Gölz Lina, Knickenberg Anna Christine, Keilig Ludger, Reimann Susanne, Papageorgiou Spyridon N, Jäger Andreas, Bourauel Christoph
Department of Orthodontics, School of Dentistry, University of Bonn, Bonn, Germany.
Department of Oral Technology, School of Dentistry, University of Bonn, Welschnonnenstr. 17, 53111, Bonn, Germany.
J Orofac Orthop. 2016 Mar;77(2):85-93. doi: 10.1007/s00056-016-0012-x. Epub 2016 Feb 24.
Orthodontic appliances are considered to be highly biocompatible although adverse effects attributed to the release of nickel ions (Ni(2+)) have been documented. Self-ligating brackets have grown in popularity for economic reasons and supposed friction reduction. The aim of the present prospective cohort study was therefore to determine salivary Ni(2+) concentrations in patients undergoing orthodontic treatment with self-ligating fixed appliances.
A group of 30 patients between 10 and 13 years of age were treated with self-ligating brackets (SmartClip™), molar bands, and nickel-titanium (NiTi) archwires. Unstimulated saliva samples were collected after different time points (before treatment, after self-ligating bracket and band placement, before archwire insertion, after archwire insertion, and finally 4 and 8 weeks afterwards) and analyzed with an ICP mass spectrometer followed by generalized estimating equation modelling with α = 5 %.
The baseline median salivary Ni(2+) concentration was 21.85 µg/l, while the Ni(2+) concentrations at the following visits ranged between 13.73 and 85.34 µg/l. Significant increases in Ni(2+) levels compared to the baseline levels were detected after band/bracket placement [+59.76 µg/l; 95 % confidence interval (CI) 44.88-74.64 µg/l; P < 0.001] and after archwire insertion (+53.55 µg/l; 95 % CI 25.57-81.52 µg/l; P < 0.001). After 4 weeks, Ni(2+) concentrations returned to initial control levels or were lower.
Self-ligating orthodontic appliances may affect salivary Ni(2+) concentrations in vivo over the short term. However, levels resembled those documented in conjunction with conventional bracket use and remained below the daily dietary Ni intake.
尽管已有文献记载正畸矫治器会因镍离子（Ni(2+)）释放而产生不良反应，但人们仍认为正畸矫治器具有高度的生物相容性。由于经济原因以及假定的摩擦力降低，自锁托槽越来越受欢迎。因此，本前瞻性队列研究的目的是确定接受自锁固定矫治器正畸治疗患者的唾液Ni(2+)浓度。
一组30名年龄在10至13岁之间的患者接受了自锁托槽（SmartClip™）、磨牙带环和镍钛（NiTi）弓丝治疗。在不同时间点（治疗前、自锁托槽和带环放置后、弓丝插入前、弓丝插入后，以及最后在之后的4周和8周）收集未刺激的唾液样本，并用ICP质谱仪进行分析，随后采用α = 5%的广义估计方程模型。
唾液Ni(2+)浓度的基线中位数为21.85μg/l，而后续随访时的Ni(2+)浓度在13.73至85.34μg/l之间。与基线水平相比，在带环/托槽放置后[增加59.76μg/l；95%置信区间（CI）44.88 - 74.64μg/l；P < 0.001]和弓丝插入后（增加53.55μg/l；95%CI 25.57 - 81.52μg/l；P < 0.001）检测到Ni(2+)水平显著升高。4周后，Ni(2+)浓度恢复到初始对照水平或更低。
自锁正畸矫治器可能在短期内影响体内唾液Ni(2+)浓度水平。然而，该水平与传统托槽使用时记录的水平相似，且仍低于每日饮食中的镍摄入量。
