A. Ronchi

C. Guastella

G. Guzzi

L. Brambilla

M. Scarpelli

P.D.M. Pigatto

S. Ferrucci

AIR Universita degli studi di Milano

Page 83
Notes:
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Volume 8Journal of Clinical Toxicology
ISSN: 2161-0495
Euro Toxicology 2018
July 02-04, 2018 
July 02-04, 2018 | Berlin, Germany
15th Euro Global Summit on 
Toxicology and Applied Pharmacology
Mercury in BMS, OLP and trigeminal neuralgia
Gianpaolo Guzzi1, Anna Ronchi2, Claudio Guastella3, Lucia Brambilla3, Silvia Ferrucci3, Marco Scarpelli4 and Paolo D Pigatto5
1Italian Association for Metals and Biocompatibility Research – A.I.R.M.E.B., Milan, Italy.
2Pavia Poison Control Center and National Toxicology Information Centre, Toxicology Unit, IRCCS Maugeri Found. and University of Pavia, Italy.
3Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Italy
4Private Practice, Forensic Odontologist, Milan, Italy.
5IRCCS Galeazzi Hospital, University of Milan, Milan, Italy.
Oral neuropathy and oral precancerous lesions may be caused by exposure to mercury. We evaluated a cohort of 227 patients with burning mouth syndrome (BMS) associated with adverse reactions to dental metals. Mean (±SD) age was 57.1±12, 
199 were female (87.7%). In 57 patients, mean (±SD) concentrations of mercury in whole-blood was 7.9±8.4 micrograms Hg 
per liter, toxic limit: 2 micrograms Hg per liter. In 88 patients, mean (±SD) concentrations in salivary mercury was 24±45.7 
micrograms Hg per liter, toxic limit: 2.7 micrograms Hg per liter. Patch testing was performed in 167 patients, 33.5% had 
nickel allergy; 11.4% had cobalt allergy; 9.6% had chromium allergy; 14.4% had allergy to gold; 14.4% had palladium allergy; 
10.8% had mercurials allergy (in aggregate). As oral pathology, the most common adverse events associated to dental metals 
were: sialadenitis (3 patients, 1.3%); metallic taste/dysgeusia (3 patients, 1.3%); leukokeratosis (9 patients, 4%); oral lichen 
planus (OLP) (8 patients, 3.5%); oral allergic syndrome (37 patients, 16,3%). As systemic disease: fibromyalgia (15 patients, 
6.6%); hypothyroidism (11 patients, 4.8%) headache (22 patients, 9.7%); urticaria (20 patients, 8.8%); dizziness (20 patients, 
8.8%); multiple chemical sensitivity – MCS (29 patients, 12.8%); atypical facial pain (18 patients, 7.9%); trigeminal neuralgia (7 
patients, 3.1%) can develop years before and/or years after diagnosis of BMS/OLP. Acute and/or chronic exposure to mercury-
containing dental amalgam may inevitably trigger a small fiber neuropathy of the oral cavity. Burning mouth syndrome (BMS) 
may be also associated with concurrent diseases, such as oral lichen planus and/or trigeminal neuralgia. 
Recent Publications:
1. Costa A, V Branca, P D Pigatto and G Guzzi (2007) BMD, fMRI study and brain hypoactivity. Pain. 128:290-291.
2. Guzzi G (2006) Case 21-2006: a man with left-sided facial pain. N. Engl. J. Med. 355:2375-2376.
3. Pigatto P D, G Guzzi, P Persichini and S Barbadillo (2004) Recovery from mercury-induced burning mouth syndrome 
due to mercury allergy. Dermatitis. 15(2):75-77.
4. Pigatto P D et al. (2014) Trace elements in saliva and burning mouth syndrome. Contact Dermatitis 70:110.
5. Lamey P J et al. (1994) Type 3 burning mouth syndrome: psychological and allergic aspects. J. Oral. Pathol. Med. 
23(5):216-219.
Biography
Gianpaolo Guzzi is the President - Founder and Clinical Research Coordinator of the Italian Association for Metals and Biocompatibility Research – A.I.R.M.E.B., 
a Milan-based not-for-profit organization. His field of expertise is toxicology of mercury. 
gianpaolo_guzzi@fastwebnet.it
Gianpaolo Guzzi et al., J Clinic Toxicol, 2018, Volume 8
DOI: 10.4172/2161-0495-C1-028


Mercury in BMS, OLP, and trigeminal neuralgia

https://air.unimi.it/retrieve/handle/2434/606291/1117871/Mercury%20in%20BMS%2c%20OLP%20and%20trigeminal%20neuralgia.pdf

Mercury in BMS, OLP, and trigeminal neuralgia

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