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Abstract
Objective Previous studies have shown the effect of amalgam removal on the healing of oral lichenoid lesions (OLLs); however, no specific replacement materials have been suggested. The present series evaluated long-term results following the complete replacement of amalgam restorations with feldspathic ceramic inlay-onlay restorations for a group of patients with OLLs whose lesions were suspected to be related to amalgam restorations. Materials and Methods Twenty-four patients who had OLLs suspected to be related to their amalgam restorations were initially recruited. The patients underwent patch tests for a series of dental materials, in addition to clinical and histopathological examination. Sixteen (67%) of the 24 patients had their amalgam replaced with feldspathic ceramic inlay-onlay restorations and were examined within a follow-up period of 3 months to 5 years. Results After 3 months of clinical follow-up, complete healing (63%) was noted in all patients with OLLs whose lesions were in only close contact with their amalgam restorations. Healing was significantly related to the combination of lesions with close contact with the amalgam restoration and a diagnosis of OLL (x2 test, P=0.02). Conclusion Feldspathic ceramic can be safely used as a replacement material for patients with OLLs to diminish adverse reactions to amalgam restorations.
Highlights
Various components found in amalgam often result in hypersensitivity reactions [1,2,3]
It is evident from many previous studies that certain components of dental amalgam restorations may induce the formation of oral lichenoid lesions (OLLs) [4,5,6]
In the absence of clinicopathological correlations, the oral lichenoid tissue reaction associated with dental amalgam restorations may be mistaken for oral lichen planus (OLP) during histopathological examination of biopsy material [7]
Summary
Various components found in amalgam often result in hypersensitivity reactions [1,2,3] It is evident from many previous studies that certain components of dental amalgam restorations may induce the formation of oral lichenoid lesions (OLLs) [4,5,6]. In the absence of clinicopathological correlations, the oral lichenoid tissue reaction associated with dental amalgam restorations may be mistaken for oral lichen planus (OLP) during histopathological examination of biopsy material [7]. Some studies have suggested that complete removal of amalgam restorations is required to facilitate clinical healing and histopathological resolution or regression of OLLs as well as diminishing the negative effects of the amalgam materials on the affected patients [9, 10]. The differential diagnosis of OLLs should be made on the basis of past medical history, complete mucocutaneous examination, and specific diagnostic tests
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