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Oral lichenoid reactions associated with amalgam: improvement after amalgam removal

Identifieur interne : 008111 ( Main/Exploration ); précédent : 008110; suivant : 008112

Oral lichenoid reactions associated with amalgam: improvement after amalgam removal

Auteurs : A. Dunsche [Allemagne] ; I. K Stel [Allemagne] ; H. Terheyden [Allemagne] ; I. N. G. Springer [Allemagne] ; E. Christophers [Allemagne] ; J. Brasch [Allemagne]

Source :

British journal of dermatology : (1951) [ 0007-0963 ] ; 2003.

RBID : Pascal:03-0166984

Descripteurs français

Pascal (Inist)
- Amalgame, Dent, Enlèvement, Lichen plan, Cavité buccale, Allergie, Complication, Iatrogène, Patch, Exploration, Traitement, Homme.
Wicri :
- topic : Allergie, Homme.

English descriptors

KwdEn :
- Allergy, Amalgams, Complication, Exploration, Human, Iatrogenic, Lichen planus, Oral cavity, Patch, Removal, Tooth, Treatment.

Abstract

Background The pathogenetic relationship between oral lichenoid reactions (OLR) and dental amalgam fillings is still a matter of controversy. Objectives To determine the diagnostic value of patch tests with amalgam and inorganic mercury (INM) and the effect of amalgam removal in OLR associated with amalgam fillings. Methods In 134 consecutive patients 467 OLR were classified according to clinical criteria. One hundred and fifty-nine biopsies from OLR lesions were histologically diagnosed according to the World Health Organization criteria for oral lichen planus (OLP) and compared with 47 OLP lesions from edentulous patients without amalgam exposure. One hundred and nineteen patients were patch tested with an amalgam series. In 105 patients (357 of 467 lesions) the amalgam fillings were removed regardless of the patch test results and OLR were re-examined within a follow-up period of about 3 years. Twenty-nine patients refused amalgam removal and were taken as a control group. Results Eleven patients with OLR (8.2%) had skin lesions of lichen planus (LP). Histologically, the lesions in the OLR group could not be distinguished from those seen in the OLP group. Thirty-three patients (27.7%) showed a positive patch test to INM or amalgam. Amalgam removal led to benefit in 102 of 105 patients (97.1%), of whom 31 (29.5%) were cured completely. Of 357 lesions, 213 (59.7%) cleared after removal of amalgam, whereas 65 (18.2%) did not improve. In the control group without amalgam removal (n = 29) only two patients (6.9%) showed an improvement (P < 0.05). Amalgam removal had the strongest impact on lesions of the tongue compared with lesions at other sites (P < 0.05), but had very little impact on intraoral lesions in patients with cutaneous LP compared with patients without cutaneous lesions (P < 0.05). Patients with a positive patch test reaction to amalgam showed complete healing more frequently than the amalgam-negative group (P < 0.05). After an initial cure following amalgam removal, 13 lesions (3.6%) in eight patients (7.6%) recurred after a mean of 14.6 months. Conclusions Of all patients with OLR associated with dental amalgam fillings, 97.1% benefited from amalgam removal regardless of patch test results with amalgam or INM. We suggest that the removal of amalgam fillings can be recommended in all patients with symptomatic OLR associated with amalgam fillings if no cutaneous LP is present.

Affiliations:

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Le document en format XML

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<author><name sortKey="Terheyden, H" sort="Terheyden, H" uniqKey="Terheyden H" first="H." last="Terheyden">H. Terheyden</name>
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<affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Oral and Maxillofacial Surgery, University of Kiel, Arnold-Heller-Str. 16</s1>
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<author><name sortKey="Christophers, E" sort="Christophers, E" uniqKey="Christophers E" first="E." last="Christophers">E. Christophers</name>
<affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Department of Dermatology, University of Kiel, Arnold-Heller-Str. 16</s1>
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<country>Allemagne</country>
<placeName><region type="land" nuts="2">Schleswig-Holstein</region>
<settlement type="city">Kiel</settlement>
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<author><name sortKey="Brasch, J" sort="Brasch, J" uniqKey="Brasch J" first="J." last="Brasch">J. Brasch</name>
<affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Department of Dermatology, University of Kiel, Arnold-Heller-Str. 16</s1>
<s2>24105 Kiel</s2>
<s3>DEU</s3>
<sZ>5 aut.</sZ>
<sZ>6 aut.</sZ>
</inist:fA14>
<country>Allemagne</country>
<placeName><region type="land" nuts="2">Schleswig-Holstein</region>
<settlement type="city">Kiel</settlement>
</placeName>
</affiliation>
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<series><title level="j" type="main">British journal of dermatology : (1951)</title>
<title level="j" type="abbreviated">Br. j. dermatol. : (1951)</title>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Allergy</term>
<term>Amalgams</term>
<term>Complication</term>
<term>Exploration</term>
<term>Human</term>
<term>Iatrogenic</term>
<term>Lichen planus</term>
<term>Oral cavity</term>
<term>Patch</term>
<term>Removal</term>
<term>Tooth</term>
<term>Treatment</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr"><term>Amalgame</term>
<term>Dent</term>
<term>Enlèvement</term>
<term>Lichen plan</term>
<term>Cavité buccale</term>
<term>Allergie</term>
<term>Complication</term>
<term>Iatrogène</term>
<term>Patch</term>
<term>Exploration</term>
<term>Traitement</term>
<term>Homme</term>
</keywords>
<keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Allergie</term>
<term>Homme</term>
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<front><div type="abstract" xml:lang="en">Background The pathogenetic relationship between oral lichenoid reactions (OLR) and dental amalgam fillings is still a matter of controversy. Objectives To determine the diagnostic value of patch tests with amalgam and inorganic mercury (INM) and the effect of amalgam removal in OLR associated with amalgam fillings. Methods In 134 consecutive patients 467 OLR were classified according to clinical criteria. One hundred and fifty-nine biopsies from OLR lesions were histologically diagnosed according to the World Health Organization criteria for oral lichen planus (OLP) and compared with 47 OLP lesions from edentulous patients without amalgam exposure. One hundred and nineteen patients were patch tested with an amalgam series. In 105 patients (357 of 467 lesions) the amalgam fillings were removed regardless of the patch test results and OLR were re-examined within a follow-up period of about 3 years. Twenty-nine patients refused amalgam removal and were taken as a control group. Results Eleven patients with OLR (8.2%) had skin lesions of lichen planus (LP). Histologically, the lesions in the OLR group could not be distinguished from those seen in the OLP group. Thirty-three patients (27.7%) showed a positive patch test to INM or amalgam. Amalgam removal led to benefit in 102 of 105 patients (97.1%), of whom 31 (29.5%) were cured completely. Of 357 lesions, 213 (59.7%) cleared after removal of amalgam, whereas 65 (18.2%) did not improve. In the control group without amalgam removal (n = 29) only two patients (6.9%) showed an improvement (P < 0.05). Amalgam removal had the strongest impact on lesions of the tongue compared with lesions at other sites (P < 0.05), but had very little impact on intraoral lesions in patients with cutaneous LP compared with patients without cutaneous lesions (P < 0.05). Patients with a positive patch test reaction to amalgam showed complete healing more frequently than the amalgam-negative group (P < 0.05). After an initial cure following amalgam removal, 13 lesions (3.6%) in eight patients (7.6%) recurred after a mean of 14.6 months. Conclusions Of all patients with OLR associated with dental amalgam fillings, 97.1% benefited from amalgam removal regardless of patch test results with amalgam or INM. We suggest that the removal of amalgam fillings can be recommended in all patients with symptomatic OLR associated with amalgam fillings if no cutaneous LP is present.</div>
</front>
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<affiliations><list><country><li>Allemagne</li>
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<region><li>Schleswig-Holstein</li>
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<settlement><li>Kiel</li>
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<tree><country name="Allemagne"><region name="Schleswig-Holstein"><name sortKey="Dunsche, A" sort="Dunsche, A" uniqKey="Dunsche A" first="A." last="Dunsche">A. Dunsche</name>
</region>
<name sortKey="Brasch, J" sort="Brasch, J" uniqKey="Brasch J" first="J." last="Brasch">J. Brasch</name>
<name sortKey="Christophers, E" sort="Christophers, E" uniqKey="Christophers E" first="E." last="Christophers">E. Christophers</name>
<name sortKey="K Stel, I" sort="K Stel, I" uniqKey="K Stel I" first="I." last="K Stel">I. K Stel</name>
<name sortKey="Springer, I N G" sort="Springer, I N G" uniqKey="Springer I" first="I. N. G." last="Springer">I. N. G. Springer</name>
<name sortKey="Terheyden, H" sort="Terheyden, H" uniqKey="Terheyden H" first="H." last="Terheyden">H. Terheyden</name>
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Oral lichenoid reactions associated with amalgam: improvement after amalgam removal

Oral lichenoid reactions associated with amalgam: improvement after amalgam removal

Source :

Descripteurs français

English descriptors

Abstract

Links toward previous steps (curation, corpus...)

Le document en format XML

Pour manipuler ce document sous Unix (Dilib)

Pour mettre un lien sur cette page dans le réseau Wicri