Evaluation of nickel ion release from various orthodontic arch wires: An in vitro study

Nickel and copper ion release, deflection and the surface roughness of copper-nickel-titanium orthodontic archwire in sodium fluoride solution

OBJECTIVE

Sodium fluoride (NaF) is commonly used in oral hygiene products, leading to corrosion and reduced archwire properties. In addition, ion release can cause allergies and become toxic to the oral environment. This research aimed to observe the Nickel (Ni) and Copper (Cu) ions released that affected initial corrosion as deflection and surface roughness changed in the Copper-Nickel-Titanium (CuNiTi) archwire.

MATERIAL AND METHODS

The total samples were 54 copper-nickel-titanium (CuNiTi-Tanzo, American orthodontic®) archwires immersed in three solutions. Artificial saliva was used in the control group NaF 0.05%, and a NaF 0.15% solution was used in the intervention groups (n = 6). The groups were divided into three observation times (two, four, and six weeks). Cu and Ni ions released, deflection, the surface roughness of the archwires, and solution acidities were recorded and analyzed.

RESULTS

Ni and Cu ion release and surface roughness of the CuNiTi archwires significantly increased as the NaF concentration increased. The Ni ion release improved along the immersion period; the opposite was true for the Cu ion release. The solutions became more alkaline after the CuNiTi archwires were immersed. The pH and the archwires' deflections of the three solutions did not show significant differences.

CONCLUSION

The NaF increased Cu-Ni ion release and surface roughness but not the deflection force of the CuNiTi. The increase was affected by the concentration and duration of immersion.

Determination of metal ions release from orthodontic archwires in artificial saliva using inductively coupled plasma-optical emission spectrometer (ICP-OES)

Over the last decades many concerns have been raised regarding the migration of potentially toxic metals from the orthodontic appliances to the oral environment due to the dynamic dominant conditions. The current study aimed to investigate the effect of the oral environment acidity and aging time on the ion release from orthodontic archwires. For this purpose, dental archwires consisted of three different alloys were immersed in artificial saliva of varied pH values for 7 and 30 days at 37±1°C. The liquid extracts were then analyzed with inductively coupled plasma-optical emission spectrometer (ICP-OES). It was found that the released ion species and the measured concentrations were not in accordance with manufacturers’ data. Furthermore, the leachates were mainly enriched with Cr and Ni ions by decreasing the saliva pH, while most of the archwires released the highest amounts of Ni, Mn and Cr ions after 30 days aging at pH = 3.5. Independent of the material type or the aging conditions, the total release of Ni and Cr ions was within the considered average dietary intake levels.

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.

Maternal and fetal exposure to metal (loid)s, maternal nutrition status, and impact on prenatal growth in an energy rich zone and an urban area along the Persian Gulf

The main purposes of the study were to determine whether maternal and cord blood (MB and CB) levels of metal (loid)s (MLs) are different between industrial and urban areas. Subjects were derived from the petrochemical and gas area (PGA) of Asaluyeh County and the urban area (UA) of Bushehr County in Iran. Adjusted models revealed significant differences between the PGA and UA for maternal Fe, Cu, Mg, Cd, Zn, Ni, V and Pb levels, likewise cord Cu, V, Pb and Ni levels, which were higher in the PGA. Unadjusted models revealed there were decreases in neonatal weight and head circumference by 16.550 g and 0.059 cm, respectively for each Ln unit increase in maternal Cr levels. The mean blood levels of MLs significantly associated with food consumption frequency. The MLs were detected at higher levels in the body's fetuses and their mothers who resided in the PGA than those from the UA. So, the fetuses of mothers living in an industrial areas may be at higher risk from anthropometric measures. The impact of prenatal exposure to MLs on prenatal growth should be considered for better understanding in the further studies.

Differences in Metal Ions Released from Orthodontic Appliances in an In Vitro and In Vivo Setting

The aim was to assess the composition of released metal ions from fixed orthodontic appliances both in an in vitro and in vivo setting and to compare their quantities to evaluate any possible health risks associated with them. For the in vitro setting, a set of 24 as-received sterile SS brackets, 2 SS sterile archwires, and 2 NiTi sterile archwires were aged for 90 days in artificial saliva, and released metal ion concentrations were determined by inductively coupled plasma mass spectrometry (ICP-MS), using matrix-matched standards for calibration. For the in vivo setting, 15 brackets, 15 SS, and 15 NiTi archwires were retrieved after 90 days of intraoral exposure in 15 subjects. Debris composition on each part of the orthodontic appliance was assessed using scanning electron microscopy with energy dispersive spectroscopy (SEM/EDS). The present study evidenced a difference in the composition of released metal ions from fixed orthodontic appliances detected in an in vitro and in vivo setting. Generally, the relative content of metal ions was higher in the retrieved debris than that released in artificial saliva. The concentration of released metal ions from all tested alloys was below the upper recommended limit of daily intake; however, possible local effects in terms of hypersensitivity due to their accumulation in the debris cannot be excluded even with such concentrations.

Causation of Oxidative Stress and Defense Response of a Yeast Cell Model after Treatment with Orthodontic Alloys Consisting of Metal Ions

Misaligned teeth have a tremendous impact on oral and dental health, and the most efficient method of correcting the problem is orthodontic treatment with orthodontic appliances. The study was conducted to investigate the metal composition of selected orthodontic alloys, the release of metal ions, and the oxidative consequences that the metal ions may cause in the cell. Different sets of archwires, stainless steel brackets, and molar bands were incubated in artificial saliva for 90 days. The composition of each orthodontic material and quantification of the concentration of metal ions released were evaluated. Metal ion mixtures were prepared to determine the occurrence of oxidative stress, antioxidant enzyme defense system, and oxidative damage to proteins. The beta titanium alloy released the fewest metal ions and did not cause oxidative stress or protein damage. The metal ions from stainless steel and the cobalt-chromium alloy can cause oxidative stress and protein damage only at high concentrations. All metal ions from orthodontic alloys alter the activity of antioxidant enzymes in some way. The determined amounts of metal ions released from orthodontic appliances in a simulated oral environment are still below the maximum tolerated dose, and the concentrations of released metal ions are not capable of inducing oxidative stress, although some changes in antioxidant enzyme activity were observed at these concentrations.

Salt Heat Treatment and Passivation to Improve the Corrosion Resistance of Nitinol (Ni-Ti)

Corrosion of nitinol (NiTi) is a major factor in the failure of implantable materials. Recently, as the importance of corrosion of metals has increased, testing according to international guidelines is essential. The purpose of this study was to evaluate the corrosion resistance of NiTi wire through heat treatment and passivation process. In this study, NiTi wire used two commercially available products and a self-manufactured stent. Experimental consideration was carried out according to ASTM standards. Heat treatment was carried out in an air or a salt furnace, and the corrosion was measured after additional process, such as passivation and scratch tests. As a result, the metal potential was rapidly decreased in the air furnace group. On the other hand, the potential of wires was dramatically increased in the salt furnace group compared to the air furnace group. The dislocation decreased below the acceptance criteria (>600 mV) within 60 s of heat treatment time in the air furnace. Moreover, the potential was dramatically improved, even after only 20 min of passivation treatment (1076 mV, 442% compared to the non-passivated group), and it continued to rise until 180 min. This phenomenon was similarly observed in the group of self-manufactured stents. The potential slightly decreased by the scratch process (93.1%) was significantly reduced by the air furnace process (315 mV, 24.4% of the nontreated group). In the passivated group of the air furnace sample with reduced potential, the potential was restored to the level before the air furnace (scratch stage) (1032 mV). In conclusion, the heat treatment is preferably carried out in a salt furnace rather than an air furnace, and the passivation process can be an advantageous tool to improve corrosion resistance by suppressing the oxidation process.

Risk Assessment of Oxidative Stress Induced by Metal Ions Released from Fixed Orthodontic Appliances during Treatment and Indications for Supportive Antioxidant Therapy: A Narrative Review

The treatment with fixed orthodontic appliances could have an important role in the induction of oxidative stress and associated negative consequences. Because of the simultaneous effects of corrosion, deformation, friction, and mechanical stress on fixed orthodontic appliances during treatment, degradation of orthodontic brackets and archwires occurs, causing higher concentrations of metal ions in the oral cavity. Corroded appliances cause the release of metal ions, which may lead to the increased values of reactive oxygen species (ROS) due to metal-catalyzed free radical reactions. Chromium, iron, nickel, cobalt, titanium, and molybdenum all belong to the group of transition metals that can be subjected to redox reactions to form ROS. The estimation of health risk due to the amount of heavy metals released and the level of selected parameters of oxidative stress generated for the time of treatment with fixed orthodontic appliances is presented. Approaches to avoid oxidative stress and recommendations for the preventive use of topical or systemic antioxidants during orthodontic treatment are discussed.

Detection of DNA adduct 8-hydroxy-2'-deoxyguanosine (8-OHdG) as a toxicity bioindicator to the effects of nickel on Ni-Cr alloy prosthesis users

Previous studies have suggested that exposure to Ni from Ni-Cr alloys can affect the human body through oxidative stress. The present study discusses the effect of nickel from Ni-Cr alloy prostheses on the formation of DNA Adduct 8-Hydroxy-2′-Deoxyguanosine (8-OHdG), evaluated based on creatinine and 8-OHdG concentrations in urine, determined with LC-MS/MS, for a Ni-Cr alloy user group and a never-user control group. The mean creatinine and 8-OHdG concentrations were not significantly different between the test groups, although highest levels were observed for the in the Ni-Cr user group. It is suggested that samples with relatively high creatinine and/or 8-OHdG levels are further studied in more detail for stability of concentrations and for the effect of contributing factors.

Corrosion Resistance of Graphene oxide/Silver Coatings on Ni-Ti alloy and Expression of IL-6 and IL-8 in Human Oral Fibroblasts

Graphene based materials (GBMs) have potentials for dental and medical applications. GBMs may cause changes in the levels of cytokine released in the body. This study aimed to study the corrosion resistance of graphene oxide (GO) and GO/silver (GO/Ag) nanocomposite coated nickel-titanium (NiTi) alloy by electrophoretic deposition and to access the viability of human pulp fibroblasts, and the interleukin (IL)-6 and IL-8 expression level. The bare and coated NiTi samples were characterized by scanning electron microscope (SEM), energy-dispersive X-ray spectroscopy (EDS), Raman spectroscopy, surface profilometry, and X-ray diffraction (XRD). The corrosion resistance of the bare NiTi and coated NiTi samples were investigated by potentiodynamic polarization and electrochemical impedance spectroscopy in 3.5% NaCl solution. The cell viability of human pulp fibroblasts was accessed by the treated culture medium of the bare NiTi and coated NiTi alloys containing 1% fetal bovine serum. IL-6 and IL-8 expression levels were studied by human enzyme-linked immunosorbent assay (ELISA). Data were analyzed using One-way ANOVA (α  =  0.05). Both the GO-coated NiTi and GO/Ag-coated NiTi alloys showed better corrosion resistance, a lower rate of corrosion, and higher protection efficiency than the bare NiTi alloy. The coated NiTi alloys were biocompatible to human pulp fibroblasts and showed upregulation of IL-6 and IL-8 levels.

Release of nickel and chromium ions from orthodontic wires following the use of teeth whitening mouthwashes

BACKGROUND

Corrosion resistance is an important requirement for orthodontic appliances. Nickel and chromium may be released from orthodontic wires and can cause allergic reactions and cytotoxicity when patients use various mouthwashes to whiten their teeth. Our study aimed to assess the release of nickel and chromium ions from nickel titanium (NiTi) and stainless steel (SS) orthodontic wires following the use of four common mouthwashes available on the market.

METHODS

This in vitro, experimental study was conducted on 120 orthodontic appliances for one maxillary quadrant including five brackets, one band and half of the required length of SS, and NiTi wires. The samples were immersed in Oral B, Oral B 3D White Luxe, Listerine, and Listerine Advance White for 1, 6, 24, and 168 h. The samples immersed in distilled water served as the control group. Atomic absorption spectroscopy served to quantify the amount of released ions.

RESULTS

Nickel ions were released from both wires at all time-points; the highest amount was in Listerine and the lowest in Oral B mouthwashes. The remaining two solutions were in-between this range. The process of release of chromium from the SS wire was the same as that of nickel. However, the release trend in NiTi wires was not uniform.

CONCLUSIONS

Listerine caused the highest release of ions. Listerine Advance White, Oral B 3D White Luxe, and distilled water were the same in terms of ion release. Oral B showed the lowest amount of ion release.

Release of metal ions from round and rectangular NiTi wires

Background

The aim of this study was to evaluate the amount of nickel and titanium ions released from two wires with different shapes and a similar surface area.

Methods

Forty round nickel-titanium (NiTi) arch wires with the diameter of 0.020 in. and 40 rectangular NiTi arch wires with the diameter of 0.016 × 0.016 in. were immersed in artificial saliva during a 21-day period. The surface area of both wires was 0.44 in.². Wires were separately dipped into polypropylene tubes containing 50 ml of buffer solution and were incubated and maintained at 37 °C. Inductively coupled plasma atomic emission spectrometry (ICP-AES) was used to measure the amount of ions released after exposure lengths of 1 h, 24 h, 1 week, and 3 weeks. Repeated measures ANOVA and Tukey tests were used to evaluate the data.

Results

The results indicated that the amount of nickel and titanium concentrations was significantly higher in the rectangular wire group. The most significant release of all metals was measured after the first hour of immersion. In the rectangular wire group, 243 ± 4.2 ng/ml of nickel was released after 1 h, while 221.4 ± 1.7 ng/ml of nickel was released in the round wire group. Similarly, 243.3 ± 2.8 ng/ml of titanium was released in the rectangular wire group and a significantly lower amount of 211.9 ± 2.3 ng/ml of titanium was released in the round wire group.

Conclusions

Release of metal ions was influenced by the shape of the wire and increase of time.

Comparative evaluation of nickel discharge from brackets in artificial saliva at different time intervals

Objectives:

To determine and compare the potential difference of nickel release from three different orthodontic brackets, in different artificial pH, in different time intervals.

Materials and Methods:

Twenty-seven samples of three different orthodontic brackets were selected and grouped as 1, 2, and 3. Each group was divided into three subgroups depending on the type of orthodontic brackets, salivary pH and the time interval. The Nickel release from each subgroup were analyzed by using inductively coupled plasma-Atomic Emission Spectrophotometer (Perkin Elmer, Optima 2100 DV, USA) model. Quantitative analysis of nickel was performed three times, and the mean value was used as result. ANOVA (F-test) was used to test the significant difference among the groups at 0.05 level of significance (P < 0.05). The descriptive method of statistics was used to calculate the mean, standard deviation, minimum and maximum. SPSS 18 software ((SPSS.Ltd, Quarry bay, Hong Kong, PASW-statistics 18) was used to analyze the study.

Result:

The analysis shows a significant difference between three groups. The study shows that the nickel releases from the recycled stainless steel brackets have the highest at all 4.2 pH except in 120 h.

Conclusion:

The study result shows that the nickel release from the recycled stainless steel brackets is highest. Metal slot ceramic bracket release significantly less nickel. So, recycled stainless steel brackets should not be used for nickel allergic patients. Metal slot ceramic brackets are advisable.

An evaluation of two types of nickel-titanium wires in terms of micromorphology and nickel ions' release following oral environment exposure

Background

This study aimed to compare superelastic and heat-activated nickel-titanium orthodontic wires’ surface morphology and potential release of nickel ions following exposure to oral environment conditions.

Methods

Twenty-four 20-mm-length distal cuts of superelastic (NiTi Force I®) and 24 20-mm-length distal cuts of heat-activated (Therma-Ti Lite®) nickel-titanium wires (American Orthodontics, Sheboygan, WI, USA) were divided into two equal groups: 12 wire segments left unused and 12 segments passively exposed to oral environment for 1 month. Scanning electron microscopy and atomic force microscopy were used to analyze surface morphology of the wires which were then immersed in artificial saliva for 1 month to determine potential nickel ions’ release by means of atomic absorption spectrophotometer.

Results

Heat-activated nickel-titanium (NiTi) wires were rougher than superelastic wires, and both types of wires released almost the same amount of Ni ions. After clinical exposure, more surface roughness was recorded for superelastic NiTi wires and heat-activated NiTi wires. However, retrieved superelastic NiTi wires released less Ni ions in artificial saliva after clinical exposure, and the same result was recorded regarding heat-activated wires.

Conclusions

Both types of NiTi wires were obviously affected by oral environment conditions; their surface roughness significantly increased while the amount of the released Ni ions significantly declined.

Evaluation and comparison of the marginal adaptation of two different substructure materials

PURPOSE

In this study, we aimed to evaluate the amount of marginal gap with two different substructure materials using identical margin preparations.

MATERIALS AND METHODS

Twenty stainless steel models with a chamfer were prepared with a CNC device. Marginal gap measurements of the galvano copings on these stainless steel models and Co-Cr copings obtained by a laser-sintering method were made with a stereomicroscope device before and after the cementation process and surface properties were evaluated by scanning electron microscopy (SEM). A dependent t-test was used to compare the mean of the two groups for normally distributed data, and two-way variance analysis was used for more than two data sets. Pearson's correlation analysis was also performed to assess relationships between variables.

RESULTS

According to the results obtained, the marginal gap in the galvano copings before cementation was measured as, on average, 24.47 ± 5.82 µm before and 35.11 ± 6.52 µm after cementation; in the laser-sintered Co-Cr structure, it was, on average, 60.45 ± 8.87 µm before and 69.33 ± 9.03 µm after cementation. A highly significant difference (P<.001) was found in marginal gap measurements of galvano copings and a significant difference (P<.05) was found in marginal gap measurements of the laser-sintered Co-Cr copings. According to the SEM examination, surface properties of laser sintered Co-Cr copings showed rougher structure than galvano copings. The galvano copings showed a very smooth surface.

CONCLUSION

Marginal gaps values of both groups before and after cementation were within the clinically acceptable level. The smallest marginal gaps occurred with the use of galvano copings.

Effect of thermocycling on nickel release from orthodontic arch wires: an in vitro study

The amount of daily intake of metals from orthodontic appliances over time is a matter of great concern. Nickel results in one of the most common metal-induced allergic contact dermatitis in humans; it produces more allergic reactions than all the other metals combined together. The purpose of this study was to evaluate the effects of thermocycling on the nickel release from orthodontic arch wires stored in artificial saliva with different pH values. Forty new wire pieces were selected. Each wire piece was placed in a special capillary Pyrex tube filled with artificial saliva, which was sealed and immersed in deionized water at 37 °C. The samples were divided into four groups of ten. Group I received no treatment; group II was subjected to thermocycling. The pH of storage in groups III and IV was reduced to 4.5, and group IV was subjected to thermocycling. Thermocycling was carried out between 5 and 55 °C for 500 cycles. The release of nickel ions was statistically analyzed by two-way ANOVA for the effects of two variables: pH and thermocycling. The interaction between pH and thermocycling was found to be statistically significant (F = 12.127, P = 0.001). Two-way ANOVA showed that different storage media or pH and thermocycling had a significant effect on the nickel release (F = 52.812, P < 0.001 and F = 197.035, P < 0.001, respectively). Thermocycling and pH can adversely affect the release of nickel from orthodontic wires, while thermocycling is clearly the dominant factor.