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Evaluating the Failure Rates of Dental Crowns on Endodontically Treated Teeth: A Comprehensive Review of Contributing Factors and Clinical Outcomes
1 , 2 , 2 , * 3 , 1 , * 4
1  School of Dentistry, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via Consolare Valeria, 1, 98125 Messina, Italy
2  School of Dentistry, University of Sassari, 07100 Sassari, Italy
3  Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, 98100 Messina, Italy.
4  University of Messina, Italy
Academic Editor: Takahito Ohshiro

Abstract:

A comprehensive review of the literature was conducted, focusing on clinical studies, retrospective analyses, and systematic reviews that reported the failure rates of crowns placed on endodontically treated teeth. Factors such as the type of crown material, quality of root canal treatment, crown-to-root ratio, occlusal forces, and the presence of residual tooth structure were examined. Data were synthesized to identify common patterns and potential predictors of failure. This review revealed that the failure rates of crowns on endodontically treated teeth vary widely, with mechanical failures such as crown dislodgement, fractures, and secondary caries being the most prevalent. Factors such as inadequate root canal obturation, poor crown fit, insufficient ferrule effect, and high occlusal stress were strongly associated with increased failure rates. Additionally, the use of certain crown materials, such as metal–ceramic and all-ceramic crowns, showed different performance outcomes based on the clinical scenario. The success of crown restorations on endodontically treated teeth is highly dependent on multiple factors, including the quality of endodontic treatment, crown design, material selection, and proper case management. To reduce failure rates, clinicians should focus on ensuring optimal root canal therapy, using appropriate crown materials, and adhering to principles such as achieving a sufficient ferrule. Continued research and advances in dental materials and techniques are essential to further enhance the outcomes of these rehabilitations.

Keywords: Endodontically treated teeth, dental crowns, failure rates, root canal treatment, crown materials, ferrule effect.
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