Strengthening immature teeth during and after apexification

The purpose of this study was to evaluate the strengthening effect of an internal resin bonding technique. One hundred central incisors were end-odontically treated and divided equally into five groups. Group 1, without any cervical preparation and with access repaired with bonded resin, served as the positive control. Teeth in groups 2 to 5 were cervically prepared to simulate the thin dentinal wall of immature teeth, and obturation material was removed to 3 mm below the cementoenamel junction (CEJ). In group 2, the negative control, the access was restored with bonded composite to the level of the CEJ. In group 3, access was restored with composite resin 3 mm apical to the CEJ using a clear post system. Group 4 was treated similarly to group 3, but an opaque post replaced the clear post. Group 5 was treated like group 3, after which a metal post was cemented into the channel left after removal of the clear post. All teeth were subjected to compression testing and the force required to fracture the teeth cervically was recorded for each group and the Kruskal-Wallis analysis performed to detect intergroup differences. All of the bonded resin techniques significantly strengthened the teeth against fracture, compared with the negative control group (p < 0.05). None of the experimental groups (3–5) were significantly different from the positive control group.