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@#Amalgam has been widely used in dentistry and its components may cause some oral mucosal changes (OMC), commonly presenting as oral lichenoid lesions (OLLs), acute or generalized sensitivity reaction or amalgam tattoo. Our objective was to determine the demographic and clinical profile of patients with and without OMC adjacent to their amalgam restorations (AR) and to evaluate the prevalence and types of AR-related OMC and associated clinical parameters.Materials and methods: In this retrospective cross-sectional study, 83 outpatients attending the Primary Dental Care Unit at the Faculty of Dentistry, University Malaya wereexamined for the presence of AR-related OMC. The studyperiod was from early to mid July 2016. Firstly, patients’ personal details (age, gender, medical status, social habits) were analyzed and history of AR (the age, condition and number of restorations) was determined. Clinical examination of patient’s oral cavity was carried out to detect any AR-related OMC. The data collected was analyzed using SPSS 12.0.1 Result: Approximately 14.6 % patients had OMC. OLLs and amalgam tattoo made up 1.2% and 13.4% respectively. Females (8.4%) had higher predilection and Chinese were more commonly affected (8.4%). Social habits were not associated with OMC. Certain systemic diseases, age (p=0.005) and duration of amalgam (p=0.007) in the oral cavity were significant risk factors for OMC. Conclusions: Present findings suggest that AR-related OMC is uncommon. Three key parameters namely systemic diseases, patient’s age and duration of AR were identified as significant risk factors predisposing to the development of OMCs.
RESUMEN
Purpose: Black macules on the oral mucosa may be diagnostic of melanotic macule, melanotic nevus, amalgam tattoo or oral pigmented lesions caused by endodontic sealers, vascular lesions and melanoma. The differential diagnosis of such lesions is important as melanoma may be quite serious and must be treated quickly. A case of black macule on the oral mucosa is reported here, focusing on the importance of the differential diagnosis instituted. Case description: A 56-year-old female patient with a previous history of cutaneous melanoma consulted the Stomatology Service for evaluation of a black macule on the floor of the mouth. The diagnosis was found to be amalgam tattoo, although a radiographic exam had not shown an image compatible with amalgam. Conclusion: The diagnosis of amalgam tattoo can be confirmed by the detection of a metallic fragment in a radiographic exam, a situation that dispenses with the institution of treatment. However, if such a fragment is not detected, a biopsy is necessary to rule out the diagnostic hypothesis of melanocytic neoplasia.
Objetivo: As máculas negras que acometem a mucosa oral incluem os diagnósticos de mácula melânica, nevo melânico, tatuagem por amálgama ou por cimento endodôntico, lesões vasculares e melanoma. O diagnóstico diferencial de tais lesões é importante considerando-se a gravidade desta última. Os autores relatam um caso de mácula negra na mucosa oral enfatizando a importância do diagnóstico diferencial e a conduta instituída. Descrição do caso: Paciente do sexo feminino, 56 anos de idade, com história prévia de melanoma cutâneo, consultou o Serviço de Estomatologia para avaliação de mácula negra em assoalho de boca. O diagnóstico foi de tatuagem por amálgama, embora o exame radiográfico não exibisse imagem compatível com fragmento metálico. Conclusão: O diagnóstico de tatuagem por amálgama pode ser confirmado por meio da detecção de fragmentos metálicos ao exame radiográfico, situação que dispensa a instituição de tratamento. Entretanto, se os fragmentos não forem detectados, a biópsia se faz necessária para descartar a hipótese de neoplasia melanocítica.