Nickel Allergy Orthodontics — ORE Part 1 MCQ
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Correct answer: A — Ceramic or titanium brackets with titanium or nickel-free archwires (e.g., beta-titanium, TMA)
For patients with confirmed nickel allergy, all nickel-containing materials must be avoided during fixed appliance therapy. Option A is correct because: (1) Ceramic and alloyed titanium brackets are nickel-free alternatives with proven biocompatibility; (2) Beta-titanium (TMA) and titanium archwires contain no nickel and provide excellent mechanical properties; (3) evidence explicitly states nickel-containing materials should be renounced in known allergy. Option D is contraindicated—stainless steel contains 8–17% nickel and nickel-titanium contains 50–55% nickel, both posing allergic risk. Option B is incomplete (no archwire specification; cobalt-chromium alone lacks flexibility). Option E pairs nickel-free brackets with high-nickel archwire, defeating the allergy management. Option C incorrectly restricts treatment; nickel-free fixed appliances are clinically established and have been successfully used in > 50% of allergy cases requiring modification.
Reference: Allergies induced by orthodontic alloys: incidence and impact on treatment. Results of a survey in private orthodontic offices in the Federal State of Hesse, Germany. PubMed 2003. https://pubmed.ncbi.nlm.nih.gov/14749889/; TMA archwires: high biocompatibility due to lack of nickel. Clinical Trials.gov 2020s.