Failure mechanism of ProTaper Ni-Ti rotary instruments during clinical use: fractographic analysis

To evaluate the failure mechanism of ProTaper Ni-Ti rotary instruments fractured under clinical conditions.

A total of 46 ProTaper instruments that failed (fractured and/or plastically deformed) during the clinical use were collected from various dental clinics, whereas a new set of ProTaper instruments served as control. After inspection under stereomicroscopy the instruments were classified into three categories: (i) plastically deformed but not fractured, (ii) fractured with plastic deformation and (iii) fractured without plastic deformation. Three instruments from each group were analysed with computerized X-ray microtomography (micro-XCT) to detect surface and internal defects, whilst all the fracture surfaces were investigated under SEM.

Stereomicroscopic inspection showed that 17.4% of the discarded instruments were only plastically deformed, 8.7% were fractured with plastic deformation and 73.9% were fractured without plastic deformation. Micro-XCT revealed instruments without any surface or bulk defects along with a few files with crack development below the fracture surface. No defects were identified in the unused instruments. SEM examination of fractured surfaces demonstrated the presence of dimples and cones, a typical pattern of dimple rupture developed because of ductile failure.

The results suggest that a single overloading event causing ductile fracture of ProTaper instruments is the most common fracture mechanism encountered under the clinical conditions.