Klinik der oralen lichenoiden Reaktion auf Amalgam

Oral lichenoid reactions resemble oral lichen planus clinically and histologically and may arise in the vicinity of amalgam fillings, frequently. 108 out of 122 patients with oral lichenoid reactions were patch tested against a variety of dental materials. Patients were screened for cutaneous lichen planus by a dermatologist. The local relation of lesions to fillings in question was documented. 33 patients had positive patch test reactions to amalgam or inorganic mercury components. Amalgam fillings were replaced in 105 patients, which led to a benefit in 94 patients regardless of patch test results. In 31 patients lesions cleared completely, in 8 patients subtotally. An improvement was observed in 63 patients, no change at all in 3 patients. 17 patients refused replacement of amalgam fillings. In one of these patients lesions cleared subtotally while lesions remained unchanged in 16 patients. Amalgam removal had very little impact on intraoral lesions in patients with cutaneous lichen planus as compared to patients without cutaneous lesions. Oral lichenoid reactions may have a multifactorial etiology. We suggest that removal of amalgam restorations can be recommended in all patients with symptomatic OLR associated with amalgam fillings if no cutaneous LP is present.