Additive vs Subtractive Manufacturing for Endocrown Fabrication: A 24-Month RCT (ENDO-3D)
4. juni 2026 oppdatert av: Dina Ezz, Cairo University
Additive Versus Subtractive Manufacturing for Endocrown Fabrication: A Clinical Comparison of 3D-Printed Ceramic-Filled Photopolymer Resin and CAD/CAM Milled Resin Nano-Ceramics Endocrowns in Posterior Teeth - A 24-Month Randomized Controlled Trial
This randomized controlled trial (RCT) compares the 24-month clinical performance of endocrown restorations fabricated by two digital manufacturing pathways: additive manufacturing using 3D-printed ceramic-filled photopolymer resin (VarseoSmile TriniQ, BEGO) versus subtractive computer-aided design/computer-aided manufacturing (CAD/CAM) milling from hybrid nano-ceramic blocks (HC Hard Block, Shofu).
Sixty endocrowns will be placed in endodontically treated posterior molars and evaluated using modified United States Public Health Service (USPHS) criteria at 6, 12, and 24 months.
The trial is conducted at the Conservative Dentistry Department, Faculty of Dentistry, Cairo University.
Studieoversikt
Status
Har ikke rekruttert ennå
Intervensjon / Behandling
Detaljert beskrivelse
Post-endodontic rehabilitation of extensively damaged posterior molars using endocrowns represents a minimally invasive alternative to conventional crown-plus-post-and-core approaches.
Digital fabrication has advanced both the precision and reproducibility of endocrown manufacture.
While computer-aided design/computer-aided manufacturing (CAD/CAM) milled hybrid ceramic endocrowns are well-validated clinically, prospective clinical data comparing 3D-printed definitive restorations to milled counterparts are absent.
This trial employs a parallel-group, 1:1 randomized design with triple blinding of participants, outcome assessors, and statistician.
All restorations are delivered using Beautilink SA self-adhesive dual-cure resin cement.
The primary outcome is fracture resistance at 24 months; secondary outcomes include retention, marginal adaptation, marginal discoloration, surface texture, anatomic form, color match, secondary caries, fabrication time, and patient satisfaction assessed by Visual Analogue Scale (VAS).
Studietype
Intervensjonell
Registrering (Antatt)
60
Fase
- Ikke aktuelt
Kontakter og plasseringer
Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.
Studiekontakt
- Navn: Dina Ez Mohamed, BDS MSc PhD
- Telefonnummer: 01008007157
- E-post: dina.ezz@dentistry.cu.edu.eg
Studer Kontakt Backup
- Navn: Rawda H Abdelaziz, BDS MSc PhD
- E-post: rawda.hesham@dentistry.cu.edu.eg
Deltakelseskriterier
Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
- Voksen
Tar imot friske frivillige
Nei
Beskrivelse
Inclusion Criteria:
- Age 25-45 years, male or female
- Endodontically treated molar tooth with radiographically confirmed treatment success and no clinical signs of failure
- Sufficient remaining coronal structure for endocrown preparation: minimum three walls, wall thickness 1.5 mm or greater, pulp chamber depth 3 mm or greater, supragingival preparation margins
- Completely erupted tooth with intact periodontal support
- Minimum of 20 occluding teeth
- Satisfactory oral hygiene status
- Capable of providing written informed consent and committed to scheduled follow-up visits
Exclusion Criteria:
- Diagnosed parafunctional habit or nocturnal bruxism
- Uncontrolled systemic illness or physical disability precluding safe participation
- Heavy tobacco use
- Current or suspected pregnancy
- Periapical disease or radiographic signs of endodontic failure
- Evidence of pathological tooth wear or occlusal erosion
- Moderate-to-severe periodontitis or tooth with hopeless prognosis
- Radiographic or clinical evidence of vertical root fracture
- Impaired decision-making capacity or anticipated non-compliance
Studieplan
Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.
Hvordan er studiet utformet?
Designdetaljer
- Primært formål: Behandling
- Tildeling: Randomisert
- Intervensjonsmodell: Parallell tildeling
- Masking: Dobbelt
Våpen og intervensjoner
Deltakergruppe / Arm |
Intervensjon / Behandling |
|---|---|
|
Aktiv komparator: CAD/CAM Milled Endocrown
Endocrown restoration fabricated by subtractive CAD/CAM milling from HC Hard Block hybrid nano-ceramic (Shofu Inc., Japan), designed using ExoCAD software and milled on a five-axis wet-milling unit.
Adhesively cemented using Beautilink SA self-adhesive dual-cure resin cement (Shofu Inc., Japan).
|
Endocrown restoration milled from HC Hard Block hybrid nano-ceramic (Shofu Inc., Japan) using a five-axis wet-milling CAD/CAM unit.
Restoration designed with ExoCAD software, finished and glazed per manufacturer protocol, and cemented with Beautilink SA self-adhesive dual-cure resin cement (Shofu Inc., Japan).
Andre navn:
|
|
Eksperimentell: 3D-Printed Endocrown
Endocrown restoration fabricated by additive manufacturing using VarseoSmile TriniQ ceramic-filled photopolymer resin (BEGO GmbH & Co. KG, Germany), printed on a 4K LCD printer at 30-45 degree build angle, post-cured under nitrogen atmosphere.
Adhesively cemented using Beautilink SA self-adhesive dual-cure resin cement (Shofu Inc., Japan).
|
Endocrown restoration 3D-printed using VarseoSmile TriniQ ceramic-filled photopolymer resin (BEGO GmbH & Co. KG, Germany) on a 4K LCD printer at 30-45 degree build angle.
Post-cured under nitrogen atmosphere, surface glazed, and cemented with Beautilink SA self-adhesive dual-cure resin cement (Shofu Inc., Japan).
Andre navn:
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Hva måler studien?
Primære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
|
Restoration Fracture Resistance
Tidsramme: 24 months
|
Assessed using modified USPHS criteria: Alpha = absence of fracture; Bravo = minor chip amenable to repair; Charlie = catastrophic fracture, unrestorable
|
24 months
|
Sekundære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
|
Retention
Tidsramme: 6, 12, and 24 months
|
Modified USPHS: Alpha = in situ; Bravo = partial displacement; Charlie = complete loss
|
6, 12, and 24 months
|
|
Marginal Discoloration
Tidsramme: 6, 12, and 24 months
|
Modified USPHS: Alpha = absent; Bravo = superficial; Charlie = penetrating
|
6, 12, and 24 months
|
|
Surface Texture
Tidsramme: 6, 12, and 24 months
|
Modified USPHS: Alpha = smooth; Bravo = minor irregularities; Charlie = extensive breakdown
|
6, 12, and 24 months
|
|
Anatomic Form
Tidsramme: 6, 12, and 24 months
|
Modified USPHS: Alpha = conforms to natural contour; Bravo = discrepancy present, dentin intact; Charlie = dentin or base exposed
|
6, 12, and 24 months
|
|
Color Match
Tidsramme: 6, 12, and 24 months
|
Modified USPHS: Alpha = indistinguishable from adjacent tooth; Bravo = minor deviation, clinically acceptable; Charlie = obvious mismatch; Delta = gross color failure
|
6, 12, and 24 months
|
|
Secondary Caries
Tidsramme: 6, 12, and 24 months
|
Modified USPHS: Alpha = absent; Charlie = present
|
6, 12, and 24 months
|
|
Fabrication Time
Tidsramme: Periprocedural
|
Time in minutes from CAD design completion to restoration readiness for cementation
|
Periprocedural
|
|
Patient Satisfaction
Tidsramme: 6, 12, and 24 months
|
Visual Analogue Scale 0-100 mm; 0 = entirely dissatisfied, 100 = entirely satisfied
|
6, 12, and 24 months
|
Samarbeidspartnere og etterforskere
Det er her du vil finne personer og organisasjoner som er involvert i denne studien.
Sponsor
Publikasjoner og nyttige lenker
Den som er ansvarlig for å legge inn informasjon om studien leverer frivillig disse publikasjonene. Disse kan handle om alt relatert til studiet.
Generelle publikasjoner
- Abou-Steit S, Ibrahim SH, Salem M. Three years clinical evaluation of lithium disilicate and hybrid nano-ceramic CAD/CAM endocrowns (randomized clinical trial). Egyptian Dental Journal 2024;70:551-561.
Studierekorddatoer
Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.
Studer hoveddatoer
Studiestart (Antatt)
1. juni 2026
Primær fullføring (Antatt)
1. juni 2028
Studiet fullført (Antatt)
1. september 2028
Datoer for studieregistrering
Først innsendt
30. mai 2026
Først innsendt som oppfylte QC-kriteriene
4. juni 2026
Først lagt ut (Faktiske)
8. juni 2026
Oppdateringer av studieposter
Sist oppdatering lagt ut (Faktiske)
8. juni 2026
Siste oppdatering sendt inn som oppfylte QC-kriteriene
4. juni 2026
Sist bekreftet
1. juni 2026
Mer informasjon
Begreper knyttet til denne studien
Ytterligere relevante MeSH-vilkår
Andre studie-ID-numre
- /4/26 3D-Printed vs CAD/CAM
Plan for individuelle deltakerdata (IPD)
Planlegger du å dele individuelle deltakerdata (IPD)?
NEI
Legemiddel- og utstyrsinformasjon, studiedokumenter
Studerer et amerikansk FDA-regulert medikamentprodukt
Nei
Studerer et amerikansk FDA-regulert enhetsprodukt
Nei
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