Dynamic Reconstruction of the Nickel Ions’ Behavior in Different Orthodontic Archwires Following Clinical Application in an Intraoral Environment

Abstract

Rationale: Orthodontic archwires undergo chemical and structural changes in the complex intraoral environment. The present work aims to investigate the safe duration for intraoral use (related to the nickel release hypothesis) of different types of nickel-containing wires. By analyzing how the nickel content (NC) varies over time, we aim to provide practical recommendations for the optimal use of said archwires. Materials and Methods: Our analysis focuses on the following nickel-containing archwires: stainless steel, Ni-Ti superelastic, heat-activated NiTi and CuNiTi, and multi-force archwires. The studied archwires of each type were divided into three groups: group 1, as received; group 2, retrieved after intraoral exposure for less than 6 weeks; group 3, used for more than 8 weeks. To assess NC, measurements using scanning electron microscopy (SEM), energy-dispersive X-ray (EDX), and laser-induced breakdown spectroscopy (LIBS) were performed in multiple regions of each wire. Statistical analysis of the measured values using one-way ANOVA and multiple group comparisons showed significant differences in nickel content between groups. The dynamic behavior of the statistical results for NC was then modeled using logistic regression and fitted with cubic splines. Conclusions: The proposed behavior model, with further refinement, could enable orthodontists to make informed, patient-specific decisions regarding the safe and effective use of orthodontic floss. The overall conclusion of the study is that due to stability, SS-CrNi, HA-Ni-Ti with Cu, and TriTaniumTM are suitable for long-term use, and due to higher nickel release, Ni-Ti-Superelastic, HA-Ni-Ti without Cu, and Bio-ActiveTM are better for short- to medium-term use.