{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T06:37:27Z","timestamp":1769755047853,"version":"3.49.0"},"reference-count":26,"publisher":"The Angle Orthodontist (EH Angle Education & Research Foundation)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2009,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>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.<\/jats:p>","DOI":"10.2319\/111507-531.1","type":"journal-article","created":{"date-parts":[[2008,8,1]],"date-time":"2008-08-01T18:01:50Z","timestamp":1217613710000},"page":"186-192","source":"Crossref","is-referenced-by-count":29,"title":["A Severe Reaction to Ni-Containing Orthodontic Appliances"],"prefix":"10.2319","volume":"79","author":[{"given":"Olga Elpis","family":"Kolokitha","sequence":"first","affiliation":[{"name":"a\u2009Lecturer, Department of Orthodontics, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Evangelia","family":"Chatzistavrou","sequence":"first","affiliation":[{"name":"b\u2009Research Fellow, Department of Orthodontics, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1164","reference":[{"key":"2020042118062395000_i0003-3219-079-01-0186-b1","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1016\/0889-5406(92)70127-V","article-title":"Composition and in vitro corrosion of orthodontic appliances.","volume":"101","author":"Gr\u00edmssd\u00f3ttir","year":"1992","journal-title":"Am J Orthod Dentofacial Orthop"},{"key":"2020042118062395000_i0003-3219-079-01-0186-b2","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1016\/0002-9416(83)90180-X","article-title":"In vitro release of nickel and chromium from stimulated orthodontic appliances.","volume":"84","author":"Park","year":"1983","journal-title":"Am J Orthod"},{"key":"2020042118062395000_i0003-3219-079-01-0186-b3","doi-asserted-by":"crossref","article-title":"Orthodontic wires.","author":"Brantley","DOI":"10.1055\/b-0034-43092"},{"key":"2020042118062395000_i0003-3219-079-01-0186-b4","first-page":"222","article-title":"In vivo aging of orthodontic alloys: implications for corrosion potential, nickel release, and biocompatibility.","volume":"72","author":"Eliades","year":"2002","journal-title":"Angle Orthod"},{"key":"2020042118062395000_i0003-3219-079-01-0186-b5","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1053\/j.sodo.2004.09.002","article-title":"Adverse hypersensitivity reactions in orthodontics.","volume":"10","author":"Leite","year":"2004","journal-title":"Semin Orthod"},{"key":"2020042118062395000_i0003-3219-079-01-0186-b6","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1016\/S0889-5406(98)70226-4","article-title":"Nickel hypersensitivity reaction before, during, and after orthodontic therapy.","volume":"113","author":"Janson","year":"1998","journal-title":"Am J Orthod Dentofacial Orthop"},{"key":"2020042118062395000_i0003-3219-079-01-0186-b7","doi-asserted-by":"crossref","article-title":"Contact dermatitis.","author":"Wilkinson","DOI":"10.1177\/003591576205500706"},{"key":"2020042118062395000_i0003-3219-079-01-0186-b8","doi-asserted-by":"crossref","first-page":"511","DOI":"10.2340\/0001555561511515","article-title":"Lymphocyte transformation test in patients with nickel sensitivity: an aid to diagnosis.","volume":"61","author":"Al-Tawil","year":"1981","journal-title":"Acta Derm Venereol"},{"key":"2020042118062395000_i0003-3219-079-01-0186-b9","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1111\/j.1600-0714.1988.tb01899.x","article-title":"T-lymphocyte and Langerhans cell distribution in normal and allergically-induced oral mucosa in contact with nickel-containing dental alloys.","volume":"17","author":"van Loon","year":"1988","journal-title":"J Oral Pathol"},{"key":"2020042118062395000_i0003-3219-079-01-0186-b10","article-title":"Allergic reactions and safety concerns.","author":"Hensten-Pettersen"},{"key":"2020042118062395000_i0003-3219-079-01-0186-b11","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1111\/j.1600-0536.1979.tb05531.x","article-title":"Nickel sensitivity in the general population.","volume":"5","author":"Peltonen","year":"1979","journal-title":"Contact Dermat"},{"key":"2020042118062395000_i0003-3219-079-01-0186-b12","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1111\/j.1600-0536.1987.tb01403.x","article-title":"Epidemiology of nickel allergy.","volume":"16","author":"Schubert","year":"1987","journal-title":"Contact Dermat"},{"key":"2020042118062395000_i0003-3219-079-01-0186-b13","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1093\/oxfordjournals.ejo.a035993","article-title":"Occupational health problems and adverse patient reactions in orthodontics.","volume":"11","author":"Jacobsen","year":"1989","journal-title":"Eur J Orthod"},{"key":"2020042118062395000_i0003-3219-079-01-0186-b14","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1016\/0022-3913(84)90193-8","article-title":"A study of nickel allergy.","volume":"52","author":"Blanco-Dalmau","year":"1984","journal-title":"J Prosthet Dent"},{"key":"2020042118062395000_i0003-3219-079-01-0186-b15","first-page":"31","article-title":"Clinical evaluation of nickel hypersensitivity reaction in patients under orthodontic treatment.","volume":"27","author":"Janson","year":"1994","journal-title":"Ortodontia"},{"key":"2020042118062395000_i0003-3219-079-01-0186-b16","doi-asserted-by":"crossref","first-page":"1192","DOI":"10.1034\/j.1398-9995.2001.00086.x","article-title":"Epidemiology of contact allergy in adults.","volume":"56","author":"Sch\u00e4fer","year":"2001","journal-title":"Allergy"},{"key":"2020042118062395000_i0003-3219-079-01-0186-b17","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1111\/j.1600-0536.1986.tb01198.x","article-title":"Contact clinic survey of nickel-sensitive subjects.","volume":"14","author":"Gawkrodger","year":"1986","journal-title":"Contact Dermat"},{"key":"2020042118062395000_i0003-3219-079-01-0186-b18","first-page":"537","article-title":"Epidemiology of contact dermatitis.","volume":"108","author":"North American Contact Dermatitis Group.","year":"1973","journal-title":"Arch Dermatol"},{"key":"2020042118062395000_i0003-3219-079-01-0186-b19","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1093\/ortho\/30.2.171","article-title":"Current products and practice. Nickel allergy and orthodontics.","volume":"30","author":"Rahilly","year":"2003","journal-title":"J Orthod"},{"key":"2020042118062395000_i0003-3219-079-01-0186-b20","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1016\/j.jaad.2003.11.069","article-title":"Prevalence and relevance of contact dermatitis allergens: a meta-analysis of 15 years of published T.R.U.E. Test data.","volume":"51","author":"Krob","year":"2004","journal-title":"J Am Acad Dermatol"},{"key":"2020042118062395000_i0003-3219-079-01-0186-b21","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1016\/j.ajodo.2003.05.014","article-title":"Hypersensitivity to metals in orthodontics.","volume":"126","author":"Menezes","year":"2004","journal-title":"Am J Orthod Dentofacial Orthop"},{"key":"2020042118062395000_i0003-3219-079-01-0186-b22","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1016\/0889-5406(93)70009-D","article-title":"Nickel hypersensitivity in the orthodontic patient.","volume":"103","author":"Bass","year":"1993","journal-title":"Am J Orthod Dentofac Orthop"},{"key":"2020042118062395000_i0003-3219-079-01-0186-b23","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1007\/BF02716959","article-title":"Orthodontic appliances in relation to nickel hypersensitivity. A review.","volume":"58","author":"Lindsten","year":"1997","journal-title":"J Orofac Orthop"},{"key":"2020042118062395000_i0003-3219-079-01-0186-b24","article-title":"Disintegration of orthodontic appliances.","author":"Hensten-Pettersen"},{"key":"2020042118062395000_i0003-3219-079-01-0186-b25","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1016\/j.ajodo.2005.03.002","article-title":"Characterization of nickel-induced allergic contact stomatitis associated with fixed orthodontic appliances.","volume":"128","author":"Genelhu","year":"2005","journal-title":"Am J Orthod Dentofacial Orthop"},{"key":"2020042118062395000_i0003-3219-079-01-0186-b26","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1093\/ejo\/10.1.87","article-title":"The corrosion of orthodontic wire.","volume":"10","author":"Toms","year":"1988","journal-title":"Eur J Orthod"}],"container-title":["The Angle Orthodontist"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/meridian.allenpress.com\/angle-orthodontist\/article-pdf\/79\/1\/186\/1384583\/111507-531_1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/meridian.allenpress.com\/angle-orthodontist\/article-pdf\/79\/1\/186\/1384583\/111507-531_1.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,7]],"date-time":"2025-05-07T16:11:00Z","timestamp":1746634260000},"score":1,"resource":{"primary":{"URL":"https:\/\/angle-orthodontist.kglmeridian.com\/view\/journals\/angl\/79\/1\/article-p186.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009,1,1]]},"references-count":26,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2009,1,1]]}},"URL":"https:\/\/doi.org\/10.2319\/111507-531.1","relation":{},"ISSN":["0003-3219","1945-7103"],"issn-type":[{"value":"0003-3219","type":"print"},{"value":"1945-7103","type":"electronic"}],"subject":[],"published":{"date-parts":[[2009,1,1]]}}}