Amalgam tattoos: Light and electron microscopy and electron-probe micro-analysis

A common tattoo occurring in the mouth is caused by the insertion of amalgam filling material into the soft tissues. Fifteen amalgam tattoos were examined. Amalgam or its derivatives were found within macrophages, fibroblasts and multinuclear giant cells. Fine particles were found associated with: the basement-membranes of mucosal epithelium, of striped muscle fibres, and of muscle cells of blood vessels; collagen; elastic tissue; and the connective tissue of nerves. Amalgam consists mainly of mercury, silver and tin. The analytical results suggest that corrosion occurs and that mercury and some tin are lost from the tattoos, leaving silver and tin in macrophages and giant cells, and silver in fibroblasts and in the above-mentioned extracellular sites.