Endocrowns as Permanent Restorations for Endodontically Treated Permanent Molars in Young Age: Two-Year Follow up

December 8, 2021 updated by: Roqaia Mohammad Alassar, Al-Azhar University

Background: A real challenge faces practitioners in dealing with permanent molars in young patients starting from proper selection of endodontic treatment system till the type of final coronal restoration. For permanent molars in young age patients, which system should be followed to guarantee better performance and enhance the integrity of such weakened teeth? The question most commonly asked.

Purpose: To evaluate two-year clinical performance of endocrowns as permanent restorations for endodontically treated molars in young age.

Study Overview

Detailed Description

Endodontic treatment will be done for all patients using ProTaper Next rotary files and iRoot SP sealer. Then patients were randomly divided into two groups;

Gr 1: Conventional group (CG), the coronal cavity will be restored directly with bulk-fill nanohybrid composite restorations.

Gr 2: Endocrown group (EG), the coronal cavity will be restored with IPS e.max CAD endocrown restorations.

  • First step: Endodontic treatment protocol will be used as the following:

    1. Biomechanical preparation using; 2.6% NaOCl for irrigation, ProTaper Next rotary files for instrumentation and 17% EDTA gel for lubrication.
    2. Obturation of root canal using; ProTaper gutta-percha and iRoot SP sealer.
  • Second step: Endocrown restoration protocol will be used as the following:

    1. Occlusal Butt joint design for Endocrown preparation.
    2. Putty-wash technique for taking impression.
    3. IPS e.max CAD for Endocrown construction.
    4. G-CEM self-adhesive resin cement for Endocrown cementation.
  • Follow up visits: The patients will be recalled every 6 months for evaluation.
  • Evaluation methods:

    • Endodontic treatment evaluation: The outcome will be evaluated clinically and radiographically.
    • Endocrown restoration evaluation: The outcome will be evaluated clinically in terms of; marginal adaptation, marginal discoloration and surface alteration.

Study Type

Interventional

Enrollment (Actual)

10

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

      • Cairo, Egypt
        • Faculty of dental Medicine for girls, Al-AZhar University

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

9 years to 12 years (Child)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  1. Patients were systemic free.
  2. Mature lower permanent first molar needs conventional endodontic treatment.
  3. The remaining coronal tooth structure after endodontic treatment is not less than 50%.
  4. Presence of teeth in opposite arch with normal occlusion.
  5. Absence of para-functional habits.
  6. Supra-gingival margin after preparation.
  7. No known allergies.
  8. Complaint patient (parent/ guardians)

Exclusion Criteria:

  1. Immature lower permanent first molar.
  2. Presence of teeth, whose coronal anatomy does not allow use of rubber dam for optimum bonding.
  3. Lack of cooperation of the patients to perform a postoperative radiograph and use a rubber dam for bonding.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Health Services Research
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: Control Group
ProTaper Next rotary system and iRoot SP sealer will be used for root canal treatment, followed by composite restorations.
ProTaper Next rotary system and iRoot SP sealer with composite restorations.
Experimental: Endocrown Group
ProTaper Next rotary system and iRoot SP sealer will be used for root canal treatment, followed by endocrown restorations.
ProTaper Next rotary system and iRoot SP sealer with endocrown restorations.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in marginal adaptation, discoloration and surface of the restoration.
Time Frame: At 6 months, 12 months, 18 months, and 24 months following application.

Alpha:

No lack of continuity along the margin as observed with the explorer. No pigmentation anywhere on the margin.The surface of the restoration is unaltered.

Bravo:

Evidence of a crevice along the margin, but the explorer cannot penetrate.Pigmentation present but does not penetrate along the margin toward the pulp. The surface of the restoration shows wear, and must be controlled.

Charlie:

Evidence of a crevice along the margin, into which an explorer can penetrate. Requires control, repair or retreatment. Severe pigmentation. The restoration must be removed. The surface of the restoration shows perforations, fractures or significant tear. It must be polished, repaired or retreated.

At 6 months, 12 months, 18 months, and 24 months following application.

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in the Retention Status.
Time Frame: At 6 months, 12 months, 18 months, and 24 months following application.
Debonding or dislodgement of the restoration.
At 6 months, 12 months, 18 months, and 24 months following application.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Investigators

  • Principal Investigator: Roqaia M Alassar, DDS, Fixed Prosthodontist, Faculty of Dental Medicine for Girls, Al-Azhar University
  • Principal Investigator: Heba Abdelkafy, DDS, Endodontist, Faculty of Dental Medicine for Girls, Al-Azhar University
  • Principal Investigator: Eman Abdelraouf, DDS, Pedodontist, Faculty of Dental Medicine for Girls, Al-Azhar University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

October 1, 2019

Primary Completion (Actual)

November 1, 2019

Study Completion (Actual)

November 1, 2021

Study Registration Dates

First Submitted

August 8, 2020

First Submitted That Met QC Criteria

August 11, 2020

First Posted (Actual)

August 13, 2020

Study Record Updates

Last Update Posted (Actual)

December 28, 2021

Last Update Submitted That Met QC Criteria

December 8, 2021

Last Verified

December 1, 2021

More Information

Terms related to this study

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

No

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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