title: Lichenoid reaction associated to amalgam restoration.
abstract: Hypersensitivity to mercury associated with amalgam restorations may occur and present in one of two different ways. Most commonly it presents as an oral lichenoid reaction affecting oral mucosa in direct contact with an amalgam restoration and represents a delayed, type IV, cell mediated immune response to mercury or one of the other constituents of the dental amalgam. We report a case of oral lichenoid reaction associated to amalgam restoration. A 38 year-old woman presented a caries lesion of tooth #37. A Blacks class I preparation was performed and filled with amalgam. After 19 months, intra-oral examination revealed atrophic lesion, lightly erythematous, affecting the left buccal mucous. The lesion contacted directly with the amalgam restoration in the lower first molar. The right buccal mucosa was normal. His medical history was unremarkable, he was taking no medication and had no known allergies. However, the patient had felt certain rare sensation in that zone when eating sharp meals. Biopsy showed histological changes compatible with oral lichen planus. The patient decided not to change again the restoration, because she did not have important annoyances and she did not wish to be treated again. Other restorations were performed with composite resins, and no reaction was evidenced in the mucosa.
authors.affiliation: Dpto. de Estomatología, Facultad de Odontología, Universidad de Sevilla. segurajj@wanadoo.es
authors.forename: Juan José
authors.initials: JJ
authors.lastname: Segura-Egea
authors.forename: Pedro
authors.initials: P
authors.lastname: Bullón-Fernández
mesh_terms: D000328:Adult; D003723:Dental Amalgam / Q000009:adverse effects*; D005260:Female; D006801:Humans; D017676:Lichen Planus, Oral / Q000139:chemically induced*
chemical_list: D003723:Dental Amalgam