Advances in Clinical and Experimental Medicine
2017, vol. 26, nr 7, October, p. 1155–1162
Publication type: review article
Trace metal ions release from fixed orthodontic appliances and DNA damage in oral mucosa cells by in vivo studies: A literature review
1 Department of Facial Abnormalities, Wroclaw Medical University, Poland
2 Department of Maxillofacial Orthopaedics and Orthodontics, Wroclaw Medical University, Poland
An overview of professional literature referring to the release of metal ions from fixed orthodontic appliances and their influence on oral mucosa in conditions of in vivo are presented, along with a detailed analysis of the exposure of the cells of cheek mucosa epithelium to metal ions. Electronic databases (PubMed, Elsevier, Ebsco) were searched with no language restrictions. The relevant orthodontic journals and reference lists were checked for all eligible studies. A total of 38 scientific articles were retrieved in the initial search. However, only 7 articles met the inclusion criteria. Statistically significant differences in the levels of the amount of nickel ions, cobalt ions and chromium ions were observed in cells of cheek mucosa. The most biocompatible material used in the production of fixed orthodontic appliances is titanium, and the least biocompatible material is steel, which releases the largest amount of nickel and chromium. Metal ions are released from fixed orthodontic appliances only in the first phase of treatment. It is recommended to conduct further, long-term research on a larger number of patients to define the influence of using fixed orthodontic appliances and biological effect they might have on tissues.
atomic absorption spectrophotometry, cells of cheek mucosa, chromium ions, nickel ions, orthodontic treatment
- House K, Sernetz F, Dymock D, Sandy JR, Ireland AJ. Corrosion of orthodontic appliances: Should we care? Am J Orthod Dentofacial Orthop. 2008;133:584–592.
- Kusy RP. Types of corrosion in removable appliances: Annotated cases and preventative measures. Clin Orthod Res. 2000;3:230–239.
- Maia L, Filho H, Ruellas A, Araujo M, Vaitsman D. Corrosion behavior of self-ligating and conventional metal brackets. Dental Press J Orthod. 2014;19:108–114.
- Rafeeq R, Saleem A, Nissan L. Ions release from fixed orthodontic appliance in two different mouthwashes. J Bagh Coll Dentistry. 2014;26:152–155.
- Pillai A, Gangadharan A, Gangadharan J, Kumar N. Cytotoxic effects of the nickel release from the stainless steel brackets: An in vitro study. J Pharm Bioallied Sci. 2013;5:1–4.
- Ahmed R, Aref M, Hassan R, Mohammed N. Cytotoxic effect of composite resin and amalgam filling materials on human labial and buccal epithelium. Nature and Science. 2010;10:48–53.
- Kocadereli I, Atac A, Kale S, Ozer D. Salivary nickel and chromium in patients with fixed orthodontic appliances. Angle Orthod. 2000;70:431-434.
- Okazaki Y, Gotoh E. Comparison of metal release from various metallic biomaterials in vitro. Biomaterials. 2005;26:11–21.
- Huang H, Chiu Y, Lee T, et al. Ion release from NiTi orthodontic wires in artificial saliva with various acidities. Biomaterials. 2003;24:3585–3592.
- Petoumenou E, Arndt M, Keilig L, et al. Nickel concentration in the saliva of patients with nickel-titanium orthodontic appliances. Am J Orthod Dentofacial Orthop. 2009;135:59–65.
- Agaoglu G, Arun T, Izgu B, Yarat A. Nickel and chromium levels in the saliva and serum of patients with fixed orthodontic appliances. Angle Orthod. 2001;71:375–379.
- Kempson IM, Lombi E. Hair analysis as a biomonitor for toxicology, disease and health status. Chem Soc Rev. 2011;40:3915–3940.
- Mikulewicz M, Wołowiec P, Loster B, Chojnacka K. Metal ions released from fixed orthodontic appliance affect hair mineral content. Biol Trace Elem Res. 2015;163:11–18.
- Wołowiec P, Michalak I, Chojnacka K, Mikulewicz M. Hair analysis in health assessment. Clin Chin Acta. 2013;419:139–171.
- Gil F, Hernandez AF, Marquez C, et al. Biomonitorization of cadmium, chromium, manganese, nickel and lead in whole blood, urine, axillary hair and saliva in an occupationally exposed population. Sci Total Environ. 2011;409:1172–1180.
- Marquezan M, Osorio A, Sant’Anna E, Souza MM, Maia L. Does bone mineral density influence the primary stability of dental implants? A systematic review. Clin Oral Implants Res. 2012;23:767–774.
- Faccioni F, Franceschetti P, Cerpelloni M, Fracasso ME. In vivo study on metal release from fixed orthodontic appliances and DNA damage in oral mucosa cells. Am J Orthod Dentofacial Orthop. 2003;124:687–694.
- Amini F, Borzabadi Farahani A, Jafari A, Rabbani M. In vivo study of metal content of oral mucosa cells in patients with and without fixed orthodontic appliances. Orthod Craniofac Res. 2008;11:51–56.
- Hafez HS, Selim EMN, Eid FHK, Tawfik WA, Al-Ashkar EA, Mostafa YA. Cytotoxicity, genotoxicity, and metal release in patients with fixed orthodontic appliances: A longitudinal in-vivo study. Am J Orthod Dentofacial Orthop. 2011;140:298–308.
- Natarajan M, Padmanabhan S, Chitharanjan A, Narasimhan M. Evaluation of the genotoxic effects of fixed appliances on oral mucosal cells and the relationship to nickel and chromium concentrations: An in-vivo study. Am J Ortho Dentofacial Orthop. 2011;40:383–388.
- Fernandez-Minano E, Ortiz C, Vicente A, Calvo JL, Ortiz AJ. Metallic ion content and damage to the DNA in oral mucosa cells of children with fixed orthodontic appliances. Biometals. 2011;24:935–941.
- Angelieri F, Carlin V, Martins R, Ribeiro A. Biomonitoring of mutagenicity and cytotoxicity in patients undergoing fixed orthodontic therapy. Am J Orthod Dentofacial Orthop. 2011;139:e399–e404.
- Heravi F, Abbaszadegan MR, Merati M, Hasanzadeh N, Dadkhah E, Ahrari F. DNA damage in oral mucosa cells of patients with fixed orthodontic appliances. J Dent. 2013;10:494–500.
- Huang TH, Yen CC, Kao CT. Comparison of ion release from new and recycled orthodontic brackets. Am J Orthod Dentofacial Orthop. 2001;120:68–75.
- Eliades T, Athanasiou AE. In vivo aging of orthodontic alloys: Implications for corrosion potential, nickel release, and biocompatibility. Angle Orthod. 2002;72:222–237.
- Kerosuo H, Moe G, Kleven E. In vitro release of nickel and chromium from different types of simulated orthodontic appliances. Angle Orthod. 1995;65:111–116.
- Sfondrini MF, Cacciafesta V, Maffia E, et al. Chromium release from new stainless steel, recycled and nickel free orthodontic brackets. Angle Orthod. 2009;79:361–367.
- Lindsten R, Kurol J. Orthodontic appliances in relation to nickel hypersensitivity: A review. J Orofac Orthop. 1997;58:100–108.
- Genelhu MCLS, Marigo M, Alves-Olivera LF, Malaquias LCC, Gomez RS. Characterization of nickel-induced allergic contact stomatitis associated with fixed orthodontic appliances. Am J Orthod Dentofacial Orthop. 2005;128:378–381.
- Eliades T, Pratsisin H, Kletsas D, Eliades G, Macou M. Characterization and cytotoxicity of ions released from stainless steel and nickel-titanium orthodontic alloys. Am J Ortod Dentofacial Orthop. 2005;128:378–381.
- Mikulewicz M, Chojnacka K, Wołowiec P. Release of metal ions from fixed orthodontic appliance: An in vitro study in continuous flow system. Angle Orthod. 2014;84:140–148.
- Trombetta D, Mondello MR, Cimino F, Cristani M, Pergolizzi S, Saija A. Toxic effect of nickel in an in vitro model of human oral epithelium. Toxicology Letters. 2005;159:219–225.
- Angelieri F, Marcondes JPC, de Almeida DC, Salvadori DMF, Ribeiro DA. Genotoxicity of corrosion eluates obtained from orthodontic brackets in vitro. Am J Orthod Dentofacial Orthop. 2011;139:504–509.