A case of severe crowding with nickel allergy, treated using non-nickel-containing orthodontic appliances

Here we report the successful treatment of a patient, aged 19 years 6 months, with Class III malocclusion, severe crowding and nickel allergy; non-nickel-containing orthodontic appliances were used for whole treatment period. As a result of performing a patch test, a positive reaction for nickel sulfate and palladium chloride were noted. Then, we directly bonded composite resin braces and titanium molar tubes on the teeth after extraction of the first premolars in both jaws. Only beta-titanium alloy arch wire was used with a multi bracket appliance. The active treatment period was 25 months. As a result, no symptoms of metal allergy were noted, and good facial appearance and occlusal relationships were seen for 2 years after starting retention.