Nickel hypersensitivity in the orthodontic patient

Area of Science:

• Allergy and Immunology
• Dental and Oral Health
• Materials Science

Background:

• Nickel is a prevalent cause of allergic contact dermatitis, exceeding other metals in allergic reactions.
• Nickel-titanium alloys are commonly used in orthodontic wires, posing a risk for oral allergic reactions due to nickel content.

Purpose of the Study:

• To investigate if standard orthodontic therapy can induce nickel sensitization in patients.
• To evaluate the gingival response to nickel-containing orthodontic appliances in patients with pre-existing nickel sensitivity.

Main Methods:

• Nickel sensitivity was assessed using patch tests in 29 orthodontic patients (ages 12-48).
• Patients with confirmed nickel sensitivity were monitored monthly for gingival and plaque index scores.
• Patients without initial nickel sensitivity were retested after three months of orthodontic treatment to detect sensitization.

Main Results:

• 18.5% of patients (5 out of 29) exhibited positive nickel patch tests; all were female (27.7% of females).
• Two patients initially negative for nickel sensitivity converted to positive after three months of orthodontic treatment.
• Nickel-sensitive patients showed gingival responses to nickel-containing appliances.

Conclusions:

• Standard orthodontic therapy may carry a risk of sensitizing patients to nickel.
• Long-term exposure to nickel-containing orthodontic appliances could lead to nickel sensitization.
• Further research is warranted to understand the clinical implications of nickel sensitization in orthodontics.