Assessing the survival and fit of crowns provided for premolar and molar teeth which have undergone root canal treatment

ISRCTN ISRCTN69046497
DOI https://doi.org/10.1186/ISRCTN69046497
ClinicalTrials.gov (NCT) Nil known
Clinical Trials Information System (CTIS) Nil known
Integrated Research Application System (IRAS) 325439
Protocol serial number UoL001789
Sponsor University of Liverpool
Funder Investigator initiated and funded
Submission date
14/11/2024
Registration date
27/11/2024
Last edited
04/12/2025
Recruitment status
No longer recruiting
Overall study status
Ongoing
Condition category
Oral Health
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data
Record updated in last year

Plain English summary of protocol

Background and study aims
This study aims to assess whether 3D printed hybrid resin-ceramic restorations perform as well as conventional milled ceramic restorations for teeth that have had root canal treatment. These restorations, such as crowns or onlays, are used to protect and restore the function of treated teeth.

Who can participate?
Patients who are 18 years or older and have had root canal treatment on their premolar or molar teeth can participate. The tooth must require a tooth-colored restoration and be restorable without needing a metal-based restoration.

What does the study involve?
Participants will be randomly assigned to receive either a 3D printed hybrid resin-ceramic restoration or a lithium disilicate restoration. The teeth will be prepared, and the restorations will be made and fitted by postgraduate endodontic students. The study will monitor the performance of these restorations over a year.

What are the possible benefits and risks of participating?
Participants will receive a free restoration for their root-treated tooth, which provides necessary protection. They will also benefit from a year of monitoring, allowing any issues to be addressed. There are no significant risks associated with participating in this study.

Where is the study run from?
The study is being conducted at the Endodontic Department of Liverpool University Dental Hospital (UK).

When is the study starting and how long is it expected to run for?
April 2023 to December 2026.

Who is funding the study?
Investigator initiated and funded

Who is the main contact?
Ahmed Elmatary, ahmede15@liverpool.ac.uk
Prof Fadi Jarad, f.jarad@liverpool.ac.uk

Contact information

Prof Fadi Jarad
Public, Scientific, Principal investigator

Liverpool University Dental Hospital
Liverpool
L3 5PS
United Kingdom

ORCiD logoORCID ID 0000-0002-5485-2706
Phone +44 151 706 2000
Email f.jarad@liverpool.ac.uk

Study information

Primary study designInterventional
Study designInterventional randomised controlled trial
Secondary study designRandomised controlled trial
Study type Participant information sheet
Scientific titleSurvival and clinical performance of indirect restorations provided for root canal treated teeth
Study acronymCROWNS
Study objectivesThe aim of the study is to assess whether 3-D printed hybrid resin-ceramic restorations have the same clinical performance and longevity as conventional milled ceramic restorations
Ethics approval(s)

Approved 13/11/2023, North West - Greater Manchester South Research Ethics Committee (2 Redman Place, Liverpool, E20 1JQ, United Kingdom; +44 2071048065; gmsouth.rec@hra.nhs.uk), ref: 23/NW/0311

Health condition(s) or problem(s) studiedPosterior root canal treated teeth requiring cuspal coverage restorations
InterventionPatients are being randomised, via sealed envelope and a block randomisation method to either the 3-D printed group or the LiDi group. Teeth are then prepared to receive the cuspal coverage restoration and then randomisation occurs. The crowns/onlays are then received back from the lab and cemented if adequate.

The treatment will consist of 3 appointments for each study participant:
Appointment 1: Preparation of the Posterior Endodontically Treated Tooth for the Indirect Restoration (2-3 hours)
Appointment 2 (2-4 weeks later): Fit of the indirect restoration and assessment of the fit using the Modified United States Public Health Service (USPHS) Criteria (45 mins-1 hour).
Appointment 3: 1 year review appointment to assess survival of restoration and USPHS criteria used to score the restoration (30-45 mins).
Intervention typeProcedure/Surgery
Primary outcome measure(s)

‘Survival/Non-Survival of the Restoration’ assessed chairside by 2 examiners at visit 3 (1 year review appt)

Key secondary outcome measure(s)

1. Colour match is measured using USPHS criteria at baseline and 1 year
2. Marginal discolouration is measured using USPHS criteria at baseline and 1 year
3. Secondary caries is measured using USPHS criteria at baseline and 1 year
4. Anatomical form is measured using USPHS criteria at baseline and 1 year
5. Marginal adaptation is measured using USPHS criteria at baseline and 1 year
6. Surface texture is measured using USPHS criteria at baseline and 1 year
7. Fracture is measured using USPHS criteria at baseline and 1 year

Completion date01/12/2026

Eligibility

Participant type(s)Patient, Service user
Age groupMixed
Lower age limit18 Years
Upper age limit110 Years
SexAll
Target sample size at registration80
Total final enrolment82
Key inclusion criteria1. 18+ year old patient requiring cuspal coverage of an indirect restoration
2. Root canal treated premolar/molar
3. Tooth requires tooth coloured restoration
4. Tooth is restorable
5. Tooth would not require metal-based restoration
Key exclusion criteriaAnterior (Incisor or Canine Tooth)
Date of first enrolment14/10/2024
Date of final enrolment01/12/2025

Locations

Countries of recruitment

  • United Kingdom
  • England

Study participating centre

Liverpool University Hospitals NHS Foundation Trust
Royal Liverpool University Hospital
Prescot Street
Liverpool
L7 8XP
England

Results and Publications

Individual participant data (IPD) Intention to shareYes
IPD sharing plan summaryAvailable on request
IPD sharing planThe datasets generated during and/or analysed during the current study will be available upon request from Ahmed Elmatary, ahmede15@liverpool.ac.uk

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Participant information sheet Participant information sheet 11/11/2025 11/11/2025 No Yes

Editorial Notes

04/12/2025: The total final enrolment was added.
15/11/2024: Trial's existence confirmed by North West - Greater Manchester South Research Ethics Committee.