mercuric-chloride--ammoniated and Mouth-Diseases

The purpose of the present investigation was to determine, in patients with oral mucosal lesions of lichenoid character, whether it is possible with epicutaneous patch tests, to detect those who will react favorably to removal of amalgam. Of 48 patients, 19 (39.6%) showed positive patch test reactions to 1% mercury ammonium chloride, and 29 (60.4%) showed negative test results. The observation period varied from 3 months to 3 yr (mean value 1.5 yr). After treatment, 94.7% of the positive group and 86.2% of the negative group showed regression of lesions. Reactions exceeding the contact zone between amalgam restorations and lesions showed positive patch test results in 21% of the cases, as compared with 47% among those with lesions restricted to the contact areas; 85.7 and 93.9%, respectively, showed regression after removal of amalgam restorations. The results of the present study indicate that removal of amalgam usually affects the lesions favorably and that epicutaneous patch tests are of little prognostic value in patients with oral mucosal lesions of lichenoid character.

Topics: Adult; Aged; Ammonia; Dental Amalgam; Dental Restoration, Permanent; Female; Follow-Up Studies; Humans; Leukoplakia, Oral; Lichen Planus, Oral; Lichenoid Eruptions; Male; Mercuric Chloride; Middle Aged; Mouth Diseases; Patch Tests; Remission Induction

Epicutaneous patch testing of a battery of 35 dental test substances was carried out in 24 patients with visible lichenoid oral mucosal lesions and in 24 patients with burning mouth syndrome (BMS) without any visible lesions. Reactions to mercury ammonium chloride were found in 33% (8/24) of the patients with visible lesions compared to 0% (0/24) of the patients with BMS. The difference was statistically significant. In 7 of the 8 patients who reacted to mercury, total or partial regression of the lesions was observed after removal of dental amalgam. Reactions to nickel sulfate were found in 21% (5/24) of the patients with BMS compared to 3% (1/24) of the patients with lichenoid lesions. This difference was also statistically significant. Nickel is a rare component in dental restorations, but the oral mucosa is daily exposed to nickel through food and water intake. Removal of nickel from the environment of the patient can therefore be hard to accomplish.

Topics: Adult; Aged; Allergens; Ammonia; Burning Mouth Syndrome; Dental Materials; Dental Restoration, Permanent; Dentures; Female; Follow-Up Studies; Humans; Hypersensitivity; Lichen Planus; Male; Mercuric Chloride; Middle Aged; Mouth Diseases; Nickel; Skin Tests