Treatment of amalgam tattoo with a subepithelial connective tissue graft and acellular dermal matrix.
A 54-year-old female was referred for management of a large amalgam tattoo involving the alveolar mucosa between teeth #6 and #9. The lesion had been present for over 20 years following endodontic treatment of teeth #7 and #8. A two-stage surgical approach was used to remove the pigmentation, beginning with removal of amalgam fragments from the underlying bone and placement of a subepithelial connective tissue graft and acellular dermal matrix to increase soft tissue thickness subadjacent to the amalgam. Following 7 weeks of healing, gingivoplasty was performed to remove the overlying pigmented tissue. At the 21-month follow-up appointment, the patient exhibited naturally appearing soft tissue with no evidence of amalgam tattoo.
Vivek
V
Thumbigere-Math
Deborah K
DK
Johnson
D062088:Acellular Dermis; D003238:Connective Tissue / Q000637:transplantation; D003723:Dental Amalgam / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D005893:Gingivoplasty / Q000379:methods; D006801:Humans; D008875:Middle Aged; D009061:Mouth Mucosa / Q000637:transplantation*; D010510:Periodontal Diseases / Q000139:chemically induced* / Q000601:surgery; D010859:Pigmentation Disorders / Q000139:chemically induced* / Q000601:surgery; D062326:Re-Epithelialization / Q000502:physiology; D016038:Skin Transplantation / Q000379:methods*
D003723:Dental Amalgam