Oral mucosal diseases investigated by patch testing with a dental screening series

Alanko, Kristiina; Kanerva, Lasse; Jolanki, R; Kannas, Liisa; Estlander, Tuula

doi:10.1111/j.1600-0536.1996.tb02197.x

Cited by 76 publications

(50 citation statements)

References 14 publications

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“…However, for patients with extensive atrophic and erosive lesions without amalgam contact, total removal is suggested as treatment (8). The percentage of patients who completely recover oscillates between 37.5% (7) and 100% (23). The most noticeable recoveries are observed when there is direct contact between lesion and restoration, and the least noticeable when there is no such contact.…”

Section: ) Patch Test Resultsmentioning

confidence: 99%

Oral lichenoid lesions related to contact with dental materials: A literature review

Mj¹,

Martínez-Sahuquillo-Márquez²,

Gallardo³

et al. 2009

Med Oral

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Oral lichenoid lesions related to contact are defined as oral-cavity eruptions with an identifiable etiology, and are clinically and histologically similar to oral lichen planus. Within this group are found oral lichenoid lesions related to contact with dental materials (OLLC), the most common being those related to silver amalgam. Currently, it remains difficult to diagnose these lesions due to the clinical and histopathological similarity with oral lichen planus and other oral mucosa lesions of lichenoid characteristics. In the present paper, we carry out an updated review of the tests for, and the different characteristics of OLLC, which may aid the diagnosis. For this review, we made searches in the Pubmed® and Cochrane® databases. Among the literature we found several published papers, from which we have used review papers, case papers, cohort studies, case and control studies, and a meta-analysis study. After carrying out this review, we can conclude that the diagnosis of these lesions is still difficult and controversial. However, there are different aspects in the clinical presentation, pathological study and results obtained when replacing suspect materials, which, when taken together, may be useful when establishing the final diagnosis of OLLC.

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Section: ) Patch Test Resultsmentioning

confidence: 99%

Oral lichenoid lesions related to contact with dental materials: A literature review

Mj¹,

Martínez-Sahuquillo-Márquez²,

Gallardo³

et al. 2009

Med Oral

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“…This can be proven only in a minority of patients with amalgam-related complaints [10]. Some findings indicate that a hypersensibility to mercury could play a role in the etiopathology of lichen planus [11]. …”

Section: Introductionmentioning

confidence: 99%

Psychological, Allergic, and Toxicological Aspects of Patients with Amalgam-Related Complaints

Gottwald¹,

Kupfer²,

Traenckner³

et al. 2002

Psychother Psychosom

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Background: To deepen the understanding of the numerous unspecific complaints which are related to the dental material amalgam both in patients and physicians, an interdisciplinary case-control study regarding toxicological, allergic, psychological and psychiatric aspects was conducted. Forty patients with amalgam-associated complaints were compared to a well-matched group of 40 amalgam bearers without complaints. Methods: Patients and controls underwent a dental examination, which included recording of the quantity, surface area and quality of amalgam fillings, a determination of the mercury load in blood and urine, an allergy examination including patch testing with amalgam and a psychometric assessment with questionnaires noting coping strategies (ABI-UMW-P), interpersonal problems (Inventory of Interpersonal Problems) and self-consciousness (SAM), the NEO Five-Factor Inventory, Symptom Checklist-90-R, Beck Depression Inventory and a screening instrument for somatoform disorders. Results: Patients and controls did not differ with respect to mercury concentrations in body fluids. Only 1 patient was found to have a positive amalgam patch test; various other allergies could be determined in 28% of patients (n = 11). Patients had higher levels of psychic distress, a higher incidence of depression and somatization disorders as well as different styles of coping with anxiety compared to controls. Conclusions: No indication for mercury intoxication or amalgam allergy as a cause of the patients’ complaints could be found. The theory of amalgam-related complaints as an expression of underlying psychic problems is supported. Treatment should focus on somatization and changing coping and attribution styles.

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“…Most of the dental material used for dental restoration is not only irritating, but also sensitizing and may cause a local damage [4]. The common allergen spectrum of material used for dental restoration includes amalgam, mercury compounds, gold salts, palladium chloride, and methyl methacrylate and nickel [5, 6, 7]. …”

Section: Introductionmentioning

confidence: 99%

Results of Double-Blind Placebo-Controlled Challenge with Nickel Salts in Patients Affected by Recurrent Aphthous Stomatitis

Pacor

Lorenzo

Martinelli

et al. 2003

Int Arch Allergy Immunol

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Background: The aetiology of recurrent aphthous stomatitis (RAS) has so far not been completely clarified. Recently, several studies reported that patients affected by cutaneous diseases (i.e. dermatitis, eczema and urticaria) with positive patch test to nickel have a positive oral nickel challenge. Objective: A retrospective data analysis of patch test and oral nickel challenge in 380 patients (204 women and 176 men) affected by RAS was performed. Patients and Methods: We examined 380 consecutive patients affected by RAS during the period 1990–1999. In 28/380 patients the appearance of their oral symptoms coincided with the fitting of orthodontic appliance, while 352/380 reported that their oral symptoms worsened after the fitting of orthodontic appliance. All patients were studied with the series (European standard series and series for dental materials) for patch tests. Results: Seventy out of 380 patients (18.4%) presented a contact sensitization to nickel sulphate (positive patch test). In all of these, the orthodontic appliance was replaced with one made of nickel-free materials. All patients were re-examined by the dentist 6 months after the removal of the orthodontic appliance. The symptoms had completely remitted in 28/70 patients, partially had improved in 31/70 patients and had remained unchanged in 11/70 patients. In all patients (n = 70) with a positive patch test to nickel we performed an oral double-blind placebo-controlled challenge (DBPC) test with nickel sulphate. The DBPC was positive in 32/70 patients, 21 of whom had partially improved and 11 had not, even after the replacement of the orthodontic appliance with material not containing nickel. None of the 28 patients in complete remission showed an adverse reaction to oral nickel challenge. Conclusion: The results of this study demonstrate that, in some patients with a positive patch test to nickel sulphate, the perpetuation of RAS can be related to a hypersensitivity to ingested nickel salts, independently of local contact to nickel.

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Oral mucosal diseases investigated by patch testing with a dental screening series

Cited by 76 publications

References 14 publications

Oral lichenoid lesions related to contact with dental materials: A literature review

Oral lichenoid lesions related to contact with dental materials: A literature review

Psychological, Allergic, and Toxicological Aspects of Patients with Amalgam-Related Complaints

Results of Double-Blind Placebo-Controlled Challenge with Nickel Salts in Patients Affected by Recurrent Aphthous Stomatitis

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