Additive vs Subtractive Manufacturing for Endocrown Fabrication: A 24-Month RCT

Inclusion Criteria: * Age 25-45 years, male or female * Endodontically treated molar tooth with radiographically confirmed treatment success and no clinical signs of failure * Sufficient remaining coronal structure for endocrown preparation: minimum three walls, wall thickness 1.5 mm or greater, pulp chamber depth 3 mm or greater, supragingival preparation margins * Completely erupted tooth with intact periodontal support * Minimum of 20 occluding teeth * Satisfactory oral hygiene status * Capable of providing written informed consent and committed to scheduled follow-up visits Exclusion Criteria: * Diagnosed parafunctional habit or nocturnal bruxism * Uncontrolled systemic illness or physical disability precluding safe participation * Heavy tobacco use * Current or suspected pregnancy * Periapical disease or radiographic signs of endodontic failure * Evidence of pathological tooth wear or occlusal erosion * Moderate-to-severe periodontitis or tooth with hopeless prognosis * Radiographic or clinical evidence of vertical root fracture * Impaired decision-making capacity or anticipated non-compliance