Nickel allergy a concern for the orthodontist because it is present in a vast array of materials frequently used in orthodontics. Nickel is the most common component of the super-elastic nickeltitanium (Ni-Ti) archwires used during the initial levelling and aligning phase of orthodontic treatment with a concentration of 47-50%.So,Biology and Immune Response of Nickel Allergy?
The response by the immune system to nickel is usually a Type IV cell mediated delayed
hypersensitivity also called an allergic contact dermatitis. It is mediated by T-cells and monocytes/
macrophages rather than antibodies and consists
of two phases. The first phase, or sensitisation, occurs when nickel initially enters the body. There
is usually no response present at this time but the
immune system is primed or sensitised for an allergic response. The major sensitisation routes are nickel-containing jewellery and foods. Foods that are
high in nickel include chocolate, soy beans, nuts and oatmeal. A response, or the elicitation phase, is in
the form of a contact mucositis or dermatitis that occurs during re-exposure to nickel and develops
over a period of days or rarely up to three weeks. If
nickel is leached from orthodontic appliances, this Type IV hypersensitivity reaction cans occur.
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