Evaluation of Nickel and Chromium Ion Release During Fixed Orthodontic Treatment Using Inductively Coupled Plasma-Mass Spectrometer: An In Vivo Study

BACKGROUND: Fixed orthodontic appliances with the use of stainless steel brackets and archwires made of nitinol have a corrosive potential in the oral environment. Nickel and chromium ions released from these appliances act as allergens apart from being cytotoxic, mutagenic and carcinogenic in smaller quantities in the range of nanograms. This study was done to evaluate the release of nickel and chromium ions from orthodontic appliances in the oral cavity using Inductively Coupled Plasma-Mass Spectrometer (ICP-MS). MATERIALS AND METHODS: Saliva samples from 30 orthodontic patients undergoing treatment with 0.022″ MBT mechanotherapy were collected prior to commencement of treatment, after initial aligning wires and after 10-12 months of treatment. Salivary nickel and chromium ion concentration was measured in parts per billion (ppb) using ICP-MS. RESULTS: Mean, standard deviation and range were computed for the concentrations of ions obtained. Results analyzed using ANOVA indicated a statistically significant increase of 10.35 ppb in nickel ion concentration and 33.53 ppb in chromium ion concentration after initial alignment. The ionic concentration at the end of 10-12 months of treatment showed a statistically significant increase in of 17.92 ppb for chromium and a statistically insignificant decrease in nickel ion concentration by 1.58 ppb. Pearson’s correlation coefficient showed a positive correlation for an increase in nickel concentration after aligning, but not at the end of 10-12 months. A positive correlation was seen for an increase in chromium ion concentration at both time intervals. CONCLUSION: Nickel and chromium ion concentration in saliva even though below the recommended daily allowance should not be ignored in light of the new knowledge regarding effects of these ions at the molecular level and the allergic potential. Careful and detailed medical history of allergy is essential. Nickel free alternatives should form an essential part of an orthodontist’s inventory.