“…11,12,[14][15][16][17] The most commonly reported causes of sterilization failure include both instrument handling and problems with the sterilizer, such as improper cleaning of instruments, improper packaging, improper loading, improper procedure (human error), malfunctioning of the equipment, unit maintenance problems, high frequency of sterilizing cycles in a day, and lack of monitoring of the sterilizer operation. 4,11,12,18,19 In our study, after the second and the third monitoring of the sterilizing cycle with the BIs and the careful analysis of the equipment questionnaires with positive results, the main causes of failure were improper procedure (preheat, temperature, or time), the absence of the supervision of the procedure performed by an assistant, and improper maintenance (including the electrical system).…”