Oral lichenoid lesions and allergy to dental materials.
BACKGROUND
Dental materials, oral hygiene products and food additives may cause contact allergic reactions in the mouth with varied clinical presentation. Oral lichenoid lesions (lichen planus-like lesions) can be induced by hypersensitivity to dental restorative metals, acrylates, flavorings and other substances.


OBJECTIVE
The aim of this study was to demonstrate contact allergy to dental materials in patients with oral lichenoid lesions using patch tests.


METHODS
Routine patch tests with two sets of allergens - "European Standard" and "Dental Screening" (Chemotechnique Diagnostics, Sweden) supplemented with pulverized amalgam, iridium, indium, menthol, sorbic acid and platinum were done on a set of 25 patients with lichenoid lesions located on the buccal mucosa, tongue and lips. Application and interpretation of the tests were conducted according to ICDRG (International Contact Dermatitis Research Group).


RESULTS
15 (60 %) patients showed sensitization to 1 or more allergens, with a total of 31 positive reactions. The greatest frequency of positive reactions was to dental metals, with a total of 27 positive reactions. The order of tested metals according to frequency of positive reactions was mercury (6/25/24 %), amalgam (6/25/24 %), nickel (4/25/16 %), palladium (4/25/16 %), cobalt (3/25/12 %), gold (2/25/8 %), chrome (1/25/4 %), indium (1/25/4 %). The clinical relevance of the results with regard to the material's presence in the mouth was demonstrated in 11 (44 %) patients. In 9 patients, replacement of the positively tested materials led to healing or to significant regression of mucosal changes.


CONCLUSIONS
The results of the patch tests showed the possible contribution of contact sensitization in the pathogenesis of lichenoid manifestations in the oral cavity. Due to the premalignant character of these lesions, replacement of positively tested materials and follow up of these patients is advised.
Ditrichova
Dagmar
D
Department of Dermatology and Venereology, Faculty of Medicine and Dentistry, Palacky University Olomouc, Olomouc, Czech Republic. dagmar.ditrichova@fnol.cz
Kapralova
Simona
S
Tichy
Martin
M
Ticha
Vlastislava
V
Dobesova
Jitka
J
Justova
Eva
E
Eber
Miroslav
M
Pirek
Petr
P
D000328:Adult; D000485:Allergens; D003764:Dental Materials / Q000009:adverse effects*; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000175:diagnosis / Q000209:etiology*; D017676:Lichen Planus, Oral / Q000139:chemically induced / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009059:Mouth Diseases / Q000175:diagnosis / Q000209:etiology*; D010328:Patch Tests
D000485:Allergens; D003764:Dental Materials