Bass J K, Fine H, Cisneros G J
Albert Einstein and Montefiore Medical Center, Bronx, N.Y.
Am J Orthod Dentofacial Orthop. 1993 Mar;103(3):280-5. doi: 10.1016/0889-5406(93)70009-D.
Nickel is one of the most common causes of allergic contact dermatitis and produces more allergic reactions than all other metals combined. Currently, several brands of orthodontic wires are made of nickel titanium alloy and potentially have a high enough nickel content to provoke manifestations of allergic reactions in the oral cavity. The objectives of this study were (1) to determine if standard orthodontic therapy can sensitize patients to nickel, and (2) to assess gingival response to nickel-containing orthodontic appliances in patients who are nickel sensitive before treatment. Nickel sensitivity patch tests were conducted to confirm hypersensitivity to nickel. Twenty-nine patients from the Division of Orthodontics, Albert Einstein/Montefiore Medical Center were tested, ranging in age from 12 to 48 years. Of the 29 patients, there were 18 female and 11 males. Five of the patients had a positive nickel patch test, a rate of 18.5%. The five patients that tested positive were all female, meaning that the overall rate for females was 27.7% (5:18). The five female patients sensitive to nickel were followed monthly by intraoral photos and gingival and plaque index scores. The remaining patients began routine orthodontic therapy and were retested 3 months into treatment to see whether sensitization occurred. Two patients converted from an initial negative patch test to a positive test. There may be a risk of sensitizing patients to nickel with long-term exposure to nickel-containing appliances as occurs in routine orthodontic therapy.
镍是过敏性接触性皮炎最常见的病因之一，其引发的过敏反应比其他所有金属引发的过敏反应总和还多。目前，有几种品牌的正畸钢丝是由镍钛合金制成的，其镍含量可能高到足以在口腔中引发过敏反应。本研究的目的是：（1）确定标准正畸治疗是否会使患者对镍敏感；（2）评估治疗前对镍敏感的患者对含镍正畸矫治器的牙龈反应。进行了镍敏感性斑贴试验以确认对镍过敏。对阿尔伯特·爱因斯坦/蒙特菲奥里医疗中心正畸科的29名患者进行了测试，年龄在12至48岁之间。29名患者中，有18名女性和11名男性。其中5名患者镍斑贴试验呈阳性，阳性率为18.5%。5名试验呈阳性的患者均为女性，这意味着女性的总体阳性率为27.7%（5:18）。对5名对镍敏感的女性患者每月进行一次口腔内照片拍摄以及牙龈和菌斑指数评分。其余患者开始进行常规正畸治疗，并在治疗3个月后重新进行测试，以观察是否发生致敏。两名患者从最初的斑贴试验阴性转为阳性。在常规正畸治疗中，长期接触含镍矫治器可能存在使患者对镍致敏的风险。
