Oral lichen planus: hypersensitivity to dental restoration material

Abstract

67 patients with oral lichen planus of the atrophic-erosive or reticular plaque type were examined. Dental amalgam in contact with mucosal lesions was present in 64 patients, and gold fillings in 33. Patch testing with a standard procedure was performed with components of dental fillings. 11 patients (16%) reacted to at least one of the mercury compounds compared to 8% in a reference group. Most positive reactions were caused by elemental mercury and ammoniated mercury. No patient reacted to gold or copper. Readings at days 10-14 did not increase the number of responders. 13 patients were patch tested with palladium; all were negative. It is not clear whether in the mercury-positive patients allergy to dental amalgam is a causative or aggravating factor, or merely on epiphenomenon.

Linear Lichen planus in the Region of the Mandibular Nerve Caused by an Allergy to Palladium in Dental Metals

“…Eruptions are present on the trunk or limbs in most cases but are extremely rare on the face. Some cases of LP caused by dental alloys [5, 6, 7, 8] have been respected, but linear LP due to dental metal allergy is rare [3]. Our patient had linear LP in the region of the mandibular nerve.…”

“…Although LP is known to be caused by dental alloys [5, 6, 7, 8], only 3 cases of linear LP due to dental metals have been reported. These cases all exhibited a positive reaction to gold or mercury on patch testing, and the eruptions were situated along Blaschko’s line.…”

Adverse Drug Reactions in the Orofacial Region

“…Significant reactions to mercuric salts on skin-testing may be seen in some patients with OLP (Finne et al, 1982;Eversole and Ringer, 1984;Mobacken et al, 1984;James et al, 1987;Ostman et al, 1994), though others have not found this (Hietanen et al, 1987). Finne et al (1982) demonstrated mercury sensitivity by patch-testing in 62% of 29 patients with OLP and only 3.2% of a control group, and in a few patients their oral lesions regressed on removal of the amalgams (Finne et al, 1982).…”

Update On Oral Lichen Planus: Etiopathogenesis and Management

“…However, contact with or proximity to restorations involving amalgams or other materials causes some lichenoid reactions-that is to say, lesions that clinically and histologically resemble LP closely, but have an identifiable etiology. These reactions are presumably due to allergic or toxic reactions to compounds released or generated, the Koebner phenomenon, or possibly plaque accumulated on the surfaces of the restorations (Holmstrup, 1991) Metal restorations Some lesions resembling OLP may occur in direct relation to amalgam restorations (Lundstrom, 1984;Lind et al, 1986;Bolewska et al, 1990a,b), and some of these oral lesions may improve after substitution of the amalgam by other materials (Finneetal., 1982;Jolly etal., 1986;Lind et al, 1986;Bolewska et al 1990a,b;Jameson et al, 1990;Skoglund and Egelrud, 1991;Laine et al, 1992;Bircher et al, 1993;Skoglund, 1994, Henriksson etal., 1995, Smartet al, 1995, Bratel et al, 1996Ibbotson et al, 1996), though this is often not the case with gingival lesions (Henriksson et al, 1995) Significant reactions to mercuric salts on skin-testing may be seen in some patients with OLP (Finne et al, 1982, Eversole andRinger, 1984;Mobacken et al, 1984a;lames et al, 1987;Ostman et al, 1994), though others have not found this (Hietanen et al, 1987) Finne et al (1982 demonstrated mercury sensitivity by patch testing in 62% of 29 patients with OLP and only 3.2% of a control group, and oral lesions regressed in a few patients when their amalgams were removed (Finne et al, 1982). Reactions to mercuric chloride have been reported (Skoglund and Egelrud, 1991;Smart et al, 1995).…”