Symptoms of titanium and nickel allergic sensitization in orthodontic treatment

Divulging the dust: An examination of particle deposition on soft ocular lens during urban commuting

Air pollution affecting the eye is a relatively new, emerging area of research that has implications for urban commuting and is the key first study. This article emphasizes the importance of understanding the effects of particle deposition on the human eye using soft lenses and their exposure, as well as identifying the chemical, elemental composition, and morphology of particles when commuting over a period of 21-day period. In this study, the focus is on personal sampling with soft contact lenses (42% Hioxifilcon A, 58% H2O) to understand particle deposition on ocular along with cascade to understand cut-off size. Volunteers are used for five different modes, namely bus, open and closed car windows, pedestrian, and two-wheeler. The SEM results show that the morphology in buses, pedestrians and cars are denser, irregular, and nodular, with no or minimal interstitial pores, while the particles in two-wheelers appeared to be fibrous, thin, crystalline, and non-porous ranging from 51.2 nm to 406.3 nm. The ICPMS results show the higher concentration compositions for different commuter types, namely: zinc (0.0562 μg/m3 and 0.1076 μg/m3) for buses and pedestrians, potassium (1.5013 μg/m3) and calcium (2.5892 μg/m3), magnesium (2.978 μg/m3), potassium (4.197 μg/m3), calcium (22.335 μg/m3) and iron (7.526 μg/m3) for two-wheelers. The organic elemental composition from FTIR predominant groups namely carbonyl, carboxylic, OH, N-H, C-H, CC, CO, and C-O. The experiment concludes that travellers in two-wheelers and pedestrians are more susceptible to particle deposits which leads to several ocular effects such as eye-irritation, dryness, and visual impairment.

Cytotoxicity of Metal Ions Released from NiTi and Stainless Steel Orthodontic Appliances, Part 1: Surface Morphology and Ion Release Variations

Despite numerous studies on ion release from orthodontic appliances, no clear conclusions can be drawn due to complex interrelations of multiple factors. Therefore, as the first part of a comprehensive investigation of cytotoxicity of eluted ions, the objective of this study was to analyze four parts of a fixed orthodontic appliance. Specifically, NiTi archwires and stainless steel (SS) brackets, bands, and ligatures were immersed in artificial saliva and studied for morphological and chemical changes after 3-, 7-, and 14-day immersion, using the SEM/EDX technique. Ion release profiles were analyzed for all eluted ions using inductively coupled plasma mass spectrometry (ICP-MS). The results demonstrated dissimilar surface morphologies among parts of the fixed appliance, due to variations in manufacturing processes. The onset of pitting corrosion was observed for the SS brackets and bands in the as-received state. Protective oxide layers were not observed on any of the parts, but adherent layers developed on SS brackets and ligatures during immersion. Salt precipitation, mainly KCl, was also observed. ICP-MS proved to be more sensitive than SEM/EDX and exhibited results undetected by SEM/EDX. Ion release was an order-of-magnitude higher for SS bands compared to other parts, which was attributed to manufacturing procedure (welding). Ion release did not correlate with surface roughness.

Quantitative analysis of restricted metals and metalloids in tattoo inks: A systematic review and meta-analysis

The various ingredients and impurities that can be detected within tattoo inks have been associated with a myriad of dermatologic complications. Legislation regarding these antigenic substances varies widely around the world, with Europe serving as both the research and regulatory center on these intradermal formulations. Although industry is said to be moving away from metallic and metalloid pigments in exchange for organic or organometallic dyes, surveys of commercially available inks continue to detect these elements at concentrations considered unsafe for application into the dermis. In order to better assess the formulation and safety of tattoo ink, we present a systematic review and meta-analysis of studies quantifying restricted metals and metalloids in commercially available tattoo ink products. Among the papers selected, inconsistencies were noted in the degree of specificity by which ink products were identified and the elements sampled for. In addition, the analytical targets' valency and/or solubility were not always considered in accordance with regulation criteria. Of note, chromium, by total content and that of its regulated +6 valency, exceeded its maximum allowed concentration in nearly every sample tested. Total copper content exceeded the limit for soluble copper in half of inks sampled. In descending order, concentrations of cadmium, barium, mercury, soluble copper, arsenic, zinc, antimony, and lead violated regulations in one-sixth or fewer of samples tested. Cobalt and tin levels never violated regulation. Overall, our findings indicate that unsafe levels of restricted elements continue to be detected across studies, warranting further investigation under a regulatory lens.

Minimization of Adverse Effects Associated with Dental Alloys

Metal alloys are one of the most popular materials used in current dental practice. In the oral cavity, metal structures are exposed to various mechanical and chemical factors. Consequently, metal ions are released into the oral fluid, which may negatively affect the surrounding tissues and even internal organs. Adverse effects associated with metallic oral appliances may have various local and systemic manifestations, such as mouth burning, potentially malignant oral lesions, and local or systemic hypersensitivity. However, clear diagnostic criteria and treatment guidelines for adverse effects associated with dental alloys have not been developed yet. The present comprehensive literature review aims (1) to summarize the current information related to possible side effects of metallic oral appliances; (2) to analyze the risk factors aggravating the negative effects of dental alloys; and (3) to develop recommendations for diagnosis, management, and prevention of pathological conditions associated with metallic oral appliances.

A comprehensive summary of disease variants implicated in metal allergy

Allergic disease represents one of the most prominent global public health crises of the 21^st century. Although many different substances are known to produce hypersensitivity responses, metals constitute one of the major classes of allergens responsible for a disproportionately large segment of the total burden of disease associated with allergy. Some of the most prevalent forms of metal allergy - including allergic contact dermatitis - are well-recognized; however, to our knowledge, a comprehensive review of the many unique disease variants implicated in human cases of metal allergy is not available within the current scientific literature. Consequently, the main goal in composing this review was to (1) generate an up-to-date reference document containing this information to assist in the efforts of lab researchers, clinicians, regulatory toxicologists, industrial hygienists, and other scientists concerned with metal allergy and (2) identify knowledge gaps related to disease. Accordingly, an extensive review of the scientific literature was performed - from which, hundreds of publications describing cases of metal-specific allergic responses in human patients were identified, collected, and analyzed. The information obtained from these articles was then used to compile an exhaustive list of distinctive dermal/ocular, respiratory, gastrointestinal, and systemic hypersensitivity responses associated with metal allergy. Each of these disease variants is discussed briefly within this review, wherein specific metals implicated in each response type are identified, underlying immunological mechanisms are summarized, and major clinical presentations of each reaction are described.Abbreviations: ACD: allergic contact dermatitis, AHR: airway hyperreactivity, ASIA: autoimmune/ autoinflammatory syndrome induced by adjuvants, BAL: bronchoalveolar lavage, CBD: chronic beryllium disease, CTCL: cutaneous T-cell lymphoma, CTL: cytotoxic T-Lymphocyte, DRESS: drug reaction with eosinophilia and systemic symptoms, GERD: gastro-esophageal reflux disease, GI: gastrointestinal, GIP: giant cell interstitial pneumonia, GM-CSF: granulocyte macrophage-colony stimulating factor, HMLD: hard metal lung disease, HMW: high molecular weight, IBS: irritable bowel syndrome, Ig: immunoglobulin, IL: interleukin, LMW: low molecular weight, PAP: pulmonary alveolar proteinosis, PPE: personal protective equipment, PRR: pathogen recognition receptor, SLE: systemic lupus erythematosus, SNAS: systemic nickel allergy syndrome, Th: helper T-cell, UC: ulcerative colitis, UV: ultraviolet.

Type IV hypersensitivity associated with restorative materials: Clinical report and systematic literature review

STATEMENT OF PROBLEM

Type IV hypersensitivity reactions (Type IV HR) are immune responses mediated by antigen-specific effector T cells.

PURPOSE

The purpose of this clinical report and systematic review was to report the clinicopathological features of Type IV HR in the oral mucosa and to present a systematic literature review of case reports and case series of individuals with Type IV HR in the oral mucosa related to contact with dental materials.

MATERIAL AND METHODS

The presented clinical lesions were melanotic macules with burning that affected the internal labial mucosa in contact with composite resin veneer crowns. Histopathological and immunohistochemical analysis of the lesion was performed. The systematic literature review was performed based on a search in 4 electronic databases (PubMed/MEDLINE, Scopus, Web of Science, and Ovid).

RESULTS

Immunohistochemistry showed positivity for CD4, CD8, CD20, CD3, tryptase, and CD117. After conservative treatment, the patient reported improvement of symptoms, and a decrease in the number of inflammatory cells was verified. Twenty-one articles were included in the review. Unlike the present patient, the authors of all the articles recommended radical treatment with the removal of the dental material.

CONCLUSIONS

Type IV HR in oral mucosa is rare, and the assessment of clinical and histopathological characteristics is essential to perform an accurate diagnosis and provide appropriate treatment.

A Comparative Electrochemical and Morphological Investigation on the Behavior of NiCr and CoCr Dental Alloys at Various Temperatures

The purpose of our study is to compare the behavior of two reprocessed dental alloys (NiCr and CoCr) at different temperatures considering the idea that food and drinks in the oral cavity create various compositions at different pH levels; the novelty is the investigation of temperature effect on corrosion parameters and ion release of dental alloys. Electrochemical stability was studied together with morphology, elemental composition and ions release determination. The results obtained are in good concordance: electrochemistry studies reveal that the corrosion rate is increasing by increasing the temperature. From SEM coupled with EDS, the oxide film formed on the surface of the alloys is stable at low temperatures and a trend to break after 310K. ICP-MS results evidence that in accordance with increasing temperature, the quantities of ions released from the alloys immersed in artificial saliva also increase, though they still remain small, less than 20 ppm.

Corrosion induced fracture of NiTi wires in simulated oral environments

This work aims to assess the influence of corrosion on fracture of nickel titanium (NiTi) superelastic wires in physiological solutions (9 g/l NaCl) with and without addition of 1 g/l NaF. The electrochemical cell was coupled to a Hounsfield Tensiometer tensile machine commonly used for corrosion investigation of alloys under stress and strain. Corrosion tests were performed on unstrained and strained conditions up to 4% total strain. This strain limit corresponds to 50% of the total elongation achieved into the superelastic stress plateau of the alloy. All wire specimens were analyzed after testing by scanning electron microscopy (SEM). The results showed that localized corrosion occurred for NiTi wires in solution containing fluoride, while no corrosion attack was detected in NaCl 9 g/l solution. There was no significant difference between the corrosion resistance of unstrained and strained wires. However, brittle like fracture occurred in NaCl + NaF solution within the superelastic domain of the material. The most relevant conclusion achieved is that the use of superelastically strained NiTi in oral environments in the presence of fluoride is followed by significant risk of corrosion induced fracture.