Nickel, chromium and iron levels in the saliva of patients with simulated fixed orthodontic appliances

Objective: To assess the in vivo release of nickel, chromium, and iron ions into saliva by different metallic brackets. Materials and Methods: Thirty volunteers wore removable appliances with bonded brackets and were divided according to the brand of brackets: group A, 3M/Unitek (AISI 303); group B, American Orthodontics (AISI 316L); and group C, Dentaurum (AISI 316L). The appliances were worn for 60 days, and saliva samples were collected at the following time points: T1, before placement of the appliance; T2, after 10 minutes; T3, 24 hours; T4, 7 days; T5, 30 days; and T6, 60 days after insertion of the removable appliance. Saliva samples were analyzed for nickel, chromium, and iron by atomic absorption spectrophotometry. Statistical analysis was performed by nonparametric tests (Friedman, Mann-Whitney, Kruskal-Wallis). Results: Saliva evaluation revealed a large variation in concentration of these ions between individuals. The results also appeared to indicate an increase in nickel and chromium ions immediately after placement of the appliance (T2), but this was statistically significant only for groups B and C. There was no increase in iron levels. A tendency for increases in nickel and chromium concentrations was verified immediately after placement of the appliance, but these values are probably reduced because of biofilm formation regardless of the bracket used. Conclusion: Nickel and chromium ion concentrations increased immediately after placement of the appliance in the mouth for all study groups. There were no significant differences in the nickel, chromium, and iron levels released by the three groups of appliances at all study periods.