Release of Nickel and Chromium Ions from Stainless Steel Orthodontics Bracket: A Review

Background: Stainless brackets containing nickel (Ni) and chromium (Cr) are attached to the patient's teeth and interact with the oral environment to cause corrosion. The release of chromium and nickel metals can enter the body and come into direct contact with the tissues. Factors that can cause ion release in stainless orthodontic brackets are temperature, microflora, oral enzymes, quality and quantity of saliva, changes in acidity (pH) of saliva, plaque, protein, physical and chemical properties of food and beverages. Objective: To describe the amount of Cr and Ni ions released on the use of stainless steel brackets in saliva through a narrative review. Methods: The data source of this research was obtained through a literature search through a database. Study about the level of Ni and Cr ions in saliva due to the release of Ni and Cr bracket stainless steel in-vitro. Results: the difference in brand and material mix of stainless steel bracket affected the amount of Ni and Cr ions released. An increase in pH acidity causes the release of nickel ions which is more than the release of ions at normal pH. Uncontrolled release of ions by the bracket can have a negative effect on patient health. Conclusion: The amount of Cr and Ni ions released in stainless steel orthodontics brackets in the saliva is influenced by the bracket raw material and the mixture of saliva solutions caused by oral conditions and the artificial saliva mixture.