Nickel hypersensitivity reaction before, during, and after orthodontic therapy

Area of Science:

• Immunology
• Dental Materials Science
• Dermatology

Background:

• Nickel is a known biological sensitizer, capable of inducing delayed hypersensitivity reactions (Type IV immune response).
• Orthodontic appliances, primarily stainless steel brackets and wires, frequently contain nickel.
• The potential for orthodontic treatment to trigger or exacerbate nickel hypersensitivity is a clinical concern.

Purpose of the Study:

• To determine the prevalence of nickel hypersensitivity before, during, and after orthodontic therapy.
• To assess whether orthodontic appliances induce nickel hypersensitivity reactions.
• To characterize individuals with nickel hypersensitivity in an orthodontic patient population.

Main Methods:

• A cross-sectional study involving 170 orthodontic patients (105 female, 65 male).
• Patients were categorized into three groups: pre-treatment, current treatment, and post-treatment.
• Nickel patch testing and questionnaires were employed to assess hypersensitivity and clinical history.

Main Results:

• Overall nickel hypersensitivity prevalence was 28.3%, with a significantly higher rate in females (23%) than males (5.3%).
• Nickel hypersensitivity showed a positive association with a prior allergic history to metals and daily use of metal objects.
• No statistically significant difference in contact dermatitis prevalence was observed across the three treatment groups.

Conclusions:

• Orthodontic therapy using conventional stainless steel appliances does not appear to initiate or aggravate nickel hypersensitivity.
• Pre-existing nickel hypersensitivity is associated with personal allergic history and metal object usage.
• The prevalence of nickel hypersensitivity remains consistent regardless of orthodontic treatment status.