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Nickel is the most common metal to cause contact dermatitis in orthodontics. Nickel-containing metal alloys, such as nickel-titanium and stainless steel, are widely used in orthodontic appliances. Nickel-titanium alloys may have nickel content in excess of 50 per cent and can thus potentially release enough nickel in the oral environment to elicit manifestations of an allergic reaction. Stainless steel has a lower nickel content (8 per cent). However, because the nickel is bound in a crystal lattice it is not available to react. Stainless steel orthodontic components are therefore very unlikely to cause nickel hypersensitivity. This article discusses the diagnosis of nickel allergy in orthodontics and describes alternative products that are nickel free or have a very low nickel content, which would be appropriate to use in patients diagnosed with a nickel allergy.
Within orthodontics, nickel is one of the most commonly used metals, as it is a component of the super elastic and shape memory wires, and is included in stainless steel and other alloys. It has been shown that the level of nickel in saliva and serum increases significantly after the insertion of fixed orthodontic appliances.2 Nickel is the most common metal to cause contact dermatitis in orthodontics, with more cases of allergic reactions than all the other metals combined. Kerosuo et al. found the prevalence of nickel allergy in Finnish adolescents to be 30 per cent in girls and 3 per cent in boys. This is thought to be due to ear piercing being a major cause of sensitization to nickel, as the occurrence in topic with stab ears was 31 per cent and those with no pierced ears 2 per cent.4 Once reaction has been documented, all oral mucosal outside can be disturbed. Sensitizing patients to nickel throughout tradition orthodontic selling with set equipment has been an anxiety it has been recommended that a entrance attention of roughly 30 ppm of nickel may be enough to remove a cytotoxic reaction. Conversely, it has been confirmed that oral antigenic associates in non-sensitized persons may persuade easiness to nickel, slightly than sensitization. Nickel sensitization is supposed to be augmented by mechanical annoyance, skin maceration, or oral mucosal wound, all of which may happen in orthodontic action. Green temperatures and period of experience may also be issue. The scratch of write to steatites may be changeable and may be hardly evident. Eager is not a frequent quality of get in touch with steatites and extra-oral reactions are extra ordinary than intra-oral effect.