Assessment of the Association between Oral Lichenoid Reactions and Amalgam Restorations and to determine the Salivary Concentrations of Interleukin-6 (IL-6) and IL-8 before and after Replacement of the Amalgam Restorations
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Keywords
Lichenoid reaction, amalgam, IL-6, IL-8
Abstract
Background: The oral mucosa is affected by chronic autoimmune lesions known as lichen planus of the oral cavity (OLP) and lichenoid reactions of the oral cavity (OLR). OLP resembles OLR in terms of histology and clinical features, however, it is a possibly premalignant condition that affects 2% of people. Some experts believe that an allergic reaction on contact with amalgam restoration or the other
above-mentioned elements is what causes OLP, whilst others assert that OLP and OLR are two distinct disorders.
Aim: This study sought to determine the efficacy of amalgam restoration, which is thought to be the etiology of OLR, and to measure IL-6 concentration and IL-8 concentrations in saliva prior to and following the replacement of amalgam restoration.
Methods and materials: In this study, amalgam restorations were changed in 40 patients by composite restoration, gold restoration, porcelain restoration, or assembly of these materials. These individuals were assessed in the hospital following a follow-up time of between two months and three and a half years. The severity of OLR and extent of OLR were rated as 1 when there was complete healing of all lesions and there was no presence of lesions. The severity of OLR and extent of OLR were rated as 2 when significant improvement (above 80%) was noticed and it was rated as 3 when there was no change in symptoms. ELISA was carried out in accordance with the package recommendations to measure the concentrations of IL-6 and the concentration of IL- 8 in saliva. The outcomes were reported in pg/mL. The experiment was run twice and then three times. In pg/mL, protein concentration was expressed
Results: On amalgam removal, there was complete healing of lesions in 32 study participants, while there was more than 80% healing of lesions in 6 study participants. On the other hand, there was no improvement observed and no deterioration of symptoms in the 2 patients. Statistics revealed that there is a significant reduction in the number of lesions on the removal of amalgam restoration giving
support to the association between amalgam restoration and oral lichenoid reactions. (p˂0.05). . Before the fillings were replaced, IL-6 levels were found to be substantially higher than afterward (P˂ 0.05). The levels of IL-8 that were found prior to replacement were similarly considerably higher than the levels that followed (P<0.05). In control subjects, the levels of IL-6 tested before and after the
intervention did not differ substantially (P ˃0.05). The same holds true for the IL-8 readings (P˂0.05).
Conclusion: Clinical observations showed that tissue recovery from oral lichenoid reaction followed the restorative replacement of amalgam restorations. When amalgam restorations were changed for restorations made of other dental restorations, concentrations of both IL-6 cytokines and IL-8 cytokines in healthy participants returned to normal.
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