ABSTRACT
Although nickel and chromium are known as allergen and cytotoxic orthodontic metals, very few and controversial studies have assessed the effect of orthodontic treatment on their systemic levels reflected by their best biomarker of exposure, hair. This prospective preliminary study was conducted to evaluate hair nickel and chromium levels in fixed orthodontic patients. Scalp hair nickel/chromium concentrations of 12 female and 12 male fixed orthodontic patients were measured before treatment and 6 months later, using atomic absorption spectrophotometry. The effects of treatment, gender, and age on hair ions were analyzed statistically (α = 0.05). The patients' mean age was 18.38 ± 3.98 years. The mean nickel levels were 0.1380 ± 0.0570 and 0.6715 ± 0.1785 µg/g dry hair mass, respectively, in the baseline and sixth month of treatment. Chromium concentrations were 0.1455 ± 0.0769 and 0.1683 ± 0.0707 µg/g dry hair mass, respectively. After 6 months, nickel increased for 387 % (paired t test P = 0.0000) and chromium increased for 16 % (P = 0.0002). No significant correlations were observed between any ion levels with age or gender (Spearman P > 0.2). Within the limitations of this preliminary study, it seems that 6 months of fixed orthodontic treatment might increase levels of hair nickel and chromium. Future larger studies are necessary to validate these results.
Subject(s)
Chromium/analysis , Hair/chemistry , Nickel/analysis , Orthodontic Appliances/adverse effects , Adolescent , Adult , Female , Humans , Male , Spectrophotometry, Atomic , Young AdultABSTRACT
INTRODUCTION: Despite the importance of nickel and chromium release from orthodontic brackets, there are no in vivo or in vitro studies on this issue in the case of metal-injection molding (MIM) brackets. METHODS: Saliva samples were collected from 30 orthodontic patients divided randomly into two groups of conventional and MIM brackets, before treatment and 2 months later. Approved attendees with odd and even numbers were, respectively, assigned to the control and treatment groups. For blinding, the patients were not informed of their bracket types, and the saliva samples were coded. Nickel and chromium levels were determined using atomic absorption spectrophotometry. Data were analysed using repeated-measures two-way analysis of covariance, independent-samples t-test, chi-squared, Spearman and point-biserial correlation coefficients, Mann-Whitney, and Wilcoxon tests (α = 0.05). RESULTS: Mean nickel level increased from 7.87±8.14 (pre-treatment) to 12.57±9.96 (2nd month) in the control group, and from 8.62±9.85 (pre-treatment) to 8.86±6.42 µg/l in the MIM group. Both of these increases were significant (Wilcoxon P < 0.03). Average chromium level changed from 0.25±0.56 (pre-treatment) to 0.35±0.62 and from 0.42±0.48 to 0.26±0.57 µg/l in the MIM group. Only the reduction observed in the MIM group was significant (Wilcoxon P = 0.0438). Age and gender had no significant influence on ion levels (P > 0.1). The differences between both ions' levels measured in the 60th day in both bracket groups were not significant (Mann-Whitney P > 0.05). The extents of changes over time were not significantly different between the bracket types (Mann-Whitney P > 0.05). LIMITATIONS: The sample size was not predetermined based on power calculations. The spectrophotometer was limited to detecting chromium concentrations above 0.25 µg/l. Ion discharge from brackets might continuously change. The current in vivo methods are unable to take such fluctuations into account. CONCLUSION: Nickel might increase in patients undergoing treatment with both bracket types, although the rate of increase might be greater in patients under treatment with conventional brackets. Using MIM brackets might reduce salivary chromium for a trivial but generalizable amount. Still, ion levels leached from conventional versus MIM brackets might not show a difference after 2 months. Age and gender might not affect the ion levels in normal people or orthodontic patients. REGISTRATION: The protocol is registered offline at the university library. PROTOCOL: The protocol was not published before the trail commencement. FUNDING: Self-funded (S. H.). CONFLICT OF INTEREST: None to declare.
