Amalgam-Associated Oral Lichenoid Reactions: A Case Series

Abstract

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.