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Immature anterior teeth are at high risk of root fracture following root canal treatment. The literature was explored to determine the current status for post-endodontic restorative management of these teeth.The authors explored multiple search engine databases to November 2008. Experiments included in the review involved simulated human or animal immature teeth with mineral trioxide aggregate as an apical plug. The experiments were designed to assess and compare the fracture strength of teeth restored with various materials. Studies that did not fulfil inclusion criteria were omitted from the review.Four in vitro studies fulfilled selection criteria and were systematically reviewed. All studies differed in sources of teeth, their simulated immature tooth model and mode of force application.Current evidence, mostly from laboratory studies, suggests the use of composite resin materials placed deep into the coronal aspect of the root canal to impart superior fracture resistance. Further clinical research is needed to assess other reinforcing materials, which include a variety of post systems and luting agents.

The aim of this review was to consider laboratory experiments and clinical studies of calcium hydroxide-based root canal sealers. An extensive search of the endodontic literature was made to identify publications related to calcium hydroxide-based root canal sealers. The articles were assessed for the outcome of laboratory and clinical studies on their biological properties and physical characteristics. Comparative studies with other sealers were also considered. Several studies were evaluated covering different properties of calcium hydroxide-based sealers including physical properties, biocompatibility, leakage, adhesion, solubility, antibacterial properties, and periapical healing effect. Calcium hydroxide-based root canal sealers have a variety of physical and biological properties. Comparative studies reveal their mild cytotoxicity, but their antibacterial effects are variable. Further research is required to establish the tissue healing properties of calcium hydroxide in root canal sealers.