FS14.6 Oral lichenoid reactions and amalgams: no topographical relationship

Abstract

Background: Several lines of evidence indicate a potential association between oral lichen‐reactions and the presence of dental amalgam fillings.Aim: We examined the relation between oral lichen reaction cases and the site of amalgam fillings in the oral cavity.Methods: We conducted an observational study in 5 consecutive patients who had OLR and underwent to dental amalgam replacement. The number of total amalgam surfaces and OLR sites were charted. Saliva samples were taken and levels of total mercury were measured by CV‐AAS method. Also we did patch‐testing with dental series in all patients. Results: Our observational study revealed that oral lichen reactions may not have an association with the physical proximity the mercury tooth fillings. Unexpectedly, we noted a complete remission in patients with OLR (n = 5). The patients with OLR presented allergies to mercury (n = 4) or gold (n = 1). All patients were negative for HCV/HBV and they had not been taking any drug‐induced lichenoid mucositis.Findings: In this case report series no topographical association was found between OLR and the dental amalgam fillings. All OLR cases were in full recovery after total amalgam removal within three months. Saliva mercury concentrations were significantly elevated in all subjects. After amalgam removal the mercury levels were undetectable. We suggest that dental amalgam removal is important therapeutic option in OLR cases even if the lichenoid lesions are not adjacent to dental amalgam restorations.