Coroas unitárias versus resinas diretas em dentes tratados endodonticamente: um estudo prospectivo de até 7 anos

Abstract

Endodontically treated teeth may present loss of coronal structure due to endodontic procedures. After root canal treatment, the dentist may choose direct (composite resin) or indirect restorations (single crown) to rehabilitate tooth’s form and function, being this choice dependent of remaining walls mostly. However there is scarce evidence about what could be the best restorative approach considering survival and success of treatments. Seventy-three endodontically treated teeth with at least one remaining wall received a glass fiber post and were randomly allocated in two groups according type of restoration: composite resin or metal-ceramic crown. Teeth were assessed by clinic and radiographic examination and the differences between baseline and last visit were noted. For each crown and restoration time in months was taken for failed restorations and time of survival for the rest. Thirty-nine teeth received composite resin restorations and thirty-four metal-ceramic crowns. Descriptive analysis was performed using FDI clinical criteria and survival of restorations/teeth analyzed using Kaplan-Meier statistics and log-rank tests (p<0.05). The recall rate was 78.3% and follow-up time ranged between 12 and 76 months. Fifty-nine patients and seventy-three teeth were assessed with a survival rate of 97% for crowns and 89.7% for composite restorations. Log rank test did not present significant differences between survival of restorations (p=0,112). However, a statistically significant difference was found between success of restorations (p<0,001). Twenty-three failures were found, five failures were considered absolute, from these, three were completely replaced and the other two indicated for extraction (root fractures). After 76 months of follow-up, all restorations presented good clinical performance with no difference between survival of restorations, irrespective the restorative material used.