Dental amalgam controversy an increasing number of studies with larger sample sizes are being conducted. Those who are not opposed to amalgam claim that, aside from rare and localized tissue irritation, recent evidence-based research has continued to demonstrate no ill effects from the minute amounts of mercury exposure from amalgam fillings. A 2004 systematic review conducted by the Life Sciences Research Office, whose clients include the FDA and NIH, concluded that, "the current data are insufficient to support an association between mercury release from dental amalgam and the various complaints that have been attributed to this restoration material." A systematic review in 2009
Amalgam tattoo from pencil leads), and is sometimes termed a "graphite tattoo", although this is less common than tattooing with amalgam. The diagnosis is clinical. Amalgam tattoo can be distinguished from other causes of localized oral pigmentation because it does not change significantly in size or color, although it may appear to slowly enlarge for several months after the initial implantation of the metal particles. Some amalgam tattoos appear radio-opaque on radiographs (i.e. they show up on x-rays), although in many cases amalgam tattoos have no radiographic features since the responsible particle(s) of amalgam are very small even though clinically the area