Abstract

Objective: To evaluate the frequency and contributing factors of instrument separation in manual vs. rotary files and stainless steel vs. nickel-titanium (NiTi) files among endodontic practitioners.
Methodology: This cross-sectional study was conducted from January 2022 to July 2024. Data were collected via an online questionnaire distributed among dentists in 5 private and 2 public dental institutes in Punjab using consecutive sampling. It had items comprising demographics, frequency of endodontic file breakage, and its contributing factors. Statistical analysis was performed using SPSS 24, and comparisons were done using the Chi-square test, with p≤0.05 considered as significant.
Results: Manual files were used by 105 (69.8%) practitioners, while 45 (30.2%) used rotary files. Stainless steel files (75.8%, n=114) were more commonly used than NiTi files (24.2%, n=36). A significant difference in instrument separation was observed between manual and rotary file users (p=0.043), but not between stainless steel and NiTi files (p=0.146). File separation was significantly associated with the apical third of the root canal (p=0.026) and was more common in complex canal anatomies (p=0.001). Older, fatigued files were the leading cause of separation (75.8%, n=66) in stainless steel and manual files (62%, n=54).
Conclusion: Manual and stainless-steel files exhibited higher separation, particularly in the apical third. Clinicians should prioritize NiTi files for complex canals and regularly assess file integrity to minimize fatigue fractures. Proper case selection and radiographic evaluation can improve procedural safety.

Key words: Dental instrument, endodontics, instrument failure, root canal therapy.