Biological Trace Element Research

, Volume 139, Issue 3, pp 241–256

Release of Metal Ions from Orthodontic Appliances by In Vitro Studies: A Systematic Literature Review



In the present work, a systematic literature review on release of metal ions from orthodontic appliances under in vitro conditions is described. Detailed and schematic analysis of used materials and applied methods (immersion media, incubation time, temperature, and analytical techniques) is provided. The PubMed search identified 40 studies, among which eight met the selection criteria. One additional study was included in the review. All the authors agreed that the doses of released metal ions were far below the toxic level and the dietary intake. Although the concentrations of metal ions in immersion media greatly differed, the general conclusions were coherent. It must be underlined that the main disadvantage of in vitro tests was that the experimental setup did not reflect in vivo conditions, e.g., the presence of biofilm, which grows on the surface of the materials in oral cavity. The presence and activity of microflora to a large extent is responsible for the process of corrosion, in particular, biodeterioration. The further scheme of in vitro research should incorporate changeable conditions of oral cavity environment (pH, dynamic conditions—saliva flow) and the presence of microbiological flora (microbiological attack) in the experimental design and, first of all, the real proportions of appliance elements.


Orthodontic appliance In vitro Corrosion Metal release Artificial saliva NaCl Acidic solution 


  1. 1.
    Eliades T, Bourauel C (2005) Intraoral aging of orthodontic materials: the picture we miss and its clinical relevance. Am J Orthod Dentofacial Orthop 127:403–412CrossRefPubMedGoogle Scholar
  2. 2.
    Kusy RP (2002) Orthodontic biomaterials: from the past to the present. Angle Orthod 72(6):501–512PubMedGoogle Scholar
  3. 3.
    Peltonen L (1979) Nickel sensitivity in the general population. Contact Dermatitis 5:27–29CrossRefPubMedGoogle Scholar
  4. 4.
    Moffa JP (1982) Council on dental materials, instruments, and equipment biological effects of nickel-containing dental alloys. J Am Dent Assoc 104:501–505PubMedGoogle Scholar
  5. 5.
    Huang TH, Yen CC, Kao CT (2001) Comparison of ion release from new and recycled orthodontic brackets. Am J Orthod Dentofacial Orthop 120(1):68–75CrossRefPubMedGoogle Scholar
  6. 6.
    Arndt M, Bruck A, Scully T, Jager A, Bourauel C (2005) Nickel ion release from orthodontic NiTi wires under simulation of realistic in-situ conditions. J Mat Sci 40:3659–3667CrossRefGoogle Scholar
  7. 7.
    Fors R, Person M (2006) Nickel in dental plaque and saliva in patients with and without orthodontic appliances. Eur J Orthod 28:292–297CrossRefPubMedGoogle Scholar
  8. 8.
    Kerosuo H, Moe G, Hensten-Pettersen (1997) A salivary nickel and chromium in subjects with different types of fixed orthodontic appliances. Am J Orthod Dentofacial Orthop 111:595–598CrossRefPubMedGoogle Scholar
  9. 9.
    Chojnacka K, Mikulewicz M (2010) Trace metal release from orthodontic appliances by in vivo studies: a systematic literature review. Biol Trace Elem Res. doi:10.1007/s12011-009-8576-6 Google Scholar
  10. 10.
    Barrett RD, Bishara SE, Quinn JK (1993) Biodegradation of orthodontic appliances Part I biodegradation of nickel and chromium in vitro. Am J Orthod Dentofacial Orthop 103(1):8–14CrossRefPubMedGoogle Scholar
  11. 11.
    Darabara MS, Bourithis LI, Zinelis S, Papadimitriou GD (2007) Metallurgical characterization, galvanic corrosion, and ionic release of orthodontic brackets coupled with Ni–Ti archwires. J Biomed Mater Res B Appl Biomater 81(1):126–134PubMedGoogle Scholar
  12. 12.
    Eliades T, Pratsinis H, Kletsas D, Eliades G, Makou M (2004) Characterization and cytotoxicity of ions released from stainless steel and nickel–titanium orthodontic alloys. Am J Orthod Dentofacial Orthop 125(1):24–29CrossRefPubMedGoogle Scholar
  13. 13.
    Gürsoy S, Acar AG, Seşen C (2004) Comparison of metal release from new and recycled bracket–archwire combinations. Angle Orthod 75(1):92–94Google Scholar
  14. 14.
    Hwang CJ, Shin JS, Cha JY (2001) Metal release from simulated fixed orthodontic appliances. Am J Orthod Dentofacial Orthop 120(4):383–391CrossRefPubMedGoogle Scholar
  15. 15.
    Kuhta M, Pavlin D, Slaj M, Varga S, Lapter-Varga M, Slaj M (2009) Type of archwire and level of acidity: effects on the release of metal ions from orthodontic appliances. Angle Orthod 79(1):102–110CrossRefPubMedGoogle Scholar
  16. 16.
    Park HY, Shearer TR (1983) In vitro release of nickel and chromium from simulated orthodontic appliances. Am J Orthod 84(2):156–159CrossRefPubMedGoogle Scholar
  17. 17.
    Staffolani N, Damiani F, Lilli C, Guerra M, Staffolani NJ, Belcastro S, Locci P (1999) Ion release from orthodontic appliances. J Dent 27(6):449–454CrossRefPubMedGoogle Scholar
  18. 18.
    Kerosuo H, Moe G, Kleven E (1995) In vitro release of nickel and chromium from different types of simulated ortodontic appliances. Angle Orthod 65(2):111–116PubMedGoogle Scholar
  19. 19.
    Huang HH, Chiu YH, Lee TH, Wu SC, Yang HW, Su KH, Hsu CC (2003) Ion release from NiTi orthodontic wires in artificial saliva with various acidities. Biomaterials 24(20):3585–3592CrossRefPubMedGoogle Scholar
  20. 20.
    Monaci F, Bargagli E, Bravi F, Rottoli P (2002) Concentrations of major elements and mercury in unstimulated human saliva. Biol Trace Elem Res 89(3):193–203CrossRefPubMedGoogle Scholar
  21. 21.
    Frisk P, Danersund A, Hudecek R, Lindh U (2007) Changed clinical chemistry pattern in blood after removal of dental amalgam and other metal alloys supported by antioxidant therapy. Biol Trace Elem Res 120(1–3):163–170CrossRefPubMedGoogle Scholar
  22. 22.
    Frisk P, Lindvall A, Hudecek R, Lindh U (2006) Decrease of trace elements in erythrocytes and plasma after removal of dental amalgam and other metal alloys. Biol Trace Elem Res 113(3):247–259CrossRefPubMedGoogle Scholar
  23. 23.
    Hol PJ, Vamnes JS, Gjerdet NR, Eide R, Isrenn R (2002) Dental amalgam affects urinary selenium excretion. Biol Trace Elem Res 85:137–147CrossRefPubMedGoogle Scholar
  24. 24.
    Ahn HS, Kim MJ, Seol HJ, Lee JH, Kim HI, Kwon YH (2006) Effect of pH and temperature on orthodontic NiTi wires immersed in acidic fluoride solution. J Biomed Mater Res B Appl Biomater 79(1):7–15PubMedGoogle Scholar
  25. 25.
    Baumann MA, Samanek K, Ruppenthal T (1992) An in-vitro study of the interference of orthodontic banding and filling materials. Fortschr Kieferorthop 53(4):211–217CrossRefPubMedGoogle Scholar
  26. 26.
    Belcastro S, Staffolani N, Guerra M (2001) Effects of organic acids on corrosion of orthodontic appliances. Minerva Stomatol 50(1–2):15–20, ItalianPubMedGoogle Scholar
  27. 27.
    Cioffi M, Gilliland D, Ceccone G, Chiesa R, Cigada A (2005) Electrochemical release testing of nickel–titanium orthodontic wires in artificial saliva using thin layer activation. Acta Biomater 1(6):717–724CrossRefPubMedGoogle Scholar
  28. 28.
    David A, Lobner D (2004) In vitro cytotoxicity of orthodontic archwires in cortical cell cultures. Eur J Orthod 26(4):421–426CrossRefPubMedGoogle Scholar
  29. 29.
    Eliades T, Eliades G, Brantley WA, Johnston WM (1995) Residual monomer leaching from chemically cured and visible light-cured orthodontic adhesives. Am J Orthod Dentofacial Orthop 108(3):316–321CrossRefPubMedGoogle Scholar
  30. 30.
    Es-Souni M, Es-Souni M, Fischer-Brandies H (2002) On the properties of two binary NiTi shape memory alloys Effects of surface finish on the corrosion behaviour and in vitro biocompatibility. Biomaterials 23(14):2887–2894CrossRefPubMedGoogle Scholar
  31. 31.
    Es-Souni M, Fischer-Brandies H, Es-Souni M (2003) On the in vitro biocompatibility of Elgiloy, a co-based alloy, compared to two titanium alloys. J Orofac Orthop 64(1):16–26CrossRefPubMedGoogle Scholar
  32. 32.
    Gil FJ, Planell JA (1999) Effect of copper addition on the superelastic behavior of Ni–Ti shape memory alloys for orthodontic applications. J Biomed Mater Res 48(5):682–688CrossRefPubMedGoogle Scholar
  33. 33.
    Gjerdet NR, Herø H (1987) Metal release from heat-treated orthodontic archwires. Acta Odontol Scand 45(6):409–414CrossRefPubMedGoogle Scholar
  34. 34.
    Grimsdottir MR, Gjerdet NR, Hensten-Pettersen A (1992) Composition and in vitro corrosion of orthodontic appliances. Am J Orthod Dentofacial Orthop 101(6):525–532CrossRefPubMedGoogle Scholar
  35. 35.
    Hanson M, Lobner D (2004) In vitro neuronal cytotoxicity of latex and nonlatex orthodontic elastics. Am J Orthod Dentofacial Orthop 126(1):65–70CrossRefPubMedGoogle Scholar
  36. 36.
    Jang HS, Son WS, Park SB, Kim HI, Yong HK (2006) Effect of acetic NaF solution on the corrosion behavior of stainless steel orthodontic brackets. Dent Mater J 25(2):339–344CrossRefPubMedGoogle Scholar
  37. 37.
    Jensen CS, Lisby S, Baadsgaard O, Byrialsen K, Menné T (2003) Release of nickel ions from stainless steel alloys used in dental braces and their patch test reactivity in nickel-sensitive individuals. Contact Dermatitis 48(6):300–304CrossRefPubMedGoogle Scholar
  38. 38.
    Jia W, Beatty MW, Reinhardt RA, Petro TM, Cohen DM, Maze CR, Strom EA, Hoffman M (1999) Nickel release from orthodontic arch wires and cellular immune response to various nickel concentrations. J Biomed Mater Res 48(4):488–495CrossRefPubMedGoogle Scholar
  39. 39.
    Kang EH, Park SB, Kim HI, Kwon YH (2008) Corrosion-related changes on Ti-based orthodontic brackets in acetic NaF solutions: surface morphology, microhardness, and element release. Dent Mater J 27(4):555–560CrossRefPubMedGoogle Scholar
  40. 40.
    Kao CT, Ding SJ, Chen YC, Huang TH (2002) The anticorrosion ability of titanium nitride (TiN) plating on an orthodontic metal bracket and its biocompatibility. J Biomed Mater Res 63(6):786–792CrossRefPubMedGoogle Scholar
  41. 41.
    Kao CT, Ding SJ, He H, Chou MY, Huang TH (2007) Cytotoxicity of orthodontic wire corroded in fluoride solution in vitro. Angle Orthod 77(2):349–354CrossRefPubMedGoogle Scholar
  42. 42.
    Kim H, Johnson JW (1999) Corrosion of stainless steel, nickel–titanium, coated nickel–titanium, and titanium orthodontic wires. Angle Orthod 69(1):39–44PubMedGoogle Scholar
  43. 43.
    Kwon YH, Cheon YD, Seol HJ, Lee JH, Kim HI (2004) Changes on NiTi orthodontic wired due to acidic fluoride solution. Dent Mater J 23(4):557–565PubMedGoogle Scholar
  44. 44.
    Lippitz SJ, Staley RN, Jakobsen JR (1998) In vitro study of 24-hour and 30-day shear bond strengths of three resin-glass ionomer cements used to bond orthodontic brackets. Am J Orthod Dentofacial Orthop 113(6):620–624CrossRefPubMedGoogle Scholar
  45. 45.
    Luft S, Keilig L, Jäger A, Bourauel C (2009) In-vitro evaluation of the corrosion behavior of orthodontic brackets. Orthod Craniofac Res 12(1):43–51CrossRefPubMedGoogle Scholar
  46. 46.
    Mockers O, Deroze D, Camps J (2002) Cytotoxicity of orthodontic bands, brackets and archwires in vitro. Dent Mater 18(4):311–317CrossRefPubMedGoogle Scholar
  47. 47.
    Nocca G, Chimenti C, Parziale V, Gambarini G, Giardina B, Lupi (2006) A In vitro comparison of the cytotoxicity of two orthodontic composite resins. Minerva Stomatol 55(5):297–305, English, ItalianPubMedGoogle Scholar
  48. 48.
    Oh KT, Kim KN (2005) Ion release and cytotoxicity of stainless steel wires. Eur J Orthod 27(6):533–540CrossRefPubMedGoogle Scholar
  49. 49.
    Peitsch T, Klocke A, Kahl-Nieke B, Prymak O, Epple M (2007) The release of nickel from orthodontic NiTi wires is increased by dynamic mechanical loading but not constrained by surface nitridation. J Biomed Mater Res A 82(3):731–739PubMedGoogle Scholar
  50. 50.
    Sfondrini MF, Cacciafesta V, Maffia E, Massironi S, Scribante A, Alberti G, Biesuz R, Klersy C (2008) Chromium release from new stainless steel, recycled and nickel-free orthodontic brackets. Angle Orthod 79(2):361–367CrossRefGoogle Scholar
  51. 51.
    Wang QY, Zheng YF (2008) The electrochemical behavior and surface analysis of Ti50Ni472Co28 alloy for orthodontic use. Dent Mater 24(9):1207–1211CrossRefPubMedGoogle Scholar
  52. 52.
    Wheeler AW, Foley TF, Mamandras A (2002) Comparison of fluoride release protocols for in-vitro testing of 3 orthodontic adhesives. Am J Orthod Dentofacial Orthop 121(3):301–309CrossRefPubMedGoogle Scholar
  53. 53.
    Young A, von der Fehr FR, Sønju T, Nordbø H (1996) Fluoride release and uptake in vitro from a composite resin and two orthodontic adhesives. Acta Odontol Scand 54(4):223–228CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.Department of Dentofacial Orthopaedics and OrthodonticsMedical University of WrocławWrocławPoland
  2. 2.Institute of Inorganic Technology and Mineral FertilizersWrocław University of TechnologyWrocławPoland

Personalised recommendations