Effect of Fixed Orthodontic Treatment on Salivary Nickel and Chromium Levels: A Systematic Review and Meta-Analysis of Observational Studies

Imani, Mohammad Moslem; Mozaffari, Hamid Reza; Ramezani, Mazaher

doi:10.3390/dj7010021

Cited by 19 publications

(14 citation statements)

References 41 publications

(68 reference statements)

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“…Nickel is the most common metal that causes contact dermatitis and induces more cases of allergic reactions. The amount of nickel as the main constituent of contemporary orthodontic appliances may vary from 8% in stainless steel to more than 50% in NiTi alloys [ 35 ]. However, in most of the in vivo studies that have evaluated the liberation of metal ions from orthodontic appliances in biological fluids, it has been concluded that levels of metal ions do not reach the normal daily dietary intake of some elements [ 2 ].…”

Section: Discussionmentioning

confidence: 99%

Comparison of Cell Viability and Chemical Composition of Six Latest Generation Orthodontic Wires

Escobar

Rivera

Arbelaez

et al. 2021

International Journal of Biomaterials

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Orthodontic wires are made of alloys containing different metals, including nickel. It is important to evaluate their biocompatibility prior to use, owing to their long-term use in patients. This in vitro study compared the cytotoxicity and chemical composition of six latest orthodontic wires: Fantasia®, Tanzo®, FLI®, NT3®, DuoForce®, and Gummetal®. The before-use group consisted of wires that were not used in the mouth, and the after-use group consisted of wires that were used in the mouth for two months. The wires were placed in contact with human gingival fibroblasts (HGF) for 72 h, and cytotoxicity was determined using the resazurin test. The chemical composition and surface characterisation were evaluated by spectrometry and scanning electron microscopy. The groups were compared using ANOVA and Kruskal–Wallis test. Only the FLI® wires produced a 36% reduction in HGF viability ( p < 0.05 ) and presented greater irregularities and loss of polymer structure. After-use wires showed a significant reduction in the percentage of nickel and the appearance of new elements (oxygen and carbon). Therefore, it can be concluded that no toxic ion release was noticed in this study. Rhodium-coated wires were more stable than PTFE-coated wires, and only the FLI® wires showed a slight cytotoxic effect.

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Section: Discussionmentioning

confidence: 99%

Comparison of Cell Viability and Chemical Composition of Six Latest Generation Orthodontic Wires

Escobar

Rivera

Arbelaez

et al. 2021

International Journal of Biomaterials

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“…There are important clinical, in vivo studies that analysed patients' saliva and monitored nickel release from orthodontic appliances before and during orthodontic treatment [96][97][98]. The results from research in the years 1997 to 2016 on the concentration of Ni in patients' saliva in patients with fixed orthodontic treatment were summarized in meta-analysis study [97].…”

Section: Biocompatibility and Ni Releasementioning

confidence: 99%

A Critical Appraisal of the Use and Properties of Nickel–Titanium Dental Alloys

Močnik

Kosec

2021

Materials

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Nickel–titanium (NiTi) archwires are used in dentistry for orthodontic treatment. NiTi alloys have favourable mechanical characteristics, such as superelasticity and shape memory, and are also known as a corrosion-resistant alloy. In specific cases, an archwire could be attacked by certain types of corrosion or wear degradation, which can cause the leaching of metal ions and a hypersensitive response due to increased concentrations of Ni in the human body. A systematic search of the literature retrieved 102 relevant studies. The review paper focuses on three main fields: (i) electrochemical properties of NiTi wires and the effect of different environments on the properties of NiTi wires (fluoride and low pH); (ii) tribocorrosion, a combination of chemical and mechanical wear of the material, and (iii) the biocompatibility of NiTi alloy and its subsequent effect on the human body. The review showed that corrosion properties are affected by microstructure, pH of saliva and the presence of fluorides. A high variation in published results should be, therefore, interpreted with care. The release of nickel ions was assessed using the same unit, showing that the vast majority of metal ions were released in the first few days of exposure, then a stable, steady state was reached. In tribocorrosion studies, the increased concentrations of Ni ions were reported.

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“…Metal ions such as chromium (Cr) and nickel (Ni) are released into the oral cavity due to corrosion of the wires and brackets of fixed orthodontic appliances under numerous environmental conditions [ 1 ]. Additionally, several mouthwashes can influence the corrosion of metallic appliances and cause the release of Ni and Cr into patient’s saliva [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

In Vitro Ion Release of Wires in Removable Orthodontic Appliances

et al. 2021

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Various orthodontic wire compositions and configurations are present on the market for removable appliances; however, there have still been only few studies focusing on the effect of resin color and additives such as glitter on corrosion of metallic wires under different conditions. Thus, the aim of the study was to compare concentrations of released ions (aluminium, chromium, nickel) in a corrosive medium under three different conditions: non-loaded wires, loaded wires, and non-loaded wires treated with Kukis® cleaning tablets. Six different wires made of three types of steel alloy were embedded in PMMA resin leaving one centimetre of each wire emerging from the resin to come into contact with the corrosive medium. Glitter particles were added to half of the produced test specimens. For the unloaded test series, five specimens of each group were covered in a petri dish with 50 mL of corrosive medium (pH 2.3) following EN-ISO 10271 for seven days at 37 °C. The wires for the mechanically loaded test specimens overlapped the resin by 5 cm and were clamped into a time-switched electric drive for a defined period of time before the samples were taken after a testing time of 7 days. In the third group, unloaded test specimens were transferred from their petri dishes into the prepared Kukis® solution every 24 h before being stored in the corrosive medium. Inductively coupled plasma mass spectrometry (ICP-MS) was used to quantify the specific ions in the corrosive solution. Statistical analysis showed that the mechanical loading of all wires could significantly raise the diffusion of ions into the corrosive medium. The colour of the resin did not affect the concentration of the released ions. The Kukis® cleaning tabs could not lower the corrosion of the tested metals, as some of the wires were corroded even more using the brace cleanser. Glitter-containing test specimens showed significantly higher amounts of aluminium. Mechanical loading as well as the presence of glitter particles in the resin significantly affected ion concentrations.

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Effect of Fixed Orthodontic Treatment on Salivary Nickel and Chromium Levels: A Systematic Review and Meta-Analysis of Observational Studies

Cited by 19 publications

References 41 publications

Comparison of Cell Viability and Chemical Composition of Six Latest Generation Orthodontic Wires

Comparison of Cell Viability and Chemical Composition of Six Latest Generation Orthodontic Wires

A Critical Appraisal of the Use and Properties of Nickel–Titanium Dental Alloys

In Vitro Ion Release of Wires in Removable Orthodontic Appliances

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