Clinical and histologic healing of lichenoid oral lesions following amalgam removal: a prospective study

Oral Surg Oral Med Oral Pathol Oral Radiol. 2012 Jun;113(6):766-72. doi: 10.1016/j.oooo.2011.12.007. Epub 2012 Mar 26.


Objective: This study aimed to see whether clinical healing after amalgam removal corresponds to histologic healing, i.e., a complete disappearance of any histologic sign of lichenoid lesion.

Study design: The study evaluated 64 patients with lichenoid lesions and at least one amalgam filling.

Results: After amalgam removal, complete clinical healing was obtained in 14 patients (22%) and was significantly related to lesion topography (χ(2) 4.7; P < .05) and positive patch test (χ(2) 6.3; P < .01). Complete histologic healing was obtained in only 7 cases (50% of clinically healed patients), and was significantly related to the combination of positive patch test and strict contact with amalgams (Fisher's exact test P < .01).

Conclusions: Contact with amalgams and positive patch testing are good but not absolute indicators of the beneficial effect of amalgam replacement. In addition, complete clinical healing does not necessarily mean a disappearance of the histologic characteristics of OLL/OLP lesions.

MeSH terms

  • Aged
  • Chi-Square Distribution
  • Dental Amalgam / adverse effects*
  • Dental Restoration, Permanent / adverse effects*
  • Dental Restoration, Permanent / methods
  • Female
  • Humans
  • Keratinocytes / drug effects
  • Lichen Planus, Oral / chemically induced
  • Lichen Planus, Oral / therapy*
  • Lichenoid Eruptions / chemically induced
  • Lichenoid Eruptions / therapy*
  • Logistic Models
  • Male
  • Middle Aged
  • Mouth Mucosa / drug effects
  • Patch Tests
  • Prospective Studies
  • Retreatment
  • Wound Healing


  • Dental Amalgam