良好的临床试验而不是SR来加强这方面的证据。
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来源期刊
Journal of Prosthetic Dentistry
Journal of Prosthetic Dentistry 医学-牙科与口腔外科
CiteScore
7.00
自引率
13.00%
发文量
599
审稿时长
69 days
期刊介绍: The Journal of Prosthetic Dentistry is the leading professional journal devoted exclusively to prosthetic and restorative dentistry. The Journal is the official publication for 24 leading U.S. international prosthodontic organizations. The monthly publication features timely, original peer-reviewed articles on the newest techniques, dental materials, and research findings. The Journal serves prosthodontists and dentists in advanced practice, and features color photos that illustrate many step-by-step procedures. The Journal of Prosthetic Dentistry is included in Index Medicus and CINAHL.
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