Comparative clinical evaluation of the quality of prosthodontic treatment of molars using CAD/CAM endocrowns with the chairside technique

Introduction. Restoration of endodontically treated posterior teeth remains one of the most challenging tasks in prosthodontics due to the high risk of tooth fracture and restoration failure. In recent years, CAD/CAM endocrowns have attracted considerable interest as a minimally invasive alternative to conventional post-and-core restorations. The active implementation of chairside technology, along with the development of new ceramic materials, including advanced lithium disilicate and multilayer zirconia, necessitates clinical evaluation of their effectiveness, including under conventional and speed sintering protocols. Aim. To perform a comparative clinical evaluation of the quality of prosthodontic treatment of endodontically treated molars restored with CAD/CAM endocrowns fabricated from advanced lithium disilicate and multilayer zirconia using the chairside technique under different sintering protocols. Materials and methods. A prospective clinical study with dynamic follow-up over a 2-year period was conducted in 30 patients who received single endocrown restorations on endodontically treated molars. Three groups were formed: endocrowns fabricated from advanced lithium disilicate CEREC Tessera (speed firing), endocrowns fabricated from multilayer zirconia Ziceram ML CT (speed sintering), and a control group of endocrowns fabricated from Ziceram ML CT using conventional sintering. All restorations were fabricated using CAD/CAM chairside technology and adhesively luted. Clinical evaluation was performed using modified FDI criteria, including assessment of esthetic, functional, and biological parameters immediately after cementation and at 1, 2, 6, 12, 18, and 24 months. Results. All groups demonstrated a high level of clinical success at all follow-up periods. No cases of loss of retention, chipping, fracture of the restorations, or complications involving hard dental tissues or periodontal structures were recorded. No statistically significant differences were observed among the groups with respect to esthetic, functional, or biological criteria. All patients reported satisfaction with the treatment outcomes. The overall clinical success rate was 100%. Conclusions. The results of the present study indicate that CAD/CAM endocrowns fabricated from multilayer zirconia Ziceram ML CT and advanced lithium disilicate CEREC Tessera provide comparably high clinical effectiveness in the restoration of endodontically treated posterior teeth. The use of a speed sintering protocol for zirconia did not adversely affect the clinical performance of the restorations compared with the conventional sintering protocol. These findings support the feasibility of chairside technology and contemporary ceramic materials in routine clinical practice; however, further long-term clinical studies are required.

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