Management Of Allergy And Hypersensitivity Reactions Due To Dental Amalgam - A Scoping Review
Keywords:
Dental amalgam, Amalgam restoration, Amalgam restoration replacement, Allergy, Hypersensitivity, Amalgam allergy, Oral lichenoid lesions, Oral lichenoid reaction, Management.Abstract
Background: Due to its long clinical success, cost, and durability, dental amalgam has been widely employed in restorative dentistry. However, allergic and hypersensitive reactions affecting the oral mucosa, most frequently oral lichenoid lesions and reactions, have been linked to amalgam restorations. Clinically, these lesions often resemble oral lichen planus, making diagnosis and treatment difficult.
Objective: To assess the data that is available at present for managing allergic and hypersensitive reactions associated with dental amalgam restorations.
Methods: A scoping review was conducted using electronic databases including PubMed, Scopus, Web of Science, and Google Scholar. Studies evaluating amalgam-associated oral hypersensitivity reactions, diagnostic approaches, management strategies, and clinical outcomes were included. Data extraction focused on study design, oral condition, triggering allergen, diagnostic methods, interventions performed, and treatment outcomes.
Results: Six studies met the inclusion criteria. Oral lichenoid lesions and oral lichenoid reactions were the most commonly reported manifestations associated with amalgam restorations. Clinical topographical association between lesions and restorations was consistently identified as an important diagnostic criterion. Most studies demonstrated significant clinical improvement or complete healing following removal or replacement of amalgam restorations. Although patch testing showed variable diagnostic value, positive patch test reactions were associated with favourable outcomes in some studies.
Conclusion: Replacement or removal of implicated amalgam restorations appears to be an effective management approach for amalgam-associated hypersensitivity reactions. Clinical lesion topography remains an important diagnostic indicator, while patch testing may serve as an adjunctive tool. Further standardized studies with larger sample sizes are required to establish definitive diagnostic and management guidelines.
