Nickel allergy and orthodontics, a review and report of two cases

Abstract

VERIFIABLE CPD PAPER• Readers will develop an understanding of the background of nickel allergy and its epidemiology in orthodontics.• Readers will learn the signs and symptoms of a nickel allergy in orthodontics.• Readers will have an understanding of making a diagnosis and alternative methods to treat orthodontic patients who have developed an intra-oral nickel allergy due to orthodontic appliances.• Two detailed real life cases are presented. I N B R I E F PRACTICENickel is a common component in many orthodontic materials. An allergy to nickel is commonly seen in the population, more frequently in women. This allergy has increased with the more frequent use of nickel containing jewellery and in traoral piercings. As a result, this allergy can be expected to be more readily encountered in dental practice. Possible allergy to nickel should be a question in the initial patient health history questionnaire. The dental practitioner should be mindful of this allergy during the course of orthodontic treatment, and know how to diagnose a nickel allergy if it appears and subsequent action in treatment and referral if it is suspected. This paper provides a summary of nickel allergy, its epide miology, diagnosis and recommendations and alternatives to treatment. A detailed description of two cases where it was discovered in orthodontic patients is also reported.

Stainless Steel: Material Facts for the Orthodontic Practitioner

“…They also reported a higher prevalence of nickel allergy in girls, which is also reported in other papers [56,57]. Although orthodontic alloys are considered safe, there are case reports on nickel hypersensitivity caused by orthodontic appliances, both from stainless steel and nickel-titanium alloys [50,[58][59][60]. Common intra-oral signs include redness, swelling, and soreness of the oral mucosa and palate, gingiva and lips [59].…”

“…This metal increases the strength, ductility and resistance to general corrosion, as well as to crevice corrosion and erosion [17]. Many researches have been carrying out to assess the possible negative side effects that this metal could bring about to oral tissues in orthodontics [47][48][49][50][51][52]. Nickel hypersensitivity has been associated with the use of dental devices, such as orthodontic appliances.…”

Microbiologically influenced corrosion of orthodontic metallic appliances

“…SUS materials have been widely used as appliances in orthodontic treatment. Corrosion of metallic appliances in the oral region, especially with the release of nickel, is one cause of metal allergy in patients [5][6][7][8] . SUS contains approximately 8-10 wt% nickel for resistance against non-oxidation acid, such as sulfuric or hydrochloric acid.…”

Ortodontik tedavide karşılaşılan allerjik reaksiyonlar

“…Yerine; polikristalin alumina, tek-kristalli safir ve zirkon kullanılarak yapılan seramik braketler, plastik polimerlerden yapılan polikarbonat braketler, titanyum veya altın kaplı braketler kullanılabilmektedir. 18,37,38 Derinin daha fazla hassas olması nedeniye headgear'in metal kısımları gibi ekstraoral metal bileşenlere dikkat edilmesi gereklidir. Plastik kaplı headgear bow'ları tercih edilmelidir.…”