Nickel and Chromium Ion Levels in Hair and Gingival Crevicular Fluid with the Corrosion of Brackets in Orthodontic Patients: A Longitudinal Study

Abstract

Objective: To assess the levels of nickel and chromium ions in hair and Gingival Crevicular Fluid (GCF) of orthodontic patients and to evaluate the corrosion of orthodontic bracket surfaces. Material and Methods: Nickel and chromium ion concentrations were measured in hair and GCF of 15 patients (9 females and 6 males, aged 16-28 years old) who had fixed orthodontic treatment using atomic absorption spectroscopy. The samples were taken before treatment (baseline), 4, 8, and 16 months later during treatment. Along with ionic sampling, microscopic sampling was done. One of each patient brackets was removed to get 15 brackets per group. Five brackets were taken randomly from each group to be examined under scanning electron microscope (SEM). Data obtained were analyzed using paired t-tests. Results: After 16 months, compared with the baseline, average hair nickel level changed from 0.125 µg/g to 0.956 µg/g with statistically significant difference (p=0.00); average chromium level changed from 0.090 µg/g to 0.295 µg/g but no significant difference (p>0.05); average GCF nickel level changed from 3.335 µg/g to 10.410 µg/g; average chromium level changed from 1.859 µg/g to 9.818 µg/g. Both of these increases were significant (p=0.000). SEM examinations showed that the corrosion on brackets was seen in the fourth month, and more severely visible after 8 and 16 months of uses. Conclusion: After 16 months of treatment, compared with the baseline, the hair nickel level was increased by 7.7 times; while for chromium was by 3.3 times. Gingival crevicular fluid nickel level was increased by 3.1 times and chromium level was by 5.3 times. The longer time of treatment, the more ions released and the more corrosion of brackets will be.