Release of nickel and chromium from metallic brackets used in orthodontic treatment: an in vitro study
DOI:
https://doi.org/10.15343/0104-7809.202549e17532025EKeywords:
Metallic Brackets, Nickel Ion, Chromium Ion, Fluoride, Salivary pHAbstract
The objective of this study was to evaluate the release of nickel (Ni) and chromium (Cr) ions from conventional metallic brackets of different commercial brands immersed in artificial saliva with and without fluoride. A total of 600 metallic brackets (Morelli®, Orthometric®, and Azdent®) were randomly allocated into an experimental group (fluoride-containing artificial saliva) and a control group (fluoride-free artificial saliva), both maintained at pH 6.5 and 37 °C for 28 days. Ni and Cr ion release was determined using inductively coupled plasma mass spectrometry (ICP-MS). Data were analyzed using the Mann–Whitney U and Kruskal–Wallis tests. The results showed that Ni ion release was higher in the presence of fluoride for all brands evaluated, with a tendency toward higher values in Azdent® brackets (383.36 µg/L). Regarding Cr ions, Azdent® brackets exhibited significantly greater release in fluoride-containing saliva (1.52 µg/L), whereas no significant differences were observed for Morelli® and Orthometric® groups. When comparing the three brands in fluoride-containing artificial saliva, all exhibited increased ion release, which was significant for Azdent® (p < 0.05). Exposure to fluoride increases Ni and Cr release, particularly in Azdent® brackets. The material and surface finish influence corrosion, constituting a key factor in clinical orthodontic selection.
Downloads
Translations of this article
References
Cheng YH, Liao Y, Chen DY, Wang Y, Wu Y (2019) Prevalence of dental caries and its association with body mass index among school-age children in Shenzhen, China. BMC Oral Health. https://doi.org/10.1186/s12903-019-0950-y
Lombardo G, Vena F, Negri P, Pagano S, Barilotti C, Paglia L, Colombo S, Orso M, Cianetti S (2020) Worldwide prevalence of malocclusion in the different stages of dentition: A systematic review and meta-analysis. Eur J Paediatr Dent 21:115–122. https://doi.org/10.23804/ ejpd.2020.21.02.05.
Castillo AA Del, Mattos-Vela MA, Castillo RA Del, Castillo-Mendoza C Del (2011) Malocclusions in children and adolescents from villages and native communities in the ucayali amazon region in peru. Rev Peru Med Exp Salud Publica 28:87–91. https://doi.org/10.1590/S1726- 46342011000100014.
Mundhada V V, Jadhav V V, Reche A (2023) A Review on Orthodontic Brackets and Their Application in Clinical Orthodontics. Cureus. https://doi.org/10.7759/cureus.46615
Triwardhani A, Amanda YA, Hamid T, Nugraha AP, Steventhie L, Hariati IVD (2023) Biocompatibility Stainless Steel Brackets with Nickel and Chromium Ions: A Scoping Review. Res J Pharm Technol 16:3251–3256. , https://doi.org/10.52711/0974-360X.2023.00534.
Rasool N, Veena K, Parson P, Anjali N (2023) Comparative evaluation of Nickel and Chromium release from three different metal brackets in artificial saliva. International Journal of Current Research . https://doi.org/10.24941/ijcr.44894.03.2023
Amato A, Martina S, De Benedetto G, Michelotti A, Amato M, Di Spirito F (2025) Hypersensitivity in Orthodontics: A Systematic Review of Oral and Extra-Oral Reactions. J Clin Med 14:4766. https://doi.org/10.3390/jcm14134766.
Kolokitha OE, Chatzistavrou E (2009) A severe reaction to Ni-containing orthodontic appliances. Angle Orthodontist 79:186–192. , https:// doi.org/10.2319/111507-531.1.
Houb-Dine A, Bahije L, Zaoui F (2018) Fluoride induced corrosion affecting Titanium brackets: A systematic review. https://doi.org/10.1016/j. ortho.2018.09.003.
Khanloghi M, Sheikhzadeh S, Khafri S, Mirzaie M (2023) Frontiers in Dentistry Effect of Different Forms of Fluoride Application on Surface Roughness of Rhodium-Coated NiTi Orthodontic Wires: A Clinical Trial. Front Dent . https://doi.org/doi: 10.18502/fid.v20i13.12660
Durgo K, Orešić S, Rinčić Mlinarić M, Fiket Ž, Jurešić GČ (2023) Toxicity of Metal Ions Released from a Fixed Orthodontic Appliance to Gastrointestinal Tract Cell Lines. Int J Mol Sci. https://doi.org/10.3390/ijms24129940
Di Spirito F, Amato A, Di Palo MP, Ferraro R, Cannatà D, Galdi M, Sacco E, Amato M (2024) Oral and Extra-Oral Manifestations of Hypersensitivity Reactions in Orthodontics: A Comprehensive Review. J Funct Biomater. https://doi.org/10.3390/jfb15070175
Velazco G, Ortiz R, Yepez J (2008) Corrosión por picadura en aleaciones de níquel-cromo (Ni-Cr) utilizadas en odontología. Revista Odontologica de los Andes 4:23–30
Karadede B (2025) Metals Used in Orthodontics and Their Side Effects. Journal of Oral Medicine and Dental Research 6:6–1. https://doi. org/10.52793/JOMDR.2025.6(1)-84
Mejía-Carrillo CR, Gutiérrez-Rojo JF (2020) Corrosión de los metales en ortodoncia. Rev Tamé 9:1037-1039.
Xu Y, Li Y, Chen T, Dong C, Zhang K, Bao X (2024) A short review of medical-grade stainless steel: Corrosion resistance and novel techniques. Journal of Materials Research and Technology 29:2788–2798. https://doi.org/10.1016/j.jmrt.2024.01.240.
Alvarado-Gámez A, Blanco-Sáenz R, Mora-Morales E (2002) El cromo como elemento esencial en los humanos. Rev Costarric Cienc Med 23:55–68
Huang GY, Jiang HB, Cha JY, Kim KM, Hwang CJ (2017) The effect of fluoride-containing oral rinses on the corrosion resistance of titanium alloy (Ti-6Al-4V). Korean J Orthod 47:306–312
Nayak RS, Shafiuddin B, Pasha A, Vinay K, Narayan A, Shetty S V (2015) Comparison of Galvanic Currents Generated Between Different Combinations of Orthodontic Brackets and Archwires Using Potentiostat: An In Vitro Study. Journal of International Oral Health 7:29–35. PMCID: PMC4513772 PMID: 26229367.
Gölz L, Knickenberg AC, Keilig L, Reimann S, Papageorgiou SN, Jäger A, Bourauel C (2016) Nickelionenkonzentration im Speichelvon Patienten mit selbstligierenden festsitzenden Apparaturen: Eine prospektive Kohortenstudie. Journal of Orofacial Orthopedics 77:85–93. https://doi.org/10.1007/s00056-016-0012-x
Tahmasbi S, Ghorbani M, Masudrad M (2015) Galvanic Corrosion of and Ion Release from Various Orthodontic Brackets and Wires in a Fluoride-containing Mouthwash. J Dent Res Dent Clin Dent Prospects 9:159–165. https://doi.org/10.15171/joddd.2015.030.
Kriswandini IL, Bagus API (2024) Release of nickel and chromium ions from stainless steel brackets as a result of long-term exposure to commonly used toothpaste. Indonesian Journal of Dental Medicine 7:35–39. https://doi.org/10.20473/ijdm.v7i1.2024.35-39
Mikulewicz M, Chojnacka K, Woźniak B, Downarowicz P (2012) Release of metal ions from orthodontic appliances: An in vitro study. Biol Trace Elem Res 146:272–280. https://doi.org/10.1007/s12011-011-9233-4
Wataha J (2000) Biocompatibility of dental casting alloys: a review. Review J Prosthet Dent 83:223–34. https://doi.org/10.1016/s0022- 3913(00)80016-5
Yanisarapan T, Thunyakitpisal P, Chantarawaratit P (2018) Corrosion of metal orthodontic brackets and archwires caused by fluoride-containing products: Cytotoxicity, metal ion release and surface roughness. Orthodontic Waves 77:78–89. https://doi.org/10.1016/j.ajodo.2020.03.035
Salazar-Jiménez J (2015) Introducción al fenómeno de corrosión: tipos, factores que influyen y control para la protección de materiales. Tecnología en Marcha 28:128–136. https://doi.org/10.18845/tm.v28i3.2417
Giraldo O (2004) Metales y aleaciones en odontología. Revista Facultad de Odontología Universidad de Antioquia 15:53–62. ISSN 0121- 246X, ISSN-e 2145-7670.
Matusiewicz H (2023) Potential release of trace metal ions from metallic orthodontic appliances and dental metal implants: A Review of in vitro and in vivo experimental studies. World Journal of Advanced Research and Reviews 19:032–090. https://doi.org/10.30574/ wjarr.2023.19.2.1404
Wu J, Wang X, Jiang J, Bai Y (2024) Fabrication of a novel aesthetic orthodontic bracket and evaluation of friction properties between PEEK and stainless steel wires. Technology and Health Care 32:269–278. https://doi.org/10.3233/THC-230001
Hajjar SN, Syahmi MM, Muaz MA, Hajjar Nasir S, Sultan Ahmad Shah J (2021) Metal Release of Standard and Fake Orthodontic Braces: An In Vitro Study. IMJM 20:75–80. https://doi.org/10.31436/imjm.v20i2.1707
Bagus Narmada I, Jaddiyya Farha N, Dwi Virgianti I, Pramita Larasati P, Patera Nugraha A, Natasha Eleena binti Tengku Ahmad Noor T (2023) Liberación de iones de níquel y cromo de brackets de ortodoncia de acero inoxidable: una revisión. Investigación J Pharm y Tech 16:4935-4942. https://doi.org/10.52711/0974-360X.2023.00800
Amini F, Jafari A, Amini P, Sepasi S (2012) Metal ion release from fixed orthodontic appliances - An in vivo study. Eur J Orthod 34:126–130. https://doi.org/10.1093/ejo/cjq181
Jurela A, Verzak Ž, Brailo V, Škrinjar I, Sudarević K, Janković B (2018) Elektroliti u slini pacijenata s metalnim i keramičkim ortodontskim bravicama. Acta Stomatol Croat 52:32–36. https://doi.org/10.15644/asc52/1/5
Schiff N, Boinet M, Morgon L, Lissac M, Dalard F, Grosgogeat B (2006) Galvanic corrosion between orthodontic wires and brackets in fluoride mouthwashes. Eur J Orthod 28:298–304. . https://doi.org/10.1093/ejo/cji102
Nahidh M, Garma NMH, Jasim ES (2018) Assessment of ions released from three types of orthodontic brackets immersed in different mouthwashes: An in vitro study. Journal of Contemporary Dental Practice 19:73–80. https://doi.org/10.5005/jp-journals-10024-2214
Alvarez CC, Bravo Gómez ME, Hernández Zavala A (2021) Hexavalent chromium: Regulation and health effects. Journal of Trace Elements in Medicine and Biology. https://doi.org/10.1016/j.jtemb.2021.126729.
International Programme on Chemical Safety (IPCS) (1990) International Agency for Research on Cancer.
Haugli KH, Syverud M, Samuelsen JT (2020) Ion release from three different dental alloys–effect of dynamic loading and toxicity of released elements. Biomater Investig Dent 7:71–79. https://doi.org/10.1080/26415275.2020.1747471.
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 O Mundo da Saúde
This work is licensed under a Creative Commons Attribution 4.0 International License.
