Treatments of unesthetic amalgam tattoo: A literature review and a case report.

Background: An amalgam tattoo is an iatrogenic lesion that can lead to esthetic concerns. This paper presents a literature review aimed at exploring treatment options available to clinicians for addressing this unesthetic issue.

Methods: The initial search identified 209 potentially relevant publications. After applying specific inclusion and exclusion criteria, 18 papers were analyzed and summarized in a comprehensive table, highlighting significant aspects for comparison.

Results: The findings indicate various treatment options reported in the existing literature. Additionally, this paper includes a case report detailing the procedure performed on a 47-year-old female with an amalgam tattoo on the buccal aspect of her upper right premolars. Following muco-abrasion to remove the oral pigmented lesion, a bilaminar mucogingival procedure was performed.

Conclusions: At the 8-year follow-up, the gingival color and texture blended well with the surrounding soft tissues, the periodontal structures appeared healthy, and the patient was satisfied with the esthetic outcomes.

Key points: Discoloration of the oral mucosa caused by amalgam can result in esthetic dissatisfaction for patients. A review of the literature indicates that the bilaminar technique is a more reliable surgical approach for achieving cosmetic results in a single operation. An 8-year follow-up case report supports this finding, detailing a procedure that involved muco-abrasion of the lesion followed by a sliding pedicle flap.

Plain language summary: An amalgam tattoo is an iatrogenic lesion associated with esthetic concerns. This paper reviews treatment options for this issue, analyzing 18 relevant publications from an initial search of 209. Additionally, a case report details the treatment of a 47-year-old female patient with an amalgam tattoo on her upper right premolars. After muco-abrasion to remove the lesion, a plastic surgery procedure with a connective tissue graft from the palate was performed. At the 8-year follow-up, the gingival color and texture matched the surrounding tissues, the periodontal structures appeared healthy, and the patient was satisfied with the results.