title: Influence of combined cyclic fatigue and torsional stress on the fracture point of nickel-titanium rotary instruments.
abstract: BACKGROUND
  The combined influence of cyclic fatigue and torsional stress on rotary nickel-titanium instruments has been little investigated. The aim of this study was to determine possible differences in the fracture point of rotary nickel-titanium instruments depending on the application of cyclic fatigue only (CO) or in combination with torsional stress (CT).
  
  
  METHODS
  A novel custom-designed testing device was constructed. The device used a 2-pin design to test files under cyclic fatigue stress and allowed the additional application of defined torsional stress to the lateral aspect of the file by cutting into a dentin block. Files were tested dynamically at an amplitude of 2 mm at 0.0625 Hz using a programmable computer-controlled system. Three rotary NiTi systems were tested at 30° under CO or CT (with an added 1-Ncm torsional load): Revo-S (Micro-Mega, Besancon, France), Vortex (Dentsply, York, PA), and Profile (Dentsply) of tip sizes 25 and 35. For each file type, 10 new files 25 mm in length with a 0.04 taper size were tested. A total of 120 files were tested: 60 for CO and 60 for CT. The mean fragment length (MFL [in millimeters from the shaft to the fracture point]) was measured under 10× magnification with an electronic gauge to assess the location of the fracture. One-way analysis of variance, the Tukey Honestly Significant Differenct (HSD) test, and the Student's t test for paired samples were used for statistical analysis.
  
  
  RESULTS
  All fractures, regardless if CO or CT was used, occurred within the area of the curvature. The addition of a torsional load (CT) resulted in a mean 1.09-mm statistically significant difference between CO and CT (P < .0001, CO MFL = 17.78 mm [standard deviation ± 1.08 mm, n = 60]; CT MFL = 16.69 mm [SD ± 0.54 mm, n = 60]), relocating the fracture point toward the area where torsional load was applied. There was a statistically significant difference between the 3 file systems when they were tested either in the CO mode (P < .01) or the CT mode (P < .05). Statistically significant differences also existed for both instrument sizes (ie, 25 [P < .01] and 35 [P < .0001]).
  
  
  CONCLUSIONS
  CT compared with CO resulted in statistically significantly different MFLs. All fractures remained within the area of the curvature, but with the addition of a torsional load, the location of the fracture moved in the direction of the additionally applied torsional stress. This suggests that stress was distributed from the area in which the torsional load was applied toward the area undergoing cyclic fatigue.
authors.affiliation: Department of Endodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA. fsetzer@exchange.upenn.edu
authors.forename: Frank C
authors.initials: FC
authors.lastname: Setzer
authors.forename: Christian P
authors.initials: CP
authors.lastname: Böhme
mesh_terms: D003722:Dental Alloys / Q000737:chemistry*; D003799:Dental Stress Analysis / Q000295:instrumentation; D003804:Dentin / Q000601:surgery; D004548:Elasticity; D004867:Equipment Design; D004868:Equipment Failure; D006801:Humans; D008422:Materials Testing; D009532:Nickel / Q000737:chemistry*; D018915:Root Canal Preparation / Q000295:instrumentation*; D012399:Rotation; D013314:Stress, Mechanical; D013499:Surface Properties; D014025:Titanium / Q000737:chemistry*; D054159:Torsion, Mechanical
chemical_list: D003722:Dental Alloys; C040654:titanium nickelide; D009532:Nickel; D014025:Titanium