title: Removal of an amalgam tattoo using a subepithelial connective tissue graft and laser deepithelialization.
abstract: BACKGROUND
  A 56-year-old female presented for periodontal treatment with a large amalgam tattoo located in alveolar mucosa on the facial aspect of her maxillary central incisors. The lesion had been present for 42 years since having endodontic surgery at teeth #8 and #9 after a traumatic childhood incident.
  
  
  METHODS
  A two-stage surgical approach was used to eliminate the lesion, beginning with a subepithelial connective tissue graft to increase tissue thickness subjacent to the amalgam tattoo. After 6 weeks of healing, the overlying pigmented tissue was removed using laser surgery to expose the underlying grafted connective tissue.
  
  
  RESULTS
  After 2 months of healing following laser surgery, the amalgam pigmentation was completely removed, with good color match and an increased width of keratinized tissue at the surgical site.
  
  
  CONCLUSIONS
  A relatively large amalgam tattoo in the esthetic zone can be adequately removed by a two-stage procedure using grafted palatal connective tissue and laser deepithelialization.
authors.affiliation: 10th Dental Squadron, U.S. Air Force Academy, Colorado Springs, CO, USA. casey.campbell@us.af.mil
authors.forename: Casey M
authors.initials: CM
authors.lastname: Campbell
authors.forename: David E
authors.initials: DE
authors.lastname: Deas
mesh_terms: D003238:Connective Tissue / Q000637:transplantation; D003723:Dental Amalgam / Q000009:adverse effects*; D005260:Female; D005882:Gingival Diseases / Q000139:chemically induced / Q000601:surgery*; D005893:Gingivoplasty / Q000379:methods*; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D008875:Middle Aged; D010859:Pigmentation Disorders / Q000139:chemically induced / Q000601:surgery*
chemical_list: D003723:Dental Amalgam