THE RELEVANCE AND EFFECT OF AMALGAM REPLACEMENT IN SUBJECTS WITH ORALLICHENOID REACTIONS

In this study we examined the prevalence of mercury hypersensitivity i n patients with oral lichenoid reactions (OLR) and the effect of amalg am replacement in subjects with amalgams adjacent to OLR irrespective of their mercury sensitivity status. One hundred and ninety-seven pati ents with oral problems were examined: 109 with OLR, 22 with oral and generalized lichen planus, and 66 with other oral diagnoses. including aphthous ulcers and orofacial granulomatosis. Nineteen per cent of pa tients with OLR reacted to mercury on patch testing, significantly mor e than in those with generalized lichen planus (0%) and in those with other oral diagnoses (3%). Twenty-two patients with OLR and adjacent a malgams had amalgam replacement and, in 16 of 17 mercury-positive subj ects and three of four mercury-negative subjects, the OLR resolved aft er amalgam removal. In conclusion, we found a significantly increased prevalence of mercury hypersensitivity in patients with localized OLR in comparison to subjects with other oral problems. Amalgam replacemen t resulted in resolution of OLR in the majority of patients with amalg ams adjacent to OLR irrespective of their mercury sensitivity status.