Clinical and radiological judgment of endodontic treatments for endocrown rehabilitation: meta-analysis

Abstract

Introduction: Endodontics focuses on diagnosing and treating pulp and periapical tissue diseases by cleaning microorganisms and shaping the canal for proper sealing. An accurate diagnosis is essential for selecting the rehabilitation that restores the functionality and aesthetics of the tooth. After treatment, it is crucial to assess structural loss to choose the appropriate rehabilitation. While posts were traditionally used, they can cause root fractures due to poor force distribution, especially in molars and premolars. As an alternative, endocrowns are proposed for more effective post-endodontic rehabilitation. Objective: To establish the clinical and radiological criteria for endodontic treatments for endocrowns through a meta-analysis. Methodology: An exhaustive systematic review was conducted across various databases such as PubMed, Scielo, Scopus, and Web of Science, among others. Data was compiled using Microsoft Office Excel 2016 for standardization. The studies were tabulated with the following data: Author, year of publication, abstract, introduction, methods, results, discussion, and other information, in accordance with the PRISMA and Modified CONSORT statements. The analyzed articles were evaluated based on the Cochrane guidelines, focusing on selection bias, performance bias, detection bias, and incomplete data bias. Results: The observed standardized mean differences ranged from 0.0273 to 1.4852, with most estimates being positive. The average standardized mean difference estimated using a random effects model was μ^=0.6425\hat{\mu} = 0.6425μ^​=0.6425 (95% CI: 0.0496 to 1.2354). Therefore, the average result differed significantly from zero (z = 2.1239, p = 0.0337). The Q test for heterogeneity was not significant, but there may still be some heterogeneity in the true results (Q (4) = 8.5752, p = 0.0726, tau² = 0.2431, I² = 53.6752%). Conclusion: It was concluded that there is no statistically significant difference between endocrown restoration and conservative treatment from the perspective of established endodontic criteria.