PDF(Pubmed)
Abstract：
Although rare, oral manifestations of hypersensitivity reactions in orthodontic patients pose a significant clinical challenge due to their heterogeneous presentations, and can cause discomfort and pain, possibly impacting patients\' quality of life and orthodontic treatment duration and outcomes. This comprehensive review aimed to elucidate the oral, perioral, and systemic manifestations of hypersensitivity reactions in orthodontic subjects, focusing on patients with fixed appliances, removable appliances, and clear aligners, and detailing their epidemiology, macroscopic and microscopic features, allergy testing, clinical implications, and specific management strategies. Oral and extra-oral manifestations of (immediate and delayed) hypersensitivity reactions occur rarely and are due to the release of metal and non-metal ions from orthodontic appliances. They typically present as erythema, erosive-ulcerative lesions, and gingival hyperplasia, with histopathological findings showing inflammatory infiltrates. Nickel is a significant allergen, and diagnostic tests like patch tests are essential for managing these reactions. Likely due to prolonged contact with oral tissues, fixed orthodontic appliances pose a higher risk compared to removable appliances and clear aligners. Early identification and removal of allergenic materials, combined with effective treatments, can resolve symptoms and prevent recurrence. Keeping dental and medical records updated and knowing family and personal medical histories helps clinicians choose appropriate materials and counsel patients about potential risks. Proper patient education, regular monitoring, and using hypoallergenic materials are key strategies for managing these reactions.
摘要：
虽然罕见，正畸患者的过敏反应的口腔表现由于其异质性表现而构成了重大的临床挑战。会引起不适和疼痛，可能影响患者的生活质量和正畸治疗持续时间和预后。这篇全面的综述旨在阐明口头，口周,以及正畸患者过敏反应的全身表现，专注于固定器具的患者，可移动电器，和清晰的对准器，详细说明他们的流行病学，宏观和微观特征，过敏测试,临床意义，和具体的管理策略。（立即和延迟）过敏反应的口腔和口腔外表现很少发生，并且是由于正畸矫治器中金属和非金属离子的释放。它们通常表现为红斑，糜烂性溃疡性病变，和牙龈增生,组织病理学发现显示炎性浸润。镍是一种重要的过敏原，和诊断测试，如补丁测试是必不可少的管理这些反应。可能是由于与口腔组织长时间接触，与可移动矫治器和清晰的矫治器相比，固定的正畸矫治器具有更高的风险。早期识别和去除过敏原，结合有效的治疗方法，可以解决症状并防止复发。保持牙科和医疗记录更新，了解家庭和个人病史，有助于临床医生选择适当的材料，并就潜在的风险向患者提供咨询。正确的病人教育，定期监测,使用低过敏性材料是管理这些反应的关键策略。
