Amalgam used for dental restoration may become embedded into the oral mucosa, resulting in a dark discoloration.
Mechanism: traumatic placement of the amalgam metal into soft tissue
(1) gingiva (adjacent to restored tooth)
(2) alveolar mucosa
(3) buccal mucosa (opposite a restored tooth)
(4) floor of the mouth
Gross appearance: flat macule that is dark gray or blue
(1) coarse, irregular, dense fragments or fine, discrete granules
(2) chronic inflammation, sometimes with foreign body giant cells
(3) varying degrees of fibrosis
The larger fragments can be visualized on an X-ray of the mouth, while the finer granules may be too small to be seen.
(1) malignant melanoma
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