A 38-year-old woman sought dental care for the treatment of # 37 tooth decay (second left mandibular molar).
At that time he had no remarkable medical or dental history, was not taking any type of drug and had no other restoration in his mouth.
After intraoral review and analysis of periapical radiograph of the tooth in question, the tissue affected by caries was removed, performing a cavity preparation Black class I filled with amalgam.
There were no postoperative problems.
After 19 months, the patient returned to the dental office because she suspected the presence of caries in other teeth.
When performing the intraoral examination, an atrophic, slightly erythematous area was observed in the left jugular mucosa, precisely in the region of the mucosa that contacted the restored molar with amalgam.
The right jugular mucosa was normal.
Interrupted about the injury, the patient informs us that she had not noticed it, although she had recently felt some rare feeling in this area when eating spicy foods.
It also informs us that he has not received any treatment since the previous visit, in which he underwent amalgam restoration.
Asked about allergic history, do not have a history of allergic reactions.
A thorough examination of the injured area shows that the lesion is projected onto amalgamation restoration appreciates, coming into intimate contact with it during some oral movements, being necessary in fact to separate the mucosa with the lesion
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To histologically confirm the nature of the lesion, a biopsy is taken.
The pathological study of the biopsy of the lesion showed a squamous epithelium with irregular acanthosis and foci of parakeratosis, with marked spongiosis and presence of exocytosis of lymphocyte stratum corneum.
The underlying stroma showed a chronic lymphocytic inflammatory infiltrate discreetly distributed in band, with involvement of the basal stratum.
In-depth fibroconnective and adipose tissue with some vascular wall structure was observed, without relevant changes.
The anatomopathological diagnosis was compatible with oral liquen planus, and the histological picture observed in the mucosa was equivalent in the skin to acute-subacute dermatitis.
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Once the patient was informed of the injury he had and the possibility of it disappearing, eliminating the amalgam because he considered it important to submit a new treatment, and decided not to change the restoration.
Restorations of other teeth were performed with composite resin, without any reaction at the mucosal level.
