Standard Orthodontic intervention, involves the use of brackets, bands and arch wires. Brackets used in orthodontic treatment provide the means to transfer force to the teeth using the arch wire. Biodegradation of different types orthodontic brackets might lead to metal ion release . Nickel (Ni) and chromium (Cr) containing alloys are present in the manufacture of most of the orthodontic appliances.Increae of nickel and/or chromium ion release could result in heath hazardous effects Analysis of released metal ions was performed through mass spectroscopy, atomic absorption spectroscopy. The aim of this study is to systematically assess the release of metal ions with fixed orthodontic appliances using ceramic brackets. Electronic searches will be performed in two databases (PubMed, Cochrane). The PubMed, identified 29 studies, 4 of which met the inclusion criteria. In conclusion, Although these studies are limited and very few, this systematic review can state that the release of metal ions in patients with fixed orthodontic appliances is in measurable amounts that are considered to be safe. In addition there are no difference in the release of salivary ions regardless of the bracket type used.