Clinical and radiographic outcomes of endocrowns fabricated from two different CAD-CAM materials versus stainless steel crowns in restoring first permanent molars in children: a randomized clinical trial
Résumé
BACKGROUND: Restoring first permanent molars after endodontic treatment in children is challenging. Improved mechanical properties and adhesion of ceramic materials have led to the emergence of endocrown as a conservative and esthetic restorative option for endodontically treated molars in adults and offer dentists a restorative treatment for endodontically treated first permanent molars in children. The purpose of this study was clinical and radiographic evaluation of both endocrowns fabricated from 2 different materials and SSCs restoring endodontically treated first permenant molars in children over one year. METHODS: Thirty children were selected (18 girls and 12 boys) with an age range of 10-13 years old, with an endodontically treated first molar. Children were randomly divided into 3 groups: PMC group (restored with preformed SSCs), EMX group (restored with litium disilicate endocrown), and COP group (restored with indirect reinforced composite endocrown) (n = 10). Evaluation was done in terms of parent satisfaction, radiograph (base line and 12 months), the restoration survival after 12 months, plaque index (PI), and gingival index (GI) at base line, 6 months, and 12 months.The data were analyzed using the Kruskal-Wallis H-test, which was used to compare an ordinal variable, and Friedman's test was used to compare an ordinal variable (P ≤.050). RESULTS: Parent satisfaction showed statistically significant differences between PMC (mean rank = 7.5) and both EMX and COP (mean rank = 19.5) (P <.001), but not between the EMX and COP groups (P = 1.00). At 6 and 12 months, the PMC group's PI values were statistically significantly higher than those of the EMX and COP groups (P =.001 and P <.001, respectively). The GI values of the EMX and COP groups did not change significantly through different intervals (P = 1.000 and P =.135, respectively), whereas the GI values of the PMC group did (P =.050). At various intervals, it was found that there was no significant difference in the GI values between the three groups. CONCLUSIONS: The survival rates of endorowns and SSCs were comparable. Compared to SSCs, endocrowns demonstrated a higher parental satisfaction, less plaque buildup, and improved gingival response. TRIAL REGISTRATION: The study protocol was retrospectively registered on Clinical Trials under No. (NCT06432049-29/05/2024).
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