Role of dental restoration materials in oral mucosal lichenoid lesions.
BACKGROUND
Dental restorative materials containing silver-mercury compounds have been known to induce oral lichenoid lesions.


OBJECTIVE
To determine the frequency of contact allergy to dental restoration materials in patients with oral lichenoid lesions and to study the effect of removal of the materials on the lesions.


RESULTS
Forty-five patients were recruited in three groups of 15 each: Group A (lesions in close contact with dental materials), Group B (lesions extending 1 cm beyond the area of contact) and Group C (no topographic relationship). Thirty controls were recruited in two groups of 15 individuals each: Group D (oral lichenoid lesions but no dental material) and Group E (dental material but no oral lichenoid lesions). Patch tests were positive in 20 (44.5%) patients. Mercury was the most common allergen to elicit a positive reaction in eight patients, followed by nickel (7), palladium (5), potassium dichromate (3), balsam of Peru, gold sodium thiosulphate 2 and tinuvin (2) and eugenol (1), cobalt chloride (1) and carvone (1). Seven patients elicited positive response to more than one allergen. In 13 of 20 patients who consented to removal of the dental material, complete healing was observed in 6 (30%), marked improvement in 7 (35%) and no improvement in 7 (35%) patients. Relief of symptoms was usually observed 3 months after removal.


CONCLUSIONS
Limited number of study subjects and short follow up after removal/replacement of dental restoration materials are the main limitations of this study.


CONCLUSIONS
Contact allergy to amalgam is an important etiologic factor in oral lichenoid lesions and removal of restorative material should be offered to patients who have lesions in close proximity to the dental material.
Rajneesh
R
Sharma
Department of Dermatology, Venereology, and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Sanjeev
S
Handa
Dipankar
D
De
Bishan Dass
BD
Radotra
Vidya
V
Rattan
D000328:Adult; D000368:Aged; D003764:Dental Materials / Q000009:adverse effects*; D017449:Dermatitis, Allergic Contact / Q000175:diagnosis* / Q000209:etiology*; D005260:Female; D006801:Humans; D017512:Lichenoid Eruptions / Q000139:chemically induced* / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000187:drug effects / Q000473:pathology*; D010328:Patch Tests / Q000379:methods; D011446:Prospective Studies
D003764:Dental Materials