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
Usual locations:
(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
Microscopic appearance:
(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.
Differential diagnosis:
(1) malignant melanoma
To read more or access our algorithms and calculators, please log in or register.
Specialty: Otolaryngology
