Nickel Sensitivity in Children Due to Using Stainless Steel Crowns: A Narrative Review

Abstract

Context: Stainless Steel Crowns (SSC) are stable and durable restorations and a valuable technique in repairing deciduous teeth with extensive caries. Nickel and chromium are the main composing elements of SSCs, i.e. released in the oral environment; they can cause allergic reactions, especially in nickel-sensitive children. The symptoms of these reactions include gingival edema and the loss of alveolar bone. Evidence Acquisition: The required data used in our review were searched from articles published until 2020 and collected from online databases, including Scopus, PubMed, Google Scholar, and Science Direct, using “Nickel, Allergy, and SSCs” keywords. Articles concerning SSCs and their application, nickel allergy released from crowns, and their symptoms were included in this study. After the abstract screening, we recalled relevant studies for full-text review. Results: We are exposed to nickel every day in various forms; some individuals present hypersensitivity reactions when exposed to the slightest amounts of this metal. Nickel is a base metal and among the elements used in SSCs. Nickel is released from SSCs during the corrosion process in the oral environment. Excessively released nickel ions cause chronic fatigue syndrome, sensitive lymph nodes, muscle aches, and headaches. Conclusions: The amount of nickel released from SSCs is less than the number of other sources; thus, the immunological reactions of a large percentage of the population to this excess amount of nickel ions in the bloodstream are normal and cause no severe problems.

Effects of decontamination protocols on the aesthetic, morphological, and material composition of preformed paediatric crowns

“…Similar corrosion has been reported on orthodontic ligature cutters after chemical disinfection and after steam sterilisation 7 . Such corrosion could potentially be problematic for individuals with hypersensitivity reactions to nickel, a component of PMCs 8,9 . As such, the decontamination process needs to be compatible with the chemical composition of the metal alloys used in PMCs.…”

Tribological Behavior of TiO2 PEEK Composite and Stainless Steel for Pediatric Crowns

“…Nevertheless, the use of PVSSCs carries the potential risk of nickel allergy and sensitivity, while polymer and pre-veneered aluminum crowns have poor mechanical and wear resistance. Zirconia crowns are costly and necessitate extensive tooth preparation for placement [ 6 , 8 , 13 , 14 ].…”