Oral lichenoid lesions and amalgam fillings

Abstract

Data sourcesMedline (1966–2000), Embase (1980–2000) and the Cochrane Library (issue 2, 2000) were reviewed along with reference lists of existing relevant reviews.Study selectionStudies were included if they were randomised controlled trials (RCT), cohort or case–control; reported in English; and dealt with amalgam restoration replacement in people who had oral lichenoid lesions (OLL).Data extraction and synthesisData were extracted that related to: study design; patient characteristics; position and type of OLL; details of histological confirmation and of patch test results; the number of patients receiving replacement restorations; duration of follow-up; and healing. No meta-analyses could be carried out because of the heterogeneity of the studies.ResultsIn total, 14 cohort and five case–controlled studies, of variable quality and including a total of 1158 participants, met the criteria. Patient ages ranged from 23–79 years. In all, 636 of the 1158 people whose OLL was suspected to be related to their amalgam restorations had these replaced with alternative materials. Positive skin patch test (SPT) results for more than one mercury compound varied widely between studies from a low of 16% to a high of 92%. Different criteria were used to select patients who needed their amalgam restorations replacing, and also for whether the contacting restoration or all amalgam restorations were replaced. Follow-up periods varied from 2–114 months. The proportion of individuals achieving complete healing varied from 37% to 100% although, in total, 15% of patients showed no improvement after replacement of their amalgam restorations.ConclusionsIn some people who have OLL, lesions may be seen to improve or heal following replacement of amalgam restorations.