Ostman P O, Anneroth G, Skoglund A
Department of Oral Pathology, Umeå University, Sweden.
Scand J Dent Res. 1994 Jun;102(3):172-9. doi: 10.1111/j.1600-0722.1994.tb01175.x.
Fifty-one consecutive patients had clinically diagnosed oral lichen planus (OLP) lesions in total or partial contact with amalgam fillings. The clinical features of the OLP lesions were characterized and registered, and biopsies were obtained from each OLP lesion. Histologic and immunohistochemical studies were performed, as well as tests for allergy to dental materials. The clinical diagnosis of OLP corresponded to the World Health Organization (WHO) morphologic OLP criteria in 31 (61%) cases. The remaining lesions were histologically diagnosed as mild OLP in 11 (22%) or as benign oral keratosis in nine (17%) cases. The immunohistochemical examination showed a positive reaction to fibrinogen in the basement membrane zone (BMZ) in 10 (20%) patients and to complement C3 in one (2%) patient. No positive reactions in the BMZ were found for IgA, IgG, and IgM. In 17 (33%) patients, an allergic reaction to mercury was found, and candidiasis was diagnosed in 13 (25%) patients. The true nature of OLP-like lesions in contact with amalgam fillings still remains to be explained. For that matter, we do not know whether OLP is one disease or a number of similar immunologic or other responses to various interacting stimuli. One such stimulus might be mercury from corroding amalgam fillings.
51例连续患者临床上诊断为口腔扁平苔藓（OLP）病变，全部或部分与汞合金充填物接触。对OLP病变的临床特征进行了描述和记录，并从每个OLP病变处获取活检组织。进行了组织学和免疫组织化学研究，以及牙科材料过敏测试。31例（61%）患者的OLP临床诊断符合世界卫生组织（WHO）形态学OLP标准。其余病变经组织学诊断，11例（22%）为轻度OLP，9例（17%）为良性口腔角化病。免疫组织化学检查显示，10例（20%）患者基底膜区（BMZ）对纤维蛋白原呈阳性反应，1例（2%）患者对补体C3呈阳性反应。BMZ中未发现IgA、IgG和IgM呈阳性反应。17例（33%）患者对汞有过敏反应，13例（25%）患者诊断为念珠菌病。与汞合金充填物接触的OLP样病变的真正性质仍有待解释。就此而言，我们不知道OLP是一种疾病，还是对各种相互作用刺激的多种类似免疫或其他反应。一种这样的刺激可能是来自腐蚀汞合金充填物的汞。
