title: Nickel-titanium rotary instrument fracture: a clinical practice assessment.
abstract: OBJECTIVE
  To prospectively determine the incidence of nickel-titanium rotary instrument fracture in an endodontic clinical practice setting.
  
  
  METHODS
  Eleven second year endodontic residents, using four nickel-titanium rotary instrument systems (ProFile, ProTaper, GTRotary and K3Endo) according to the recommendations of the manufacturers, instrumented 3181 canals in 1403 teeth of 1235 patients, in a dental school post-graduate endodontic clinic, in 1 year. The incidence of instrument fracture was determined based on the number of instruments used. When fracture occurred, data were collected concerning the type, size, taper and prior use of the fractured instruments, the length and location of the fragment within the root canal and the curvature of the canal.
  
  
  RESULTS
  The overall incidence of instrument fracture was 0.39%. The incidence of fracture for ProFile, ProTaper, GTRotary and K3Endo files was 0.28%, 0.41%, 0.39% and 0.52%, respectively. There was no statistically significant difference between instrument systems. The percentage of teeth in which instruments fractured was 1.9% (0.28% for anterior teeth, 1.56% for pre-molars and 2.74% for molars). A total of 26 instruments fractured, of which 23 had tapers of 0.06 or greater. Most of the fragments were located in the apical third of the root canal, and both the median and mode amongst the fragment lengths were 2 mm.
  
  
  CONCLUSIONS
  The low incidence of nickel-titanium rotary instrument fracture supports the continued use of these instruments in root canal treatment.
authors.affiliation: Department of Endodontics, New York University, College of Dentistry, NY 10010, USA. pmd2@nyu.edu
authors.forename: P M
authors.initials: PM
authors.lastname: Di Fiore
authors.forename: K A
authors.initials: KA
authors.lastname: Genov
authors.forename: E
authors.initials: E
authors.lastname: Komaroff
authors.forename: Y
authors.initials: Y
authors.lastname: Li
authors.forename: L
authors.initials: L
authors.lastname: Lin
mesh_terms: D016009:Chi-Square Distribution; D003722:Dental Alloys; D003762:Dental Instruments / Q000706:statistics & numerical data; D003799:Dental Stress Analysis; D004867:Equipment Design; D004868:Equipment Failure / Q000706:statistics & numerical data; D006801:Humans; D009532:Nickel; D011446:Prospective Studies; D018915:Root Canal Preparation / Q000295:instrumentation*; D014025:Titanium
chemical_list: D003722:Dental Alloys; C040654:titanium nickelide; D009532:Nickel; D014025:Titanium