title: A severe reaction to ni-containing orthodontic appliances.
abstract: Exposure to nickel-containing orthodontic appliances may cause intra- or extraoral allergic reactions. Nickel is the most typical antigen implicated in causing allergic contact dermatitis, which is a Type IV delayed hypersensitivity immune response. This report presents an unusual reaction to nickel during the orthodontic treatment of an adult female patient. The patient had no previous history of allergy and had been wearing fixed metal upper appliances while in orthodontic treatment to assist the eruption of her impacted teeth. The adverse hypersensitivity reactions appeared only after the surgical exposure and included severe signs of eczematic and urticarial reactions of the face with redness, irritation, itching, eczema, soreness, fissuring, and desquamation as well as intraoral diffuse red zones. Diagnostic patch testing performed by the allergist revealed sensitization to nickel (++++ score). Treatment was achieved with nickel-free appliances.
authors.affiliation: Department of Orthodontics, Aristotle University of Thessaloniki, Thessaloniki, Greece. okolok@dent.auth.gr
authors.forename: Olga Elpis
authors.initials: OE
authors.lastname: Kolokitha
authors.forename: Evangelia
authors.initials: E
authors.lastname: Chatzistavrou
mesh_terms: D000328:Adult; D003481:Cuspid / Q000503:physiopathology / Q000601:surgery; D003722:Dental Alloys / Q000009:adverse effects; D017449:Dermatitis, Allergic Contact / Q000209:etiology*; D005148:Facial Dermatoses / Q000139:chemically induced*; D005260:Female; D006801:Humans; D009532:Nickel / Q000009:adverse effects*; D009967:Orthodontic Appliances / Q000009:adverse effects*; D050793:Orthodontic Extrusion / Q000295:instrumentation*; D014025:Titanium / Q000009:adverse effects; D014095:Tooth, Impacted / Q000601:surgery / Q000628:therapy
chemical_list: D003722:Dental Alloys; C040654:titanium nickelide; D009532:Nickel; D014025:Titanium