Janson G R, Dainesi E A, Consolaro A, Woodside D G, de Freitas M R
Department of Orthodontics, Bauru Dental School, University of São Paulo, Brazil.
Am J Orthod Dentofacial Orthop. 1998 Jun;113(6):655-60. doi: 10.1016/s0889-5406(98)70226-4.
Nickel is a strong biological sensitizer and consequently may induce a delayed hypersensitivity reaction (type IV immune response). Because nickel is a component of the majority of the orthodontic alloys, the objectives of this cross-sectional study were to determine the prevalence of nickel hypersensitivity reaction before, during, and after orthodontic therapy with conventional stainless steel brackets and wires; to evidence the induction of this reaction by the orthodontic appliances; and to characterize the nickel hypersensitive persons. Nickel patch tests and a questionnaire were used to evaluate the hypersensitivity to this metal. The total sample consisted of 170 patients, 105 females and 65 males, from the orthodontic department at Bauru Dental School, University of São Paulo. They were divided into three groups as follows: A (n = 60), patients before the beginning of orthodontic therapy; B (n = 66), patients currently undergoing orthodontic treatment, and C (n = 44), patients who had undergone orthodontic treatment previously. The chi-square test (chi2) showed an allergic reaction in 28.3% of the total sample with 23% female and 5.3% male. This indicated a gender difference (chi2 = 10.75, p < 0.001). There was a positive association between nickel hypersensitivity and previous personal allergic history to metals (chi2 = 34.88, p < 0.0001) as well as with the daily use of metal objects (chi2 = 11.95, p < 0.0005). There was no statistically significant difference in the prevalence of contact dermatitis among the three groups (chi2 = 0.39, p = 0.848). This suggests that orthodontic therapy with conventional stainless steel appliances does not initiate or aggravate a nickel hypersensitivity reaction.
镍是一种强效的生物致敏剂，因此可能引发迟发型超敏反应（IV型免疫反应）。由于镍是大多数正畸合金的组成成分，本横断面研究的目的是确定使用传统不锈钢托槽和钢丝进行正畸治疗前、治疗期间及治疗后的镍超敏反应患病率；证明正畸矫治器会引发这种反应；并对镍过敏者进行特征描述。采用镍斑贴试验和问卷调查来评估对这种金属的超敏反应。总样本包括来自圣保罗大学鲍鲁牙科学院正畸科的170名患者，其中105名女性和65名男性。他们被分为以下三组：A组（n = 60），正畸治疗开始前的患者；B组（n = 66），正在接受正畸治疗的患者；C组（n = 44），之前接受过正畸治疗的患者。卡方检验（chi2）显示，总样本中有28.3%出现过敏反应，其中女性为23%，男性为5.3%。这表明存在性别差异（chi2 = 10.75，p < 0.001）。镍超敏反应与既往个人金属过敏史（chi2 = 34.88，p < 0.0001）以及日常使用金属物品（chi2 = 11.95，p < 0.0005）之间存在正相关。三组之间接触性皮炎的患病率无统计学显著差异（chi2 = 0.39，p = 0.848）。这表明使用传统不锈钢矫治器进行正畸治疗不会引发或加重镍超敏反应。
