Role of dental restoration materials in oral mucosal lichenoid lesions.
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Date
2015-09
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Abstract
Background: Dental restorative materials containing silver–mercury compounds have
been known to induce oral lichenoid lesions. Objectives: To determine the frequency of
contact allergy to dental restoration materials in patients with oral lichenoid lesions and
to study the effect of removal of the materials on the lesions. Results: Forty‑five patients
were recruited in three groups of 15 each: Group A (lesions in close contact with dental
materials), Group B (lesions extending 1 cm beyond the area of contact) and Group C
(no topographic relationship). Thirty controls were recruited in two groups of 15 individuals
each: Group D (oral lichenoid lesions but no dental material) and Group E (dental material
but no oral lichenoid lesions). Patch tests were positive in 20 (44.5%) patients. Mercury was
the most common allergen to elicit a positive reaction in eight patients, followed by nickel (7),
palladium (5), potassium dichromate (3), balsam of Peru, gold sodium thiosulphate 2 and
tinuvin (2) and eugenol (1), cobalt chloride (1) and carvone (1). Seven patients elicited
positive response to more than one allergen. In 13 of 20 patients who consented to removal
of the dental material, complete healing was observed in 6 (30%), marked improvement in
7 (35%) and no improvement in 7 (35%) patients. Relief of symptoms was usually observed
3 months after removal. Limitations: Limited number of study subjects and short follow up
after removal/replacement of dental restoration materials are the main limitations of this study.
Conclusion: Contact allergy to amalgam is an important etiologic factor in oral lichenoid
lesions and removal of restorative material should be offered to patients who have lesions
in close proximity to the dental material.
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Keywords
Dental amalgam, dental restoration, oral lichenoid lesions, topographical relation
Citation
Sharma Rajneesh, Handa Sanjeev, De Dipankar, Radotra Bishan Dass, Rattan Vidya. Role of dental restoration materials in oral mucosal lichenoid lesions. Indian Journal of Dermatology, Venereology and Leprology. 2015 Sept-Oct; 81(5): 478-484.