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An overview of orthodontic material degradation in oral cavity

Article in Indian journal of dental research: official publication of Indian Society for Dental Research · April 2010
DOI: 10.4103/0970-9290.66648 · Source: PubMed

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An overview of orthodontic material degradation in oral cavity

TP Chaturvedi, SN Upadhayay1

Department of Orthodontics,
Faculty of Dental Sciences,
ABSTRACT
Institute of Medical Sciences;
1
Department of Chemical
Engineering, IT, Banaras Hindu
University, Varanasi, UP, India
Received : 27-04-09
Review completed : 07-11-09
Accepted : 06-02-10
PubMed ID : ***
DOI: 10.4103/0970-9290.66648
Various types of metallic orthodontic appliances are used in the management of malocclusion.
Thèse appliances are placed in oral environnent under many stresses and variations such as
masticatory forces, appliance loading, temperature fluctuations, varieties of ingested food and
saliva. These metals undergo electrochemical reactions with the oral environment resulting in
dissolution or formation of chemical compounds. Various microorganisms and many aggressive
ions containing oral environment can cause material degradation (corrosion) and its associated
problems during long time exposure. Orthodontic alloys must have excellent corrosion resistance
to the oral environment, which is highly important for biocompatibility as well as for orthodontic
appliance durability. This article reviews various aspects of corrosion (surface degradation) of
orthodontic alloys. It explores the emerging research strategies for probing the biocompatibility
of materials. During orthodontic treatment, use of nickel free, better corrosion resistance alloys
and less use of fluoride containing toothpaste or gel is expected.
Key words: Biocompatibility, corrosion, dental alloys, material degradation, nickel allergy,
orthodontic alloys, orthodontic wires, surface degradation

Biocompatibility of dental material is now a fundamental briefly the corrosion aspects (material degradation) and its
requirement of successful clinical behavior in oral cavity. effect on orthodontic wires and brackets in oral environment,
It draws on knowledge from biology, patient risk factors, effect of fluoride gel/toothpaste on orthodontic appliances
clinical experience and engineering. There are two and nickel sensitivity. A Summary of the few experimental
key factors that appear to be important in determining works on the corrosion of orthodontic alloys (in vitro) are
biocompatibility of any dental material − some involve given in Table 2, which can explore the future research
various types of corrosion or material degradation and strategies for properties of orthodontic materials.
others include surface characteristics. Dental materials
within the mouth interact continually with physiological IMPORTANCE OF CORROSION ON
fluids. Saliva is a hypotonic solution containing bioactonate, ORTHODONTIC WIRES
chloride, potassium, sodium, nitrogenous compounds and
proteins.[1] Corrosion, the graded degradation of materials For all practical purposes, the metallic restoration/
by electrochemical attack, is of concern particularly when orthodontic wires cannot be isolated electrically from the
orthodontic appliances are placed in the hostile electrolytic tooth. Resistance to corrosion is critically important for
environment provided by the human mouth.[2,3] Various orthodontic wires because corrosion can lead to roughening
types of wires and brackets are used in the treatment of of the surface, weakening of the appliances, and liberation
malocclusion e.g. stainless steel, cobalt-chromium-nickel of elements from the metal or alloy.[5,6] Release of elements
alloys, nickel-titanium alloys, β-titanium alloys, etc
[Table 1]. A ductile wire can be formed into various shapes. Table 1: Types of wires used for orthodontic treatment and
their composition
As a manufacturing process, the industry uses brazing
alloys to join the base and wing components of brackets. Type of wires Composition
Gold alloys 15-63% Au, 11-19% Cu, 10-25% Ag,
Silver based brazing alloys form a galvanic couple that can
5-11% Pd
lead to ionic release mainly copper and zinc. Solder joints Stainless steel 70-72% Fe, 18-19% Cr, 08-9% Ni, C less
of removable appliances and face bows, and brazed joints than 0.2%
of some stainless steel brackets may affect the mechanical Chrome-cobalt 40% Co, 20% Cr, 15% Ni, 15.4% Fe,
properties.[4] The objective of the present article is to review 07% Mo, 02% Mn, 0.4 Br, 0.05% others
Nickel-titanium 55% Ni, 43-44% Ti, 1.6-3% Co
Address for correspondence:
Copper-nickel-titanium 44 Ti, 51% Ni, 0.50% Cr, 6.5% Cu
Dr. TP Chaturvedi,
E-mail: tpchaturvedi@rediffmail.com Beta-titanium 78% Ti, 13% Mo, 05% Zr, 04% Sn

275 Indian J Dent Res, 21(2), 2010

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Material degradation Chaturvedi and Upadhayay

Table 2: Summary of experimental work on the corrosion of orthodontic alloys (in vitro)
References Orthodontics wires Medium, temperature, pH, Remark
period, method etc
Eliades et al.[5] Ni-Ti arch wire 1 month, Atomic Force Exposure of orthodontic materials to the oral cavity is
Microscopy associated with a non-specific aging pattern characterized
by calcification of the absorbed complexes.
Anisa Vahed et al.[17] Stainless steel wire. Silver Fusayama Meyer artificial Significant reduction in the tensile failure load of silver-
solder. saliva. soldered stainless joints. The preponderance of Cu-rich
pH- 7 particles that form in the solder metal at the interface provides
37oC, 28 days. SEM. a micro galvanic effect that leads to selective dissolution of
these particles and corresponding weakening of the interface.
Berge etal.[28] Austenitic stainless steel, Open cell potential Austenitic stainless steel wires release nickel and chromium in
Co-Cr wires measurements higher amounts than that of cobalt- chromium wires, resulting
in discoloration, rust, or even breakages.
Silver solder is less noble metal and thus prone to corrosion.
Choubey et al.[29] Ti-6Al-4V, Ti-6Al-4Nb, Ti- Hank’s solution, Temp.=37+ All the alloys were found to be passivated immediately on
6Al-4Fe and Ti-5Al-2.5Fe 0.1oC, Electro chemical cell. immersion. The passivation properties were comparable for
the alloys. The estimated corrosion rates of the alloys were
also comparable. The electrochemical and corrosion behavior
of Ti-6Al-4V is not affected significantly on substituting
vanadium with niobium and iron.
Oshida et al. [32] Ti-6Al-4V and 17.4 Artificial Saliva, pH=6.8, 4 Ti-6Al-4V and 17-4 PH stainless steel brackets discolored with
stainless steel min. commercially available fluoride treatment agents. The APF
(acidulated phosphate fluoride) agent exhibited the greatest
corrosive effects.
Liu et al.[35] Ni based and Cr based 0.9% NaCl Solution Higher positive corrosion potential and a lower corrosion
dental materials with Potentiostat current density in alloy having coated with titanium aluminum
Titanium aluminum nitride nitride as compared with uncoated dental alloys.
coating and without The pitting corrosion was substantially reduced by the
coating. employment of TiAlN coating.
Souni et al.[36] Cr-Co alloy (Elgiloy) Half strength Ringer solution It showed high pitting corrosion, lower repassivation potentials
compared with NiTi alloy and artificial saliva. and increase in current density once pitting had occurred.
Hera kim et al.[37] Stainless steel, Nitride 0 .9% NaCl solution, Neutral SEM Photographs revealed that some nickel titanium and
coated NiTi, and titanium pH, stainless steel wire were susceptible to corrosion.
coated orthodontic wires. Room temperature. The nitride coating did not affect the corrosion of the alloy,
Potentiostat, SEM. but epoxy coating decreased corrosion. Titanium wires
and epoxy-coated nickel titanium wires exhibited the least
corrosive potential.
For patients allergic to nickel, the use of titanium or epoxy-
coated wires during orthodontic treatment is recommended.
Platt et al.[40] 2205 duplex stainless 0.9% NaCl Solution 2205 duplex stainless is an improved alternative to 316L for
steel (Ni content: 4-6wt%) Temp-37oC, orthodontic bracket fabrication when used in conjunction with
compared with 316L Ti, its alloys, or stainless steel arch wires.
stainless steel (Ni content:
10-14%)
Rogers[41] Stainless steel with silver Ringer solution, Electroplating with gold before and after silver soldering the
soldered, gold plated, 0.1 M chloride solution; stainless steel prevented crevice corrosion. The stainless
nickel plated; silver Deaerated Ringer’s solution steel surface was activated and prevented by the first layer
soldered, gold plated Temp-37oC, of electrodeposited gold. The silver soldered alloyed with this
stainless steel; replated pH 7 gold layer so a second application of electrode-deposited
with gold after soldering. gold was required to protect the joint from electrolytic action.
Masahir et al.[47] Two common bracketal. 0.9% NaCl Solution SUS 304-NiTi and Ti-NiTi may remarkably accelerate the
loys, stainless steels and 3 days, Neutral pH. corrosion of NiTi alloy, which serves as the anode.
Ti, and four common wire The different anode-cathode area ratios used in this study
alloys, NiTi alloy, β-Ti had little effect on galvanic corrosion behavior.
alloy, stainless steel, and
Co-Cr-Ni alloy
Wang et al.[50] NiTi wires Artificial saliva, Orthodontic NiTi wires were broken by stress corrosion
Room temperature, cracking during service.
30 days. The slight change in temperature will cause the dynamic
Optical and scanning electron phase transformation which causes the change in surface
microscope (SEM) state.
A tool-made notch in orthodontic NiTi wires can cause stress
corrosion cracking.

Contd...

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Material degradation Chaturvedi and Upadhayay

Table 2: Contd/-
References Orthodontics wires Medium, temperature, pH,
period, method etc
Lin et al.[51] Different brands SS Fusayama Artificial Saliva,
brackets pH=5.0 Temp.=37+1, Electro
chemical corrosion cell
Chang et al.[54] Commercially pure Gamry corrosion test system,
titanium (CPT), Ti-6Al- (1) sterilized Ringer's solution
4V (TAV), Ti-Ni (TN), as a control for (2), (2) S.
Co-Cr-Mo alloy (CCM), mutans mixed with sterilized
316L stainless steel Ringer's solution; (3) sterilized
(SSL), 17Cr-4Ni PH-type tryptic soy broth as a control
stainless steel (PH), and for (4), and (4) byproducts
Ni-Cr alloy (NC). of S. mutans mixed with
sterilized tryptic soy broth
Maruthamuthu NiTi, Stainless steel Sterile as well as mixed
et al. [55] round wire bacteria inoculated artificial
saliva.
12 hours, 37oC.
Potentiostat.
Huang et al. [57] Ti-6Al-4V alloy Artificial saliva with 0.5%
NaF, with o.1% NaF+0.01-
0.5% Bovine albumin
(BA), 37oC, pH-5, X-ray
photoelectron spectroscopy.
Schiff et al.[60] Three types of brackets Three fluoride mouthwashes
(Co Cr, FeCrNi and Ti Fusayama Meyer artificial
based brackets), saliva used as reference
corrosion resistance was solution
compared with that of
platinum
Schiff et al.[62] Ti based wires – TMA, Three fluoride mouthwashes
TiNb, NiTi, Fusayama Meyer artificial
CuNiTi. saliva used as reference
solution (24 hour)
Huang[63] Four different NITi Fluoride mouthwashes,
commercial orthodontic artificial saliva, commercial
arch wires. fluoride toothpaste or
prophylactic gels 28-days
Kerosuo et al.[65] Different types simulated 0.9% NaCl Solution
orthodontic appliances.
Jose et al.[75] Nickel based alloys, Artificial Saliva, 15 days,
one noble alloy, Metal casts were subjected
one high noble alloy, and to continuous flow of saliva
two copper aluminum thrice daily lasting 30
alloys. minutes each, consisting
pH decreases and salinity
increases.
Manaranche et al.[79] Au, Pd, Ag, Cu, Zn, Ti. Electrochemical test; NaCl
Precious alloys Pd-base, solution, 370C.
Au-Pt, Au-Pt-Pd, Au-Pd, pH – 7.4, Potentiometer, 2 h.
Au-Ag-Cu alloys. Chemical corrosion;
370C, Sodium chloride and
lactic acid. pH-2.3, 7 days,
ICP spectroscopy.
Remark
a) The corrosion phenomenon for metallic brackets can
be increased by the internal stress in the alloy or in the
inhomogeneous microstructure of the alloy, or both.
b) Therefore, the difference in Rp (or corrosion resistance)
among the tested SS brackets with the same surface passive
film might be related to the different surface characterizations,
such as surface residual stress and metallurgical factors,
produced during the various manufacturing processes,
instead of the surface roughness and preexisting defect.
S. mutans reduced the EOCP of CPT, TAV, TN, and SSL, and
the byproducts of S. mutans reduced the EOCP of TAV, TN, SSL,
and PH.
S. mutans increased the ICORR of pH, and byproducts of S.
mutans increased the ICORR of all the samples.
S. mutans reduced the ECORR of CPT, TAV and TN, and the
byproducts of S. mutans reduced the ECORR of TN, SSL, PH,
and NC.
S. mutans increased the IPASS of CPT, and the byproducts of
S. mutans increased the IPASS of CPT, pH, and NC.
Bacteria slightly reduce the resistance and increase the
corrosion current.
NiTi-0.016 and SS-26 gauge were better candidate material
for dental applications.
Leaching of manganese, chromium, nickel and iron from the
wires may be due to the availability of manganese oxidizers,
iron oxidizers and heterotrophic bacteria in the saliva.
The electrochemical mechanism of Ti-6Al-4V alloy in
artificial saliva is related to the fluoride and bovine albumin
concentration.
Electrochemical impedance spectroscopy (EIS) is suitable
for the study of the electrochemical behavior of dental alloys.
Bracket materials could be divided into two groups:
Ti and FeCrNi in one and CoCr, which has properties close
to those of Pt.
NiTi based alloys which were subjected to strong corrosion
in presence of monoflourophosphate
TMA corroded strongly with stannous fluoride mouthwash.
TiNb was most resistant to corrosion.
The increase in surface roughness of NiTi orthodontic arch
wires in the commercial fluoride containing environments.
Fluoride applications should be taken into account when
considering the effectiveness of orthodontic appliances.
It showed significantly higher cumulative release of nickel
under dynamic (simulated function) compared to static
condition.
Cu-Al alloys released Cu, Al, Ni, Mn and Fe. Ni-based alloys
released Ni, Cr.
Beryllium containing alloys released beryllium and Ni.
Noble and High noble alloys were very resistant to corrosion.
Ions released to be far below the tolerable upper intake levels
for each ion.
The Pd-base and Au-Pt-Pd dental alloys are the most
resistant to chemical and electrochemical corrosion, even
higher than gold.

Contd....

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Material degradation
Table 2: Contd/-
References Orthodontics wires Medium, temperature, pH,
period, method etc
Cioffi et al.[80] NiTi wires Flouridated artificial saliva,
370C, thin layer activation
(TLA)
5% tensile strain.
Yukyo et al.[81] Dental magnetic 0.9% NaCl Solution or 1%
attachment (ferric and lactic acid solution at 370C.
austenitic stainless steel), 7 days.
Au-Ag-Pd alloy, type 4
gold alloys, Titanium.
can produce discoloration of adjacent soft tissues and
allergic reactions in susceptible patients.[7-10] Corrosion can
severely affect the ultimate strength of the material leading
to mechanical failure of the orthodontic materials.[11] Some
alloys and metals are resistant to corrosion because of
inherent nobility or the formation of a protective surface
layer. However, many ions containing oral environment
can cause corrosion during long time exposure.
WEAKENING OF APPLIANCES
Stainless steel becomes susceptible to intergranular
corrosion, which may ultimately weaken the alloy. Tensile
strength of the orthodontic silver-soldered stainless steel
joints will be affected by corrosion process.[12,13] Despite
the good corrosion resistance of stressed NiTi, breakage
of orthodontic wires has frequently been found in clinical
studies and subjected to degradation caused by corrosion
in the oral environment.[14,15] According to Zinelis et al.[16]
Ag-based soldering alloys introduce a galvanic couple
with stainless steel alloys, inducing release of metallic ions
like Cu++ and Zn++, the elements mostly leached out from
silver solder alloys. Vahed A et al.[17] report that prolonged
exposure in stimulated saliva leads to significant reduction
in the tensile failure load of silver-soldered stainless joints.
The reduction in tensile properties is brought about by
a weakness induced by localized corrosion of the solder
metal at the solder/wire interface. The preponderance
of Cu-rich particles that forms in the solder metal at the
interface provides a micro galvanic effect that leads to
selective dissolution of these particles and corresponding
weakening of the interface. Corrosion is the main cause of
the progressive dissolution of brazing filler metal, leading
to detachment of the wing from the bracket base during
orthodontic therapy or at debonding stage.[18]
Sliding friction
Friction is a phenomenon that generally affects the clinical
efficacy of orthodontic appliances. The frictional forces
that oppose the tooth movement during sliding are effects
of different arch wire bracket combinations (e.g. material,
size, shape and angulations), influence of ligation e.g.
material and contact force and interaction of appliances with
Indian J Dent Res, 21(2), 2010
Chaturvedi and Upadhayay
Remark
a) Behavior of NiTi alloy is highly affected by the fluoride
content.
b) TLA method in the biomedical field appears a suitable
technique to monitor in real time the corrosion behavior of
medical devices.
The contact of the stainless steel and the dental metals
increased amount of ions released from the stainless steel.
Corrosion resistance of type 316L is inferior to that of ferric
stainless steel in contact with precious alloys.
surrounding environment e.g. (interbracket distances and
oral fluids). Corrosion increases orthodontic friction force
between the arch wire/bracket interfaces due to an increase
in the surface roughness.[17-19]
Local pain/swelling
Corrosion products have been implicated in causing local
pain or swelling in the region of the orthodontic appliances
in the absence of infection, which can lead to secondary
infection.[20,21]
Cytotoxic responses
Iron, nickel and chromium are major corrosive products
of stainless steel. Nickel and chromium induce Type-IV
hypersensitivity reaction in the body.[22] These metals cause
several cytotoxic responses including decrease in some
enzyme activities, interference with biochemical pathways,
carcinogenicity, and mutagenicity.[23,24] Titanium wires
containing nickel may cause localized tissue irritation in
some patients. Manganese from the alloy is also consumed
with saliva which produces toxicity leading to nervous,
skeletal disorders, etc. It has been suggested that long term
exposure to nickel containing dental materials affect both
human monocytes and oral mucosal cells.[25,26]
Decalcification of teeth
Various acids are formed during the microbial attack on
metallic orthodontic appliances in oral environment. Biofilm
for med on the tooth surface with the help of food debris and
metabolic products of microbes. Acids cause reduction of
pH and influence the decalcification of teeth and corrosion
of metallic appliances.[27]
EFFECT OF CORROSION ON ORTHODONTIC
WIRES
Corrosion of stainless steel
Orthodontic stainless steel wires are generally made of
austenitic stainless steel containing approximately 18%
chromium and 8% nickel. In general, these wires have
good biocompatibility and high corrosion resistance
in oral environment. It owes its corrosion resistance
property to chromium, a highly reactive base metal. The
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Material degradation
corrosion resistance of alloy depends on the passive film,
which spontaneously forms (passivation) and reforms
(repassivation) in air and under most wet conditions. Oxygen
is necessary to form and maintain the film, whereas acidity
and chloride ions can be particularly detrimental to it.[28] The
presence of soldered joints increase corrosion susceptibility
since they have a tendency to emit electrogalvanic currents
with saliva and consequently release metal ions. Austenitic
stainless steel may lose its resistance to corrosion if it is heated
between approximately 400oC and 900oC. Such temperatures
are within the range used by the orthodontist for soldering
and welding. The decrease in corrosion resistance is caused
by the precipitation of chromium-iron carbide at the grain
boundaries at these high temperatures.[29] Precipitation does
not occur below these temperatures and chances of corrosion
are less. Corrosion of stainless steel may result due to
galvanic cell forming in one or more of the following ways:
• Surface roughness of stainless steel of wires may cause
localized corrosion attack.
• Any cut or abrasion of stainless steel by carbon steel
pliers/carbon steel bur may act as galvanic cell, and
• Brazed or soldered joints in orthodontic appliances can
also form galvanic couples in vivo.
Titanium and its Alloys (nickel-titanium alloys,
β-titanium alloys, titanium- aluminum-vanadium
alloy)
Titanium is highly corrosion resistant as a result of the
passivating effect afforded by a thin layer of titanium oxide
that is formed on its surface. When the stable oxide layer is
broken down or removed and is unable to reform on parts
of the surface, titanium and its alloy can be as corrosive as
many other base metals. The surface roughness of titanium
containing alloy is more as compared to stainless steel wires,
which may act as galvanic cell in the mouth.[30-32]
TYPES OF CORROSION IN ORTHODONTIC WIRES
The features that determine how and why dental materials
corrode are oxidation and reduction reactions as well as
passivation or the formation of a metal oxide passive film
on a metal surface.[33] Various forms of corrosion are shown
in Figure 1 and described as follows.
Uniform corrosion
A uniform corrosion is any chemical or electrochemical
reaction that proceeds uniformly over the entire exposed
surface or over a large area. It is the most common
type of corrosion, occurring with all metals at different
rates. The process arises from the interaction of metals
with the environment and the subsequent formation of
hydroxides or organometallic compounds. For uniform
corrosion, the corrosive environment must have the same
access to all parts of the surface, and metal itself must be
metallurgically and compositionally uniform. Uniform
attack may not be detectable before large amounts of
279
Chaturvedi and Upadhayay
metal are dissolved.
Pitting corrosion
Pitting is a form of extreme attack that results in holes on
metal surface. It usually occurs on base metals, which are
protected by a naturally forming thin film of an oxide. It
has been identified in brackets and wires. In the presence
of chloride in the environment, the film locally breaks
down and rapid dissolution of the underlying metal occurs
in the form of pits. Surfaces of stainless steel and NiTi wire
may exhibit crevices and pores which may give rise to
attack since they represent sites susceptible to corrosion.
Potentiodynamic polarization experiments and scanning
electron microscopic observations of archwires composed
of stainless steel, CoCr, NiCr, NiTi and Beta-Ti exposed
to electrochemical corrosion in artificial saliva have
shown evidence of pitting corrosion formed on the wire
surfaces.[34] Liu[35] studied mechanical characteristics and
corrosion behavior of titanium aluminum nitride coating
on dental alloys, especially in nickel- and chromium-based
dental materials. They tested corrosion behaviors in 0.9%
NaCl solution and observed a higher positive corrosion
potential and a lower corrosion current density in alloys
having coated with titanium aluminum nitride as compared
with uncoated dental alloys. In addition, the pitting
corrosion was substantially reduced by the employment
of TiAlN coating. Es Souni et al.[36] found that Cr-Co alloy
(Elgiloy) showed high pitting corrosion compared with
NiTi alloy, lower repassivation potentials and increase in
current density once pitting had occurred. Kim et al.[37]
showed that nickel titanium and stainless steel wires were
susceptible to pitting and localized corrosion.
Crevice corrosion
Crevice corrosion occurs between two close surfaces or in
constricted places where oxygen exchange is not available. It
often occurs through the application of nonmetallic parts of
metal (i.e., elastomeric ligatures on a bracket). The reduction
in pH and increase in the concentration of chloride ions are
Figure 1: Schematic presentation of various form of material
degradation (corrosion)
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Material degradation
two essential factors in the initiation and propagation of
the crevice corrosion phenomenon. When the acidity of
the medium increases with time the passive layer of the
alloy dissolves and it accelerates local corrosion process.
Crevice corrosion of stainless steels in aerated salt solutions
is widely known. Corrosion products of Fe, Cr, and Ni,
the main components of stainless steel, accumulate in the
crevice and form highly acidic chloride solutions in which
corrosion rates are very high.[38,39] Platt et al.[40] report that
2205 duplex stainless steel is an improved alternative to
316L for orthodontic bracket fabrication when used in
conjunction with Ti, its alloys, or stainless steel arch wires.
Rogers[41] showed that by electroplating with gold before
and after silver soldering, the stainless steel prevented
crevice corrosion. Recycling orthodontic wires and
brackets was once common in many countries, but it is
not recommended in many countries now. Recycling can
comprise heat chemical and mechanical process which
could lead to accelerated crevice corrosion of brazed joints.
Fretting and erosion-corrosion
Erosion-corrosion is increase in rate of deterioration or
attack on material because of relative movement between
corrosive fluid and material surface. The stagnant or
slow-flowing fluids will cause a low or modest corrosion
rate, but rapid movement of the corrosive fluid physically
erodes and removes the protective corrosion product
film, exposes the reactive alloy beneath and accelerates
corrosion. Fretting corrosion (type of erosion-corrosion)
is responsible for most of the metal released into
tissues.[42,43] Conjoint action of chemical and mechanical
attack results in fretting corrosion. It occurs in contact
areas of materials under load and finds its analogue in the
slot-arch wire interface of the bracket.
Intergranular corrosion
Due to more reactive nature of grain boundaries, inter-
granular corrosion occurs adjacent to grain boundaries with
little corrosion of grains. Stainless steel brackets subjected
to a range of temperatures, known as sensitization tem-
peratures, undergo an alteration in their microstructure.
The phenomenon is due to a precipitation of carbide at
the boundaries of the grains.[44] Berge et al.[28] reported that
austenitic stainless steel wires release nickel and chromium
in higher amounts than cobalt- chromium wires, resulting
in discoloration, rust, or even breakages.
Galvanic corrosion
This type of corrosion occurs due to galvanic coupling
of dissimilar metals involved in which less corrosion
resistant metals become an anode and usually corrode. In
a clinical situation, two dissimilar alloys having different
corrosion potentials are often placed in contact such as
in orthodontic brackets and arch wires. This can cause
galvanic corrosion that leads to preferential release of metal
ions from the anodic metal or alloy. Surface area ratio of
Indian J Dent Res, 21(2), 2010
Chaturvedi and Upadhayay
the two dissimilar alloys is a very important factor because
it affects the galvanic corrosion behavior. An unfavorable
area ratio, which consists of a large cathode and a small
anode, might lead to greater corrosion rate from the anodic
alloy. Reed and Willman[45] demonstrated the presence of
galvanic currents in the oral cavity probably first time in
detail. Approximate values for magnitude were established.
Burse[46] described an experimental protocol for in vivo
tarnish evaluation and showed the importance of proper
elemental ratio in gold alloys. Masahir et al.[47] showed
the NiTi alloy coupled with SUS 304 or Ti exhibited a
relatively large galvanic current density even after 72
hours. It is suggested that coupling SUS 304-NiTi and Ti-
NiTi may remarkably accelerate the corrosion of NiTi alloy,
which serves as the anode. The different anode-cathode
area ratios used in this study had little effect on galvanic
corrosion behavior. Tufekci et al. [48] described highly
sensitive analytical technique which showed the release of
individual elements over a month period which appeared
to be correlated with micro structural phases in the alloys.
Several forms of electrochemical corrosion are based
on the mechanism that produces inhomogeneous areas.
Failures could be minimized in orthodontic solder joints
by employing material couples that minimize galvanic and
micro galvanic effects.
Stress corrosion
Stress corrosion cracking refers to cracking caused by
the simultaneous presence of tensile stress in corrosive
medium. This process can dangerously impair mechanical
integrity of orthodontic wires. When arch wire engaged
to brackets are bonded to crowded teeth, the reactivity
status of the alloy increases. The increased reactivity
results from the generation of tensile and compressive
stresses developed locally because of the multiaxial, three
dimensional loading of wire. Thus, an electrochemical
potential difference occurs with specific sites acting
as anodes and other surfaces acting as cathodes. NiTi
orthodontic wires remain in the oral environment for
several months and suffer a large number of small loads
during mastication. Despite good corrosion resistance
of stressed NiTi, the breakage of NiTi orthodontic wires
has frequently been found in clinical studies.[49,50] Wang
et al.[51] studied stress corrosion cracking of NiTi in artificial
saliva and demonstrated that the orthodontic NiTi wires
were broken by stress corrosion cracking during service.
The slight change in temperature causes the dynamic phase
transformation, which causes the change in surface state.
Hydrogen damage
Under certain circumstances, orthodontic wires can
absorb hydrogen under cathodic condition. The presence
of absorbed hydrogen decreases ductility of metals. It can
embrittle reactive metals such as titanium, vanadium,
niobium etc.[1,6]
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Material degradation
EFFECT OF ORAL ENVIRONMENT
In the oral environment, fluoride-containing commercial
mouthwashes, toothpastes and prophylactic gels are widely
used to prevent dental caries or relieve dental sensitivity or
for proper oral cleaning after application of normal brushes
with tooth paste.[52,53] The detrimental effect of fluoride
ions on the corrosion resistance of Ti or Ti alloys has been
extensively reported. Fluoride ions are very aggressive
on the protective TiO2 film formed on Ti and Ti alloys.
Since outermost surface of NiTi arch wire contains mainly
TiO2 film with trace amount of NiO, fluoride enhanced
corrosion of the NiTi arch wires in fluoride containing
environment has been considered.[54,55] Fluoride-containing
environments can penetrate into the narrow crevices
between the orthodontic arch wire and bracket in the
mouth which is not cleaned out thoroughly. Topical high
fluoride concentrations will stay in place and attack the
arch wire/bracket interface depending on the fluoride
concentration. This may increase friction force between arch
wire and bracket. Using topical fluoride agents with NiTi
wire could decrease the functional unloading mechanical
properties of wires and contribute to prolonged orthodontic
treatment. [56,57] Orthodontic patients are required to
maintain a high level of oral hygiene, which include regular
tooth brushing. In vitro studies[58,59] on effects of tooth
brushing showed significant increase in elemental release
from nickel alloys when toothpaste was used, however,
without toothpaste there is no significant increase in
elemental release. There is also evidence to suggest that
some mouth rinses may also increase ionic release from
silver soldered joints in orthodontic appliances. Schiff
et al.[60] studied corrosion resistance of three types of brackets
(cobalt-chromium, iron chromium-nickel and titanium
based brackets) in three fluoride mouthwashes. The results
showed that the bracket materials could be divided into
two groups: Ti and FeCrNi in one and CoCr, which has
properties close to those of Pt. Many studies have shown
that fluoride ions can destroy the protectiveness of the
surface TiO2 passive film on Ti or Ti alloy, leading to attacked
corrosion morphology, decreased polarization resistance and
an increased anodic current density or metal ion release.[61]
Further, the corrosion resistance of NiTi decreases on
increasing NaF concentration in the artificial saliva. Schiff
et al.[62] studied the corrosion resistance of orthodontic
wires in three different commercial mouthwashes and
found that the NiTi wires were subject to severe corrosion
in Na2FPO4 containing mouthwashes. Huang[63] studied
surface topography variations of different nickel-titanium
orthodontic arch wires in different commercial fluoride
containing environments. Four tested NiTi arch wires had
different surface topography variations, depending on the
fluoride ion concentration. The arch wire manufacturer
and emersion environment had a statistically significant
influence on surface roughness variation. The increase in
281
Chaturvedi and Upadhayay
surface roughness of NiTi orthodontic arch wires in the
commercial fluoride containing environments should be
taken into account when considering the effectiveness of
orthodontic appliances.
NICKEL CONTAINING ORTHODONTIC WIRES
Nickel containing alloys find extensive application in
orthodontics, including metallic brackets, arch wires,
bands, springs and ligature wires. For most materials, a
rough surface promotes corrosion. Doubts remain about
biocompatibility of Ni-based alloys when used in dentistry.
The use of nickel is of particular concern since it is the most
allergenic of all metallic materials. Not all nickel- allergic
individuals will react to intraoral nickel, and it is currently
not possible to predict which individuals will react. Because
the frequency of nickel allergy is high, it is possible that
individuals will become sensitized after placement of
nickel containing alloys in the mouth. Nickel is a known
allergen.[64] In a study of Finnish adolescents, the prevalence
of nickel allergy was found to be 30% in girls and 3% in
boys.[65,66] This was thought to be related to sensitization to
nickel by ear piercing as the prevalence in adolescents, with
ear piercing it was found to be 31% and only 2% otherwise.
Allergic responses are mediated through the immune
system. The majority of dental allergies, including responses
to nickel containing dental alloys, comprise type IV
hypersensitivity reactions, cell mediated by T-lymphocytes.
Nickel containing dental alloys can undergo corrosion with
release of metal ions.[67,68] High content nickel-titanium wires
should be avoided in nickel sensitive patients, nickel free
alternatives being available for use in such cases.[69] Bishara
et al.[70] studied biodegradation of orthodontic appliances in
vitro and showed that nickel ions released from orthodontic
appliances of nickel- titanium and stainless steel increased
over the first week then diminished over time. Gjerdt et al.[71]
studied metal release from heat treated orthodontic wires
and demonstrated that heat treatment of the alloys under
laboratory conditions increased the release of metal ions-
15-60 times. They showed significant initial increase in the
concentration and mass of nickel in saliva sample of patient
with fixed orthodontic appliances as compared to sampled
saliva of patients without orthodontic appliances. Other
studies have shown that the release of nickel ions is not
proportional to the nickel content of orthodontic wires, but
to the nature of the alloys and the method of construction of
the appliance. Kerosuo et al.[72] studied the in vitro release of
nickel and chromium ions from different types of simulated
orthodontic appliances. Metal appliances immersed in
0.9% sodium chloride solution showed significantly higher
cumulative release of nickel under dynamic (simulated
function) compared to static condition. It should be noted
that nickel ions released from metallic restorations and
intraoral appliances will normally be swallowed and will
not accumulate in the oral environment furthermore. The
amount of nickel released from dental alloys is significantly
Indian J Dent Res, 21(2), 2010
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Material degradation
less than that consumed orally as part of the dietary intake,
although the ingested ions will obviously add to the overall
burden of previously nickel sensitized patients. Kim et al.[37]
opine that for patients allergic to nickel, the use of titanium
or epoxy-coated wires during orthodontic treatment is
recommended.
Clinical signs and symptoms seen in allergic reactions to
nickel include oral edema, perioral stomatitis, gingivitis,
and extra oral manifestations such as eczematous
rashes.[73-75] The mechanisms of high allergy frequency
to nickel are not known, but there is probably genetic
component. [76,77] In addition, the tendency of nickel
containing alloys to release relatively large amount of nickel
ions probably contributes to their allerginicity. Nickel
ions are a documented mutagen in humans, but there is
no evidence that nickel ions cause any carcinogenesis
intraorally.[78] Galvanic Current or release of ions could
account for many types of dyscrasias, such as lichenoid
lesions, ulcers, leukoplakia, cancer and kidney disorder,
although research has failed to find any correlation between
dissimilar metals and tissue irritation. Future steps would be
to find correlation between the problems observed in the
mouth due to corrosion products and the results of corrosion
tests in vitro.[78,79] According to Cioffi et al.[80] thin layer
activation (TLA) method in the biomedical field appears to
be a suitable technique to monitor in real time the corrosion
behavior of medical devices.
PROTECTIVE MEASURE FROM CORROSION
To reduce corrosion, patient should avoid eating too much
salty food. Salt provides chlorides ions which combines with
hydrogen and produces acid which may cause corrosion.
Chloride ion is detrimental for formation of passive layer on
metal surface. Elastics should be clean or should be change
frequently. Empty pockets at the bracket/adhesive interface
should be prevented to avoid acceleration of corrosion
process. Clinician should follow proper storage, maintenance
and sterilization procedures and avoid intermetal contacts.
Selection of attachment should be made that are less
susceptible to corrosion.[81] Indiscriminate use of heat or
disinfection as well as thermal recycling should be avoided.
Orthodontic arch wires and brackets can be coated with
either titanium nitride or an epoxy resin. The former is used
to improve hardness and reduce friction, the latter improves
esthetics. Epoxy coating improves corrosion resistance by
preventing attack by corrosive fluid.[37] Another method of
reducing corrosion of metals is to add a corrosion inhibitor
to a solution into which the material is placed but it very
difficult to follow in oral cavity.
SUMMARY
A primary requisite of any alloy metal used in the mouth
Indian J Dent Res, 21(2), 2010
Chaturvedi and Upadhayay
is that it must not produce corrosion products that will be
harmful to body. In spite of recent innovative metallurgical
and technological advances and remarkable progress
related to orthodontic materials, failures do occur. One of
the reasons for these failures could be corrosion (material
degradation) of orthodontic appliances. It causes severe and
catastrophic disintegration of the metal body. Corrosion
(material degradation) attack may be extremely localized
and causes rapid mechanical failure of a structure, even
though the actual volume loss of material is quite small.
Surface roughening and deposit build up may have adverse
effects on the efficiency of relative wire/bracket function in
orthodontic treatment. Application of fluoride containing
gel/toothpaste may affect efficiency of orthodontic
appliances. In future nickel free materials should be
expected in use. Future research is needed regarding material
composition influencing corrosion, manufacturing of
metallic brackets, influence of various diet pattern as well as
diet substance on corrosion, use of topical fluoride treatment
during orthodontic treatment for oral hygiene maintenance.
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How to cite this article: Chaturvedi TP, Upadhayay SN. An overview of
orthodontic material degradation in oral cavity. Indian J Dent Res 2010;21:275-84.
Source of Support: Nil, Conflict of Interest: None declared.

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