Adaptive and Dynamic Endocrown Rehabilitation for Endodontically Treated Teeth: Report of Two Clinical Cases

Ethical ConsiderationsThe procedures conformed to the ethical principles of the Declaration of Helsinki.Written informed consent was obtained from both patients for treatment and for the use of clinical and radiographic data for publication. Case DesCription Case IThe patient reported no parafunctional habits such as bruxism or clenching, and the occlusal scheme was mutually protected.A 38-year-old female patient presented with difficulty in chewing due to extensive coronal tooth structure loss in the lower right posterior region.The patient had undergone root canal treatment 15 days earlier.Clinical examination of tooth 47 revealed severe coronal destruction with thin remaining walls; the tooth was asymptomatic introDuCtionThe clinical success of endodontically treated teeth largely depends on the quality of the postendodontic restoration, which should preserve remaining tooth structure while restoring func tion and esthetics. 1Minimally invasive preparation is essential to maximize tissue conservation. 1 Although cast post-and-core systems were once considered the standard of care, studies have shown they do not consistently outperform other post systems and require multiple appointments, laboratory procedures, and increased cost, contributing to their reduced use. 2 Advances in adhesive dentistry have further challenged the traditional need for postand-core restorations in devitalized teeth. 2 Adhesive indirect restorations, including inlays, overlays, and endocrowns, have gained popularity as conservative alternatives to full-coverage crowns. [2]3][4] First introduced by Bindl and Mörmann, endocrowns offer simplified preparation, reduced clinical time, fewer patient visits, and excellent esthetics. 3,4 Biacchi and Basting demonstrated higher resistance to compressive forces in Emax endocrowns compared to conventional crowns supported by fiber posts. 5 Additionally, in vitro and finite element studies suggest that endocrowns can reduce coronal microleakage and favor a more favorable stress distribution compared with some post-and-core-supported restorations, which may support long-term endodontic success; however, most of this evidence is laboratory-based and should be interpreted with caution. 3,4 When sufficient tooth structure remains, endocrowns represent a clinically useful alternative to full-coverage crowns, particularly in teeth with reduced crown height, as suggested by available clinical and in vitro data. 3,