Related Experiment Video
Updated: Jun 26, 2026
07:17
Studying Orthodontic Tooth Movement in Mice
Published on: August 2, 2024
A severe reaction to ni-containing orthodontic appliances
Olga Elpis Kolokitha1, Evangelia Chatzistavrou
1Department of Orthodontics, Aristotle University of Thessaloniki, Thessaloniki, Greece. okolok@dent.auth.gr
The Angle Orthodontist
|January 7, 2009
Summary
Nickel allergy can manifest during orthodontic treatment, causing severe skin and oral reactions. Switching to nickel-free appliances effectively resolved the patient's hypersensitivity symptoms.
Area of Science:
- Dentistry
- Allergology
- Immunology
Background:
- Nickel is a common allergen, frequently causing allergic contact dermatitis, a Type IV delayed hypersensitivity.
- Orthodontic appliances often contain nickel, posing a risk for allergic reactions in susceptible individuals.
- Intraoral and extraoral allergic reactions to nickel in orthodontic treatment are documented, though often less severe.
Purpose of the Study:
- To report an unusual and severe case of nickel hypersensitivity during orthodontic treatment in an adult patient.
- To highlight the diagnostic process and successful management of nickel allergy in this context.
Main Methods:
- A case report of an adult female patient undergoing orthodontic treatment for impacted teeth.
- Clinical observation of severe eczematic and urticarial reactions on the face and intraoral redness.
- Diagnostic patch testing to confirm nickel sensitization.
- Treatment with nickel-free orthodontic appliances.
Main Results:
- The patient developed severe facial and intraoral allergic reactions after surgical exposure during orthodontic treatment.
- Patch testing confirmed a strong sensitization to nickel (++++ score).
- Complete resolution of symptoms was achieved after replacing the nickel-containing appliances with nickel-free ones.
Conclusions:
- Nickel-containing orthodontic appliances can trigger severe hypersensitivity reactions, even in patients with no prior allergy history.
- Prompt diagnosis and substitution with nickel-free alternatives are crucial for managing such adverse reactions.
- This case underscores the importance of considering nickel allergy in patients presenting with unexplained dermatological and oral symptoms during orthodontic therapy.
Related Concept Videos
01:202° Amines to N-Nitrosamines: Reaction with NaNO2
Secondary amines react with nitrous acid to form N-nitrosamines, as depicted in Figure 1. Nitrous acid, a weak and unstable acid, is formed in situ from an aqueous solution of sodium nitrite and strong acids, such as hydrochloric acid or sulfuric acid, in cold conditions. In the presence of an acid, the nitrous acid gets protonated. The subsequent loss of water results in the formation of the electrophile known as nitrosonium ion.
01:19Hypersensitivity Reactions: Immune-Complex Reactions
Type III hypersensitivity reactions occur when antigen–antibody complexes form and activate the complement system. Normally, these complexes help the clearance of antigens by phagocytes and red blood cells. However, when large numbers of immune complexes are present, they can deposit in tissues—particularly in the walls of blood vessels—leading to inflammation and tissue injury. These deposits trigger complement activation and neutrophil recruitment, resulting in serum sickness, a systemic...
01:12Local Anesthetics: Adverse Effects
While local anesthetics are generally safe and well-tolerated, they can occasionally cause adverse effects that vary in severity. Local anesthetics can induce toxicity at two distinct levels. They can either produce local effects through direct contact with the neural elements or be absorbed into the bloodstream from the injection site, leading to systemic effects.
Once absorbed into the systemic circulation, local anesthetics can affect the organs that depend on the functioning of sodium...
Once absorbed into the systemic circulation, local anesthetics can affect the organs that depend on the functioning of sodium...
01:15Teeth
The formation of teeth, also known as odontogenesis, is a complex process that begins in utero, around the sixth week of embryonic development. There are three stages to this process: the bud stage, the cap stage, and the bell stage.
In the bud stage, the tooth germ (an aggregation of cells) starts to form in the developing jawbone. During the cap stage, the tooth germ differentiates into enamel organ, dental papilla, and dental sac, which will later develop into the tooth's enamel, dentin and...
In the bud stage, the tooth germ (an aggregation of cells) starts to form in the developing jawbone. During the cap stage, the tooth germ differentiates into enamel organ, dental papilla, and dental sac, which will later develop into the tooth's enamel, dentin and...
01:26Tonsillitis II: Management
This lesson will focus on the different treatment options for managing tonsillitis, which typically depend on the cause and severity.
01:18Disorders of the Autonomic Nervous System
The autonomic nervous system (ANS) is an intricate network of nerves that controls functions such as the regulation of heart rate, digestion, and blood pressure regulation. When this system malfunctions, it can lead to various disorders that affect multiple bodily functions. One common feature of many autonomic disorders is the involvement of smooth blood vessels, which play a crucial role in regulating blood flow throughout the body.
Raynaud's disease, also known as Raynaud's phenomenon, is a...
Raynaud's disease, also known as Raynaud's phenomenon, is a...