http://tinyurl.com/eu2nb

Resolution of orofacial granulomatosis with amalgam removal.

Guttman-Yassky E, Weltfriend S, Bergman R.

Department of Dermatology, Rambam Medical Centre and the Bruce Rappaport
Faculty of Medicine, Haifa, Israel. dermatology@rambam.health.gov.il

A 61-year-old woman presented with a 2-year history of an abnormal
erythematous swelling on the upper lip and cheek. Upon examination there
were no other physical findings. Histological examination found discreet
sarcoidal granulomas in the lower dermis. Routine laboratory studies, chest
radiographs and pulmonary functions were all normal. Clinical presentation
and histological findings were, therefore, compatible with the diagnosis of
orofacial granulomatosis (OFG). The patient was patch tested with an
extended standard series that included metal-salt, dental prosthesis, bakery
and corticosteroids series. The patch test was positive (score ++) after 48
and 72 h for mercury in the metal-salt and dental prosthesis series. During
the past decade the patient had received amalgam fillings of several dental
cavities, including one adjacent to the swollen cheek. The unilateral
localization of the soft tissue swelling adjacent to the amalgam tooth
fillings, along with the positive patch test for mercury, raised the
possibility that the OFG was part of a delayed hypersensitive reaction to
the fillings. The patient therefore underwent a total amalgam replacement
procedure; complete disappearance of the swelling overlying the right cheek
was observed within 7 weeks and the swelling of the upper lip subsided
completely within 6 months. We propose that mercury in amalgam tooth
fillings is another cause of OFG and suggest appropriate patch testing in
patients who do not have an apparent cause of OFG.

Publication Types:
Case Reports

PMID: 12702083 [PubMed - indexed for MEDLINE]

http://tinyurl.com/jxnjj

Oral lichenoid lesions (OLL) and mercury in amalgam fillings.

Wong L, Freeman S.

Skin and Cancer Foundation, Darlinghurst NSW, Australia.

84 patients with oral lichenoid lesions (OLL) were seen in the contact
dermatitis clinic. All these patients had reticulate, lacy, plaque-like or
erosive lichenoid changes adjacent to amalgam fillings. Patch testing to
metallic mercury, 0.1% thimerosal, 1% ammoniated mercury, 0.1% mercuric
chloride, and in some cases 0.05% phenylmercuric nitrate and amalgam discs
was undertaken. 33 (39%) patients had positive patch test findings. 30/33
patch test positive patients had replacement of their amalgam fillings, with
28 (87%) patients experiencing improvement of symptoms and signs within 3
months. This confirms that mercury allergy is a factor in the pathogenesis
of OLL in some cases. In cases where patch test negative patients improve
with amalgam replacement, mercury may be acting as an irritant in the
pathogenesis of OLL.

PMID: 12694209 [PubMed - indexed for MEDLINE]

http://tinyurl.com/lhmpr

Mercury uptake and kinetics after ingestion of dental amalgam.

af Geijersstam E, Sandborgh-Englund G, Jonsson F, Ekstrand J.

Dept. of Basic Oral Sciences, School of Dentistry, Karolinska Institutet,
Huddinge, Sweden.

The aim of the present study was to investigate the G-1 uptake of mercury
(Hg) after intake of a single dose of amalgam-Hg, followed by
pharmacokinetic analysis of the data. Eleven volunteers without amalgam
fillings ingested 1.00 g amalgam powder. Hg in plasma vs. time was analyzed
with a two-compartment model by means of mixed-effects modeling. A fraction
of the absorption rate of Hg to the central compartment was inversely
proportional to the plasma ferritin levels. The population mean half-life of
the terminal phase of Hg in plasma was 37 days, with a considerable standard
deviation in the population. The absorbed fraction of the administered dose
was estimated to be about 0.04%. It is concluded that the G-1 uptake of Hg
is of quantitative importance during dental treatment.

PMID: 11926235 [PubMed - indexed for MEDLINE]