Non-Cochrane · intervention · PM41658369
Clinical resolution of oral lichenoid lesions after amalgam replacement: A systematic review and meta-analysis of observational studies.
Kothari Harshita, Pawar Ajinkya M, Gupta Pankaj, et al. · Journal of oral biology and craniofacial research · 2026 · PubMed · doi:10.1016/j.jobcr.2026.01.008
Findings
Population Adults with clinically and/or histologically confirmed oral lichenoid lesions associated with dental amalgam restorations
15 findings
| Replacement of amalgam restorations with another restorative material (composite resin, gold, ceramic, glass ionomer) | No replacement (non-resolution comparator) | Clinical resolution of oral lichenoid lesions After replacement (follow-up varied across studies) · Overall | OR 122.18 [55.64, 268.26] Moderate Downgraded: publication bias 11 studies · 365 participants |
| Replacement of amalgam restorations with another restorative material (composite resin, gold, ceramic, glass ionomer) | No replacement (non-resolution comparator) | Clinical resolution of oral lichenoid lesions After replacement (follow-up varied across studies) · Sensitivity analysis excluding studies at moderate risk of bias | OR 113.40 [48.10, 263.50] GRADE not reported Studies not reported |
| Amalgam replaced with gold or ceramic | Amalgam replaced with composite resin | Clinical resolution of oral lichenoid lesions Subgroup comparison | Slight increase in resolution | 180 (5 studies) | Low | Small sample sizes; needs further prospective validation Low 5 studies · 180 participants |
| Amalgam replaced with gold or ceramic | Amalgam replaced with composite resin | Clinical resolution of oral lichenoid lesions Gold/Ceramic | Resolution rate (%) 83 GRADE not reported Studies not reported |
| Amalgam replaced with gold or ceramic | Amalgam replaced with composite resin | Clinical resolution of oral lichenoid lesions Composite | Resolution rate (%) 71 GRADE not reported Studies not reported |
| Amalgam replacement in patch-test positive patients | Amalgam replacement in patch-test negative or untested patients | Clinical resolution of oral lichenoid lesions Subgroup comparison | Higher vs negative/untested | 221 (7 studies) | Moderate | Patch testing useful but underreported and inconsistently interpreted Moderate 7 studies · 221 participants |
| Amalgam replacement in patch-test positive patients | Amalgam replacement in patch-test negative or untested patients | Clinical resolution of oral lichenoid lesions Patch test negative or untested | Resolution rate (%) 58 GRADE not reported Studies not reported |
| Amalgam replacement in patch-test positive patients | Amalgam replacement in patch-test negative or untested patients | Clinical resolution of oral lichenoid lesions Patch test positive | Resolution rate (%) 83 GRADE not reported Studies not reported |
| Amalgam replacement in erosive-type lesions | Amalgam replacement in reticular-type lesions | Clinical resolution of oral lichenoid lesions Reticular | Resolution rate (%) 68 GRADE not reported Studies not reported |
| Amalgam replacement in erosive-type lesions | Amalgam replacement in reticular-type lesions | Clinical resolution of oral lichenoid lesions Erosive | Resolution rate (%) 76 GRADE not reported Studies not reported |
| Amalgam replacement in studies from Europe/Asia | Amalgam replacement in studies from other regions | Clinical resolution of oral lichenoid lesions Europe/Asia | Resolution rate (%) 79 GRADE not reported Studies not reported |
| Amalgam replacement in studies from Europe/Asia | Amalgam replacement in studies from other regions | Clinical resolution of oral lichenoid lesions Other regions | Resolution rate (%) 61 GRADE not reported Studies not reported |
| Amalgam replacement, follow-up of 12 months or more | Amalgam replacement, follow-up under 12 months | Clinical resolution of oral lichenoid lesions Subgroup comparison | Higher durability of remission | 278 (8 studies) | Moderate | More stable outcomes in longer follow-up Moderate 8 studies · 278 participants |
| Amalgam replacement, follow-up of 12 months or more | Amalgam replacement, follow-up under 12 months | Clinical resolution of oral lichenoid lesions Under 12 months · Follow-up <12 months | Resolution rate (%) 66 GRADE not reported Studies not reported |
| Amalgam replacement, follow-up of 12 months or more | Amalgam replacement, follow-up under 12 months | Clinical resolution of oral lichenoid lesions 12 months or more · Follow-up >=12 months | Resolution rate (%) 82 GRADE not reported Studies not reported |
Included primary studies 35
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Aggarwal 2010 Oral lichenoid reaction associated with tin component of amalgam restorations: a case report. PMID:20098082 | 2010 | this review only | not stated | not extracted yet |
| Barbosa 2011 Oral lichenoid lesions associated with amalgam restorations: report of two cases DOI:10.1590/s1980-65232011000300012 | 2011 | this review only | not stated | not extracted yet |
| Bettoni 2023 Oral Lichenoid Lesions May Regress after Amalgama Removal: A Case Report Becomes a Proof of the Concept DOI:10.26502/acmcr.96550626 | 2023 | this review only | not stated | not extracted yet |
| Bratel 1996 Effect of replacement of dental amalgam on oral lichenoid reactions. PMID:8636491 | 1996 | this review only | not stated | not extracted yet |
| Dahiwal 2014 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Dunsche 2003 Oral lichenoid reactions associated with amalgam: improvement after amalgam removal. PMID:12534597 | 2003 | this review only | Clinical resolution of oral lichenoid lesions | not extracted yet |
| Gupta 2022 Low Prevalence of Amalgam-Associated Lichenoid Lesions in the Oral Cavity: A Prospective Study. PMID:35386156 | 2022 | this review only | not stated | not extracted yet |
| Guvenc 2019 Lichenoid hypersensitivity reaction against to dental amalgam: Case report DOI:10.5455/medscience.2018.07.8973 | 2019 | this review only | not stated | not extracted yet |
| Henriksson 1995 Healing of lichenoid reactions following removal of amalgam. A clinical follow-up. PMID:7622635 | 1995 | this review only | Clinical resolution of oral lichenoid lesions | not extracted yet |
| Issa 2005 Oral lichenoid lesions related to dental restorative materials. PMID:15789104 | 2005 | this review only | Clinical resolution of oral lichenoid lesions | not extracted yet |
| Jyothi 2015 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Kal 2008 An unusual case of immediate hypersensitivity reaction associated with an amalgam restoration. PMID:19023309 | 2008 | this review only | not stated | not extracted yet |
| Karatasli 2018 Healing of Oral Lichenoid Lesions following Replacement of Dental Amalgam Restorations with Feldspathic Ceramic Inlay-Onlay Restorations:… PMID:30627572 | 2018 | this review only | Clinical resolution of oral lichenoid lesions | not extracted yet |
| Kharangate 2013 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Klaisiri 2019 Oral lichenoid lesion related to dental amalgam: A case report. PMID:30664954 | 2019 | this review only | not stated | not extracted yet |
| Laeijendecker 2004 Oral lichen planus and allergy to dental amalgam restorations. PMID:15611418 | 2004 | this review only | Clinical resolution of oral lichenoid lesions | not extracted yet |
| Laine 1991 Resolution of oral lichenoid lesions after replacement of amalgam restorations in patients allergic to mercury compounds. PMID:1536756 | 1992 | this review only | Clinical resolution of oral lichenoid lesions | not extracted yet |
| Lartitegui-Sebastian 2012 Oral lichenoid lesions associated with amalgam restorations: a prospective pilot study addressing the adult population of the Basque… PMID:22322507 | 2012 | this review only | not stated | not extracted yet |
| Lind 1988 Oral lichenoid reactions related to composite restorations. Preliminary report. PMID:3164165 | 1988 | this review only | Clinical resolution of oral lichenoid lesions | not extracted yet |
| Marell 2014 Regression of oral lichenoid lesions after replacement of dental restorations. PMID:24843865 | 2014 | this review only | not stated | not extracted yet |
| Marouane 2015 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Montebugnoli 2012 Clinical and histologic healing of lichenoid oral lesions following amalgam removal: a prospective study. PMID:22668704 | 2012 | this review only | not stated | not extracted yet |
| Ostman 1995 Amalgam-associated oral lichenoid reactions. Clinical and histologic changes after removal of amalgam fillings. PMID:8705594 | 1996 | this review only | not stated | not extracted yet |
| Pang 1995 Oral lichenoid lesions caused by allergy to mercury in amalgam fillings. PMID:8706402 | 1995 | this review only | Clinical resolution of oral lichenoid lesions | not extracted yet |
| Pawar 2016 Lichenoid reaction associated with silver amalgam restoration in a Bombay blood group patient: A case report. PMID:27217647 | 2016 | this review only | not stated | not extracted yet |
| Petruzzi 2022 Lingual Lichenoid Lesion Due to Dental Amalgam Fillings: Case Report and Clinical Considerations DOI:10.3390/app122412895 | 2022 | this review only | not stated | not extracted yet |
| Pezelj-Ribaric 2008 Association between oral lichenoid reactions and amalgam restorations. PMID:18393961 | 2008 | this review only | Clinical resolution of oral lichenoid lesions | not extracted yet |
| Ramnarayan 2014 Amalgam contact hypersensitivity lesion: an unusual presentation-report of a rare case. PMID:25364611 | 2014 | this review only | not stated | not extracted yet |
| Sarraf 2017 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Shalabh 2014 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Sunith 2006 Amalgam associated oral lichenoid reaction DOI:10.4103/0972-0707.42317 | 2006 | this review only | not stated | not extracted yet |
| Thanyavuthi 2016 Amalgam Contact Allergy in Oral Lichenoid Lesions. PMID:27323234 | 2016 | this review only | not stated | not extracted yet |
| Thornhill 2003 Amalgam-contact hypersensitivity lesions and oral lichen planus. PMID:12627099 | 2003 | this review only | not stated | not extracted yet |
| Tsushima 2022 Oral lichenoid contact lesions related to dental metal allergy may resolve after allergen removal. PMID:35784139 | 2022 | this review only | Clinical resolution of oral lichenoid lesions | not extracted yet |
| Wong 2003 Oral lichenoid lesions (OLL) and mercury in amalgam fillings. PMID:12694209 | 2003 | this review only | Clinical resolution of oral lichenoid lesions | not extracted yet |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Adults with clinically and/or histologically confirmed oral lichenoid lesions associated with dental amalgam restorations | Adults with amalgam-associated oral lichenoid lesions (n=365 in meta-analysis) |
| Intervention | Replacement of amalgam with composite resin, gold, ceramic, glass ionomer cement or a combination | Amalgam replacement with composite, gold, ceramic, GIC (n=11 studies) |
| Comparison | Retaining amalgam or replacing with alternative materials (no replacement) | No replacement or non-resolution comparator (n=11 studies) |
| Outcomes | Partial or complete clinical resolution of oral lichenoid lesions | Lesion resolution (n=11 studies) |
| Study designs | RCTs, non-randomized trials, prospective cohorts, comparative studies and case reports | Observational studies: 10 prospective non-randomized and 1 comparative (n=11); 35 in qualitative synthesis including 16 case reports |
| Timing | Not specified | Follow-up 2 months to 6 years |