Oral lichenoid contact reaction to amalgam occurring as a leukoplakia-like lesion: a case report

Silvio Hirota, Norberto Sugaya, Dante Migliari


This article reports a case of oral lichenoid contact reaction (OLCR) in which a bilateral lesion involving the buccal mucosa was observed. Its relevance lies on that the lesions could be misdiagnosed as an oral leukoplakia, since they showed a typical feature of a homogeneous white plaque; however, fortunately, this misjudgement was spared because one of the lesions, on the right-buccal side, was in direct contact with an amalgam filling. Hence, the suspicion of mucosal contact reaction was made and the patient successfully treated by amalgam replacement. Comments on diagnosing of OLCR is also included is this report.


Oral mucosal contact reaction, Hypersensitivity reaction, Oral lichenoid lesion, Diagnosis, Amalgam filling

Full Text:



Vivas AP, Migliari DA. Cinnamon-induced oral mucosal contact reaction. Open Dent J. 2015;9:257-9.

Calapai G, Miroddi M, Mannucci C, Minciullo PL, Gangemi S. Oral adverse reactions due to cinnamon-flavoured chewing gums consumption. Oral Dis. 2014;20:637-43.

Luiz AC, Hirota SK, Dal Vechio A, Reis VM, Spina R, Migliari DA. Diagnosing oral lichenoid contact reaction: clinical judgment versus skin-patch test. Minerva Stomatol. 2012;61:311–7.

Laine J, Konttinen YT, Beliaev N, Happonen RP. Immunocompetent cells in amalgam-associated oral lichenoid contact lesions. J Oral Pathol Med. 1999;28:117–21.

Thornhill MH, Pemberton MN, Simmons RK, Theaker ED. Amalgam-contact hypersensitivity lesions and oral lichen planus. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003;95:291-9.

Raap U, Stiesch M, Kapp A. Contact allergy to dental materials. J Dtsch Dermatol Ges. 2012;10:391-6.

Issa Y, Brunton PA, Glenny AM, Duxbury AJ. Healing of oral lichenoid lesions after replacing amalgam restorations: A sistematic review. Oral Surg Oral Med Oral Pathol. 2004;98:553-65.

Vieira G, Oda M, de Freitas P, Migliari D. Painful oral ulceration developed as lichenoid contact reaction. a case report. J Dent Oral Disord Ther. 2016;4:1-2.