Everything About Endocrowns

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In this episode of DentCast, in line with the minimally invasive dentistry approach, we look at an appealing restoration called the endocrown. This review is based on a foundational, highly-cited paper from 2013.

Why an Endocrown?

The main goal of this restoration is to avoid using a post and entering the root canals. Placing a post in the canal weakens the root; an endocrown, however, is a monolithic (one-piece) restoration that sits on a butt-joint margin and draws retention only from the pulp chamber space. With advances in ceramics and bonding systems, this approach has become an excellent alternative to the old post-and-crown restorations.

Preparation Principles

• Occlusal reduction: the minimum thickness required for the restoration is 2 mm, to provide adequate strength.
• Axial preparation: the internal cavity walls are prepared with a tapered bur at a 7-degree convergence angle. Cavity depth must never be less than 3 mm.
• Cervical margin: this edge must be fully polished, its sharp edges rounded, and it should preferably be supragingival. Enamel thickness in this area must not be less than 2 mm. If the margin is not level, the connecting slope must not exceed 60 degrees.
• Pulp chamber floor: never touch the pulp chamber floor! Only remove gutta-percha from the canal entrances down to a depth of at most 2 mm. An ultrasonic unit is used for final cleaning of the cavity.

Indications and Contraindications

• Indications: the best option for molar teeth (though it is also used, with some disagreement, for premolars and maxillary anterior teeth).
• Contraindications: the endocrown should not be used when good isolation and bonding cannot be assured, when cavity depth is less than 3 mm, or when the cervical margin width is less than 2 mm.

Key Clinical Note

For cementing endocrowns, using bonding systems together with dual-cure cements — rather than self-adhesive cements — is recommended for better retention and stability.

The content of this page is intended for the educational use of dentists and dental students.