Restor Dent Endod.  2021 May;46(2):e29. 10.5395/rde.2021.46.e29.

Retrospective study of fracture survival in endodontically treated molars: the effect of single-unit crowns versus direct-resin composite restorations

• Chotvorrarak K
• Suksaphar W
• Banomyong D

• KMID: 2548073
• DOI: http://doi.org/10.5395/rde.2021.46.e29

Abstract

Objectives
This study was conducted to compare the post-fracture survival rate of endodontically treated molar endodontically treated teeth (molar ETT) restored with resin composites or crowns and to identify potential risk factors, using a retrospective cohort design.
Materials and Methods
Dental records of molar ETT with crowns or composite restorations (recall period, 2015–2019) were collected based on inclusion and exclusion criteria. The incidence of unrestorable fractures was identified, and molar ETT were classified according to survival. Information on potential risk factors was collected. Survival rates and potential risk factors were analyzed using the Kaplan-Meier log-rank test and Cox regression model.
Results
The overall survival rate of molar ETT was 87% (mean recall period, 31.73 ± 17.56 months). The survival rates of molar ETT restored with composites and crowns were 81.6% and 92.7%, reflecting a significant difference (p < 0.05). However, ETT restored with composites showed a 100% survival rate if only 1 surface was lost, which was comparable to the survival rate of ETT with crowns. The survival rates of ETT with composites and crowns were significantly different (97.6% vs. 83.7%) in the short-term (12–24 months), but not in the long-term (> 24 months) (87.8% vs. 79.5%).
Conclusions
The survival rate from fracture was higher for molar ETT restored with crowns was higher than for ETT restored with composites, especially in the first 2 years after restoration. Molar ETT with limited tooth structure loss only on the occlusal surface could be successfully restored with composite restorations.

Keyword

Crowns; Endodontically treated teeth; Resin composite; Survival rate; Tooth fractures

Figure

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  Figure 1 An overview of the methodology in this retrospective study of fracture survival in molar endoscopically treated teeth (ETT) restored with crowns or resin composite restorations.

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  Figure 2 Kaplan-Meier survival analysis of molar endoscopically treated teeth (ETT) according to the 2 different coronal restoration types. The 5-year overall survival rates of molar ETT restored with full-coverage crowns and resin composites were 92.7% and 81.6%, respectively, and a significant difference was demonstrated (p < 0.05). The survival rates of molar ETT with resin composites and crowns were significantly different (97.6% vs. 83.7%) in the short-term period (12–24 months). The long-term survival rates (24–60 months) were not significantly different between the 2 restoration types (87.8% vs. 79.5%).

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  Figure 3 Kaplan-Meier survival analysis of molar endoscopically treated teeth (ETT) restored with resin composite restorations according to the different amounts of tooth structure losses, in comparison to ETT restored with full-coverage crowns. The survival rates from fracture of molar ETT restored with resin composites with 1–4 surfaces lost and crowns were 100%, 79.2%, 78.3%, 85.7%, and 92.7%, respectively. In comparison to ETT with crowns, a significant difference was shown for ETT restored with resin composites that had 2- or 3-surface loss (p < 0.05).

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