medalphabetМедицинский алфавитMedical alphabet2078-56312949-2807ООО «Альфмед»10.33667/2078-5631-2025-1-50-56medalphabet-4193Research ArticleСтатьиЭндокоронка, как альтернативный способ восстановления коронковой части зуба. Обзор литературыEndocrown as an alternative method of restoring the crown part of the tooth. Literature reviewhttps://orcid.org/0009-0001-9502-2397ГукН. О.GukN. O.

Гук Никита Октавианович, аспирант кафедры ортопедической стоматологии

Москва

Guk Nikita Octavianovich, postgraduate student of the Department of Orthopedic Dentistry

Moscow

dr.guknikita@yandex.ruhttps://orcid.org/0000-0003-0437-1290СавельевВ. В.SavelievV. V.

Савельев Василий Владимирович, к.м.н. кафедры ортопедической стоматологии

Москва

Saveliev Vasily Vladimirovich, Candidate of Medical Sciences of the Department of Orthopedic Dentistry

Moscow

bazilsav@gmail.comhttps://orcid.org/0000-0002-4050-484XЛебеденкоИ. Ю.LebedenkoI. Y.

Лебеденко Игорь Юльевич, д.м.н., профессор, заведующий кафедрой ортопедической стоматологии

Москва

Lebedenko Igor Yulievich, MD, Professor, Head of the Department of Orthopedic Dentistry

Moscow

lebedenkoi@mail.ruhttps://orcid.org/0000-0003-4048-4057РетинскаяМ. В.RetinskayaM. V.

Ретинская Марина Владимировна, к.м.н., доцент кафедры ортопедической стоматологии

Москва

Retinskaya Marina Vladimirovna, Candidate of Medical Sciences, Associate Professor of the Department of Orthopedic Dentistry

Moscow

mvretinskaya@mail.ruФГАОУ ВО «Российский университет дружбы народов им. Патриса Лумумбы»РоссияPeoples’ Friendship University of Russia named after Patrice LumumbaRussian Federation20252802202501Стоматология (1)5056Copyright © Гук Н.О., Савельев В.В., Лебеденко И.Ю., Ретинская М.В., 20252025Гук Н.О., Савельев В.В., Лебеденко И.Ю., Ретинская М.В.Guk N.O., Saveliev V.V., Lebedenko I.Y., Retinskaya M.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-alphabet.com/jour/article/view/4193

Распространенность осложнений кариеса высока, что делает эндодонтическое лечение актуальным, хотя оно снижает прочность зуба. Прогноз эндодонтически леченых зубов благоприятный при качественном лечении и реставрации, где важен перицервикальный дентин. Композиты подходят для небольших полостей, однако уступают эмали по прочности. Для моляров часто используют штифты, но их выбор требует осторожности из-за риска ослабления корня и трещин. Важно избегать избыточного препарирования корня, сохраняя его структуру. Применение штифтов должно быть обосновано, особенно при коротких/хрупких корнях или облитерированных каналах. Эндокоронка – минимально инвазивная реставрация для эндодонтически леченных зубов, восстанавливающая анатомическую коронку, заполняя пульповую камеру. Показана при значительной потере тканей и ограниченном пространстве. Успешность – 94–100% в течение 36 месяцев. Основное осложнение – дебондинг (71%). Меньше переломов корня по сравнению с коронками (6% против 29%). В стоматологии используют композиты, керамику и полимерно-инфильтрованную керамическую сеть (PICN). PICN сочетает прочность керамики и модуль упругости композита, подходит для жевательных зубов. Дисиликат лития (LS2) обрабатывается CAD-CAM, после нагрева становится прочнее и в итоге устойчив к разрушению. PICN по твердости ближе к эмали, чем LS2 и диоксид циркоия (ZrO2), но LS2 больше изнашивает эмаль, в отличие от последнего. ZrO2 стабилизируют иттрием для улучшения свойств. Российское предприятие ЦирконКерамика производит многослойные заготовки Ziceram. Исследования показывают, что российская керамика на основе диоксида циркония превосходит китайский аналог по прочности. Двухлетние наблюдения за коронками из «Ziceram T» показали их высокую прочность, гигиеничность и биосовместимость. Отечественный диоксид циркония оправдан для CAD/CAM конструкций боковых зубов, но мало изучен, особенно для эндокоронок. Модификация поверхности диоксида циркония улучшает адгезию. Методы повышения адгезии делятся на: механические (пескоструйная обработка, кислотное травление), химические (10-MDP) и комбинированные (протокол «APC»: пескоструйка, праймер MDP, фиксация). Клинические исследования показывают высокий процент выживаемости эндокоронок из диоксида циркония, хотя исследования редки и непродолжительны. CAD/CAM система в рамках технологии «chairside» позволяет изготавливать реставрации быстро, в том числе из новых материалов, таких как CEREC Tessera (дисиликат лития с виргилитом). Использование отечественных керамических материалов и изучение экспресс-режимов их синтеризации актуально для импортозамещения.

The prevalence of caries complications is high, which makes endodontic treatment relevant, although it reduces tooth strength. The prognosis of endodontically treated teeth is favorable with quality treatment and restoration, where pericervical dentin is important. Composites are suitable for small cavities, but are inferior to enamel in terms of strength. For molars, posts are often used, but their choice requires caution due to the risk of root weakening and cracking. It is important to avoid excessive root preparation while preserving the root structure. The use of posts should be justified, especially in short/fragile roots or obliterated canals. Endocoronca is a minimally invasive restoration for endodontically treated teeth that restores the anatomical crown by filling the pulp chamber. It is indicated in cases of significant tissue loss and limited space. Success rate is 94–100% within 36 months. The main complication is debonding (71%). Fewer root fractures compared to crowns (6% vs. 29%). Composites, ceramics, and polymer-infused ceramic network (PICN) are used in dentistry. PICN combines the strength of ceramics with the elastic modulus of a composite, and is suitable for chewing teeth. Lithium disilicate (LS2) is processed by CAD-CAM, becomes stronger after heating and is ultimately fracture resistant. PICN is closer to enamel in hardness than LS2 and zirconium dioxide (ZrO2), but LS2 wears down enamel more, unlike the latter. ZrO2 is stabilized with yttrium to improve properties. The Russian company ZirconCeramics produces Ziceram multilayer blanks. Studies show that Russian zirconium dioxidebased ceramics are superior to their Chinese counterpart in terms of strength. Two-year observations of crowns made of Ziceram T have shown their high strength, hygiene and biocompatibility. Domestic zirconia is justified for CAD/CAM designs of lateral teeth, but is poorly studied, especially for endocrowns. Surface modification of zirconia improves adhesion. Methods to improve adhesion are divided into: mechanical (sandblasting, acid etching), chemical (10-MDP) and combined (APC protocol: sandblasting, MDP primer, fixation). Clinical studies show a high survival rate for zirconia endocoronets, although studies are rare and short in duration. The CAD/CAM system within the “chairside” technology makes it possible to fabricate restorations quickly, including with new materials such as CEREC Tessera (lithium disilicate with virgilite). The use of domestic ceramic materials and the study of express modes of their syntherization are relevant for import substitution.

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The authors declare that there are no conflicts of interest present.