AMALGAM TATTOO: A LITERATURE REVIEW ON CLINICAL ASPECTS, DIAGNOSIS, AND MANAGEMENT

Abstract

Introduction: Amalgam tattoo is a pigmented lesion of exogenous etiology, characterized by the deposition of metallic particles in the oral mucosa, usually associated with restorative procedures using amalgam. Although clinically harmless, it may lead to diagnostic confusion with pigmented lesions of melanocytic origin or malignant potential. Objective: To conduct a literature review on amalgam tattoo, highlighting its clinical aspects, differential diagnoses, implications for dental practice, and recommended management. Methods: A search was performed in the PubMed, SciELO, and Virtual Health Library (LILACS, MEDLINE) databases, using the descriptors: “Amalgam Tattoo,” “Pigmented Lesions,” “Oral Lesions,” and “Diagnosis,” focusing on articles published between 2020 and 2025. After applying the inclusion and exclusion criteria, 12 articles were selected for analysis. Results: Studies indicate that the amalgam tattoo is the most common exogenous pigmentation in the oral cavity, with a preference for the gingiva and buccal mucosa. Diagnosis is predominantly clinical, supported by periapical radiography and, in doubtful cases, biopsy. Removal is recommended only for aesthetic reasons or diagnostic uncertainty. Discussion: The main discrepancies are related to the need for complementary exams. Advances such as hyperspectral imaging have shown promise in differentiating pigmented lesions. Conclusion: Knowledge about the amalgam tattoo is essential to avoid unnecessary procedures, enabling safe diagnoses and appropriate management in dental practice.