Abstract
Oral lichenoid lesions (OLLs) are linked to a heterogeneous group of pathologies involving the oral mucosa that cannot be distinguished from the oral lichen planus excepting the fact that direct causal factors such as silver amalgam restorations (SARs) can be allocated to them. Purpose: To analyze the prevalence of mucosal lesions associated with SAR in a group of SAR carrying patients in the Basque Country. Study Design: A clinical prospective study was carried out on 100 adult patients over 30 years of age at the UPV/EHU Clinical Odontology Service whose rear teeth had at least one SAR. Patients were identified and mucosal lesions and amalgam restorations were characterized. Patch tests were performed on patients with lesions and amalgams were replaced with composite material. A statistical and comparative analysis was performed with the resulting data. Results: OLLs were found in 7 patients whose predominant lesion was bilateral, asymmetrical and asymptomatic white papule-macule. Lesions were related to old and corroded SARs. Patch testing was positive in two cases. SAR substitution produced an improvement in 5 cases. Conclusions: The presence of lichenoid lesions associated with SARs is infrequent in our environment and is preferentially related to old and corroded restorations. Key words:Oral mucosa, lichenoid lesions, restoration, silver amalgam, patch test.
Highlights
Dental materials can produce allergic contact reactions in the mouth with an extensive clinical presentation (1-4)
Oral lichenoid lesions (OLLs) form part of a heterogeneous group of chronic inflammatory diseases that are indistinguishable from the oral lichen planus (OLP) and produced by a type IV deferred hypersensitivity reaction triggered by extensive exposure to different antigens such as those pertaining to an amalgam (3,5,13)
Without oral lichenoid lesions associated to silver amalgam. It seems that lichenoid lesions associated with the presence of silver amalgams do not represent a pathology frequently found in our environment
Summary
Dental materials can produce allergic contact reactions in the mouth with an extensive clinical presentation (1-4). Silver amalgams have been frequently used in dentistry and can produce hypersensitivity lesions in the oral mucosa in the form of an oral lichenoid lesion (OLL) (5-12). OLLs form part of a heterogeneous group of chronic inflammatory diseases that are indistinguishable from the oral lichen planus (OLP) and produced by a type IV deferred hypersensitivity reaction triggered by extensive exposure to different antigens such as those pertaining to an amalgam (3,5,13). Amalgam-associated OLLs (AAgOLL) usually appear clinically in the form of white reticular papular lesions involving the mucosa occasionally with plaques and erosive, atrophic or ulcerated areas. Patch testing has been used to check their association with amalgam in an attempt to demonstrate allergy to amalgam components as well as the existence of a favourable course subsequent to coating or replacing other related restorations (3,11).
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