From the Faculty of Dentistry, University of Toronto, Ontario.
Faculty of Medicine, Memorial University, St John's, Newfoundland.
Dermatitis. 2021;32(3):144-150. doi: 10.1097/DER.0000000000000703.
This systematic review summarizes characteristics and treatment outcomes of dental amalgam-associated oral lichenoid lesions (OLLs) and oral lichen planus (OLP). Embase and MEDLINE were searched for original studies on OLLs or OLP associated with dental amalgam. Data extraction was completed from 44 studies representing 1855 patients. Removal of amalgam restorations led to complete resolution in 54.2% (n = 423/781), partial resolution in 34.8% (n = 272/781), and no resolution in 11.0% (n = 86/781) of the patients with OLLs, whereas complete resolution occurred in 37.1% (n = 72/194), partial resolution in 26.3% (n = 51/194), and no resolution in 36.6% (n = 71/194) of the patients with OLP. For patients with OLLs, 91.6% of the patients with positive patch tests and 82.9% with negative patch tests had improvement with removal of amalgam, whereas for patients with OLP, 89.2% of the patients with positive patch tests and 78.9% with negative patch tests had improvement with removal of amalgam. Our results suggest improvement occurs, regardless of patch testing status.
本系统综述总结了与牙银合金相关的口腔扁平苔藓（OLP）和口腔黏膜炎性病变（OLL）的特征和治疗结果。我们在 Embase 和 MEDLINE 数据库中检索了有关 OLL 或与牙银合金相关的 OLP 的原始研究。从 44 项研究中提取了数据，这些研究共涉及 1855 名患者。在 OLL 患者中，去除银汞合金修复体后，54.2%（n=423/781）的患者完全缓解，34.8%（n=272/781）的患者部分缓解，11.0%（n=86/781）的患者无缓解；而在 OLP 患者中，完全缓解分别为 37.1%（n=72/194）、部分缓解为 26.3%（n=51/194）、无缓解为 36.6%（n=71/194）。对于 OLL 患者，阳性斑贴试验患者中有 91.6%，阴性斑贴试验患者中有 82.9%的患者在去除银汞合金后病情得到改善；而对于 OLP 患者，阳性斑贴试验患者中有 89.2%，阴性斑贴试验患者中有 78.9%的患者在去除银汞合金后病情得到改善。我们的结果表明，无论斑贴试验结果如何，去除银汞合金都会使病情得到改善。
