Oral and maxillofacial pathologyOnline only articleSilver solder “tattoo,” a novel form of oral pigmentation identified with the use of field emission scanning electron microscopy and electron dispersive spectrography

ObjectiveThe aim of this study was to investigate the use of field emission scanning electron microscopy and electron dispersive spectrography (SEM-EDS) to identify silver solder “tattoo.”Study designSEM-EDS was used to analyze material present in the connective tissue of a patient who presented with bilateral pigmentation of the mandibular lingual gingiva adjacent to the first molars. No dental restorations were present.ResultsSEM-EDS analysis identified silver, with no evidence of tin, copper, or mercury. The patient was wearing an orthodontic appliance where brackets had been soldered to the archwire with silver solder. It is hypothesed that the solder underwent electrolytic corrosion with subsequent regrouping of silver ions in the submucosa leading to blue-gray discoloration.ConclusionSpectrography proved to be a powerful diagnostic tool in identifying the metal within the oral mucosa. Attention is drawn to this newly described lesion, which should be included as a differential diagnosis for pigmented oral mucosal lesions.