Breakage of Ultrasonic Root-End Preparation Tips

Modified ultrasonic tips are used to prepare rootend cavities during endodontic surgery. The purpose of this study was to determine whether such tips are prone to breakage during use. Ten different tip designs were driven by an ultrasonic unit at maximum power. Multirooted teeth were instrumented, the apex removed, and the tooth was placed horizontally on a pan balance. The apex was instrumented by each ultrasonic tip in turn for 15 min, with the load being increased by 100 g every 5 min. Those tips with curvatures of 70 degrees or greater fractured within the first 5-min loading period. Breakage occurred ∼ 2 to 3 mm from the end and always at a bend. Scanning electron microscopy revealed that the fractures were brittle in nature, with little change in the remaining section. Two tips bent: one isthmus preparation tip and one silver point removal tip. All the other designs were deemed satisfactory after experimentation. This study shows that fracture of ultrasonic tips can occur and is related to the degree of bending.