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.