In vitro lymphocyte proliferation test in the diagnosis of oral mucosal hypersensitivity reactions to dental amalgam.
Patch testing was carried out in 23 patients with oral lichenoid lesions (OLL) topographically related to dental amalgam fillings. Twelve patients displayed positive reactions to several mercury compounds, whereas 11 patients were negative. An in vitro lymphocyte proliferation (LyPro) test was carried out using different mercury compounds and other metal salts. Mercuric chloride and phenyl mercuric acetate caused positive proliferation in 3/12 patch test-positive and in 5/11 negative patients. One out of seven healthy control subjects had a positive LyPro result. The mean stimulation index (SI) values between the patient groups or compared with the control subjects did not differ significantly. Zinc, tin, copper or silver salts caused in vitro lymphocyte stimulation in most of the patients and in healthy control people. Total (14) or partial (4) replacement of amalgam fillings was carried out in 18 patients. Complete healing of lichenoid lesions was seen in 4/6 LyPro test-positive and in 5/10 patch test-positive patients at follow-up examinations 12 months after the replacement of amalgam fillings. The in vitro proliferation assay seems not to be a specific test for identifying the patients who would benefit from amalgam replacement.
Laine
J
J
Department of Oral Diseases, University Central Hospital of Turku, Finland.
Happonen
R P
RP
Vainio
O
O
Kalimo
K
K
D000328:Adult; D000368:Aged; D000891:Anti-Infective Agents, Local / Q000494:pharmacology; D003300:Copper / Q000494:pharmacology; D003723:Dental Amalgam / Q000009:adverse effects*; D003793:Dental Restoration, Permanent / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006967:Hypersensitivity / Q000175:diagnosis* / Q000209:etiology / Q000276:immunology; D017512:Lichenoid Eruptions / Q000139:chemically induced / Q000175:diagnosis* / Q000276:immunology; D008213:Lymphocyte Activation / Q000187:drug effects; D008297:Male; D008627:Mercuric Chloride / Q000494:pharmacology; D017669:Mercury Compounds / Q000009:adverse effects / Q000494:pharmacology; D008670:Metals / Q000494:pharmacology; D008875:Middle Aged; D009059:Mouth Diseases / Q000139:chemically induced / Q000175:diagnosis* / Q000276:immunology; D010328:Patch Tests; D010592:Pharmaceutic Aids / Q000494:pharmacology; D010662:Phenylmercuric Acetate / Q000494:pharmacology; D018030:Silver Compounds / Q000494:pharmacology; D017971:Tin Compounds / Q000494:pharmacology; D014945:Wound Healing; D017967:Zinc Compounds / Q000494:pharmacology
D000891:Anti-Infective Agents, Local; D017669:Mercury Compounds; D008670:Metals; D010592:Pharmaceutic Aids; D018030:Silver Compounds; D017971:Tin Compounds; D017967:Zinc Compounds; D008627:Mercuric Chloride; D003300:Copper; D003723:Dental Amalgam; D010662:Phenylmercuric Acetate