Oral lichen planus and dental materials: a case-control study

The purpose of this study was to examine the association of dental materials with oral lichen planus (OLP) and, particularly, the effects of amalgam, amalgam corrosion status, gold and dissimilar metals in continuous contact. A case-control study was performed with 43 OLP cases from the Oral Medicine Clinic at the School of Dentistry, University of Washington and 78 controls from a general dental care-screening clinic, also at the School of Dentistry, University of Washington. Health histories and oral examinations were obtained. Current metal or metal-based restorations were charted, along with corrosion status of amalgams and the presence of dissimilar metals in continuous contact. Adjusted odds ratios (ORs) and 95% confidence intervals for the following potential risk factors were found to be: (1) number of teeth with amalgam, OR = 1.02 (0.92, 1.13); (2) total surfaces of amalgam, OR = 0.96 (0.92, 1.0); (3) number of teeth with gold, OR = 1.12 (0.95, 1.31); (4) mean amalgam corrosion score, OR = 5.74 (2.34, 14.1); (5) presence of dissimilar metals in contact (per quadrant), OR = 1.25 (0.81, 1.92). These findings suggest that although the presence of amalgam or gold themselves is not associated with increased risk of OLP, corrosion of amalgams and the presence of a 'galvanic effect' from dissimilar dental materials in continuous contact (bimetallism) are associated with an increased risk of OLP.