Amalgam-Associated Oral Lichenoid Reactions: A Case Series

Yıl 2023, Cilt: 1 Sayı: 3, 71 - 74, 20.12.2023

Aida Kurbanova , Gürkan Ünsal , Kaan Orhan

Öz

Aim This case series report aims to discuss clinical findings of lichenoid reactions that were induced by amalgam fillings in 3 patients.
Case Report Three patients who applied to our clinic with the complaint of a burning sensation in the buccal mucosa were referred to our clinic. All patients were males who had amalgam restorations. Only one of the patients described a burning sensation in both the buccal mucosa and the lateral side of the tongue. In all three patients, intraoral examination revealed white lichenoid lesions which are located at the relevant complaint areas and were close to a large amalgam restoration that is in contact with the mucosa. The lesions were associated with amalgam fillings. One of the cases had a patch test regarding the dental materials and had a positive patch result to dental amalgam which is important in the oral lichenoid lesions diagnosis.
Discussion Two studies in the literature suggest a link between metal dental fillings and immunopathological lesions in the oral mucosa. Sensitization to mercury, found in amalgam fillings, is associated with oral lichenoid lesions. Corrosion of dental alloys is correlated with the development of lichenoid lesions. Dental amalgam can induce immunological reactions, including increased autoantibody production. Replacing amalgam fillings resulted in complete remission of lesions in patients without other metal restorations.
Conclusion Burning sensation in the buccal mucosa was common in 3 patients and this was the main complaint.

Anahtar Kelimeler

Amalgam filling, Autoimmunity, Mercury, Oral lichen planus, Oral lichenoid reactions

Destekleyen Kurum

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Proje Numarası

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Teşekkür

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Kaynakça

• Perricone C, Colafrancesco S, Mazor RD, Soriano A, Agmon-Levin N, Shoenfeld Y. Autoimmune/inflammatory syndrome induced by adjuvants (ASIA) 2013: Unveiling the pathogenic, clinical and diagnostic aspects. J Autoimmun. 2013;47:1-16.
• Watad A, Azrielant S, Bragazzi NL, Sharif K, David P, Katz I, et al. Seasonality and autoimmune diseases: The contribution of the four seasons to the mosaic of autoimmunity. J Autoimmun. 2017;82:13-30.
• Mignogna MD, Lo Muzio L, Lo Russo L, Fedele S, Ruoppo E, Bucci E. Clinical guidelines in early detection of oral squamous cell carcinoma arising in oral lichen planus: a 5-year experience. Oral Oncol. 2001;37(3):262-7.
• Eliaz N. Corrosion of Metallic Biomaterials: A Review. Materials (Basel). 2019;12(3).
• Dunsche A, Kastel I, Terheyden H, Springer IN, Christophers E, Brasch J. Oral lichenoid reactions associated with amalgam: improvement after amalgam removal. Br J Dermatol. 2003;148(1):70-6.
• Cruz-Dominguez MP, Vera-Lastra O, Deras-Quinones A, Jandete-Rivera F, Grajeda-Lopez P, Montes-Cortes DH, et al. Mercury tissue deposits: a new adjuvant in autoimmune/inflammatory syndrome. Isr Med Assoc J. 2013;15(11):716-9.
• Shklar G, Meyer I. The histopathology and histochemistry of dermatologic lesions in the mouth. Oral Surgery, Oral Medicine, Oral Pathology. 1961;14(9):1069-84.
• Andreasen JO. Oral lichen planus. 1. A clinical evaluation of 115 cases. Oral Surg Oral Med Oral Pathol. 1968;25(1):31-42.
• Williams BG. Oral drug reaction to methyldopa. Report of a case. Oral Surg Oral Med Oral Pathol. 1983;56(4):375-7.
• Gange RW, Jones EW. Bullous lichen planus caused by labetalol. Br Med J. 1978;1(6116):816-7.
• Ferguson MM, Wiesenfeld D, MacDonald DG. Oral mucosal lichenoid eruption due to fenclofenac. J Oral Med. 1984;39(1):39-40.
• Lind PO, Hurlen B, Stromme Koppang H. Electrogalvanically-induced contact allergy of the oral mucosa. Report of a case. Int J Oral Surg. 1984;13(4):339-45.
• Gupta P, Mallishery S, Bajaj N, Banga K, Mehra A, Desai R. Low Prevalence of Amalgam-Associated Lichenoid Lesions in the Oral Cavity: A Prospective Study. Cureus. 2022;14(2):e22696.
• Agha-Hosseini F, Gholamrezayi E, Moosavi MS. Patch test of dental materials in Oral Lichen Planus with considering the role of saliva. Sci Rep. 2021;11(1):8264.
• Lehner J, Agbo-Godeau S, Bertolus C. A Retrospective Study of 23 Cases: Are Lichenoid Lesions of the Labial Mucosa Induced? Cureus. 2022;14(5):e25012.
• Tsushima F, Sakurai J, Shimizu R, Kayamori K, Harada H. Oral lichenoid contact lesions related to dental metal allergy may resolve after allergen removal. J Dent Sci. 2022;17(3):1300-6.
• Koch P, Bahmer FA. Oral lesions and symptoms related to metals used in dental restorations: a clinical, allergological, and histologic study. J Am Acad Dermatol. 1999;41(3 Pt 1):422-30.
• Andrei M, Tovaru S, Parlatescu I, Gheorghe C, Pirvu C. Correlation of corrosion resistance of dental alloy restorations with oral lichen planus pathology. Materials and Corrosion. 2016;67(8):882-7.
• Seno K, Ohno J, Ota N, Hirofuji T, Taniguchi K. Lupus-like oral mucosal lesions in mercury-induced autoimmune response in Brown Norway rats. BMC Immunol. 2013;14:47.
• Jha V, Workman CJ, McGaha TL, Li L, Vas J, Vignali DA, et al. Lymphocyte Activation Gene-3 (LAG-3) negatively regulates environmentally-induced autoimmunity. PLoS One. 2014;9(8):e104484.