Subcutaneous emphysema during third molar surgery: a case report

Abstract

extraction of third molars is the most common surgical procedure performed in oral surgery on a daily basis and, despite surgical skills and expertise, complications may occur. Complications observed during or after third molar removal may include pain, swelling, bleeding, infection, sinus perforation and nerve damage. Fortunately, with a proper management and a good surgical technique, the incidence of such events is low. Subcutaneous emphysema associated with dental extraction occurs when the air from the high-speed dental handpiece is forced into the soft tissue through the reflected flap and invades the adjacent tissues, leading to swelling, crepitus on palpation and occasionally spreading through the tissue spaces of the fascial planes. Although rare, iatrogenic subcutaneous emphysema can have serious and potentially life-threatening consequences. Care should be taken when using air-driven handpieces. The access of air into the facial tissues is not limited to tooth extractions, but may also occur through other portals of entrance, such as endodontically treated teeth, periodontium and lacerations of intraoral soft tissues. When subcutaneous emphysema occurs, it must be quickly diagnosed and properly managed to reduce the risk of further complications. This report presents a case of subcutaneous emphysema occurred during extraction of a mandibular third molar extraction with the use of an air turbine handpiece. Case management is described and issues relative to the diagnosis and prevention of this surgical complication are discussed.key Words: subcutaneous emphysema, third molar extraction, high pressure air instruments.

Subcutaneous Emphysema During Root Canal Therapy: A Case Report

“…Emphysema also has been reported during oral laser surgery. Air can be introduced unto the soft tissue spaces by several routes, but it usually passes through the dentoalveolar membrane or a root canal (9). In accordance with recent studies, the efficacy of the sodium hypochlorite solutions depends on its concentration.…”

Pneumatic dental extractions: an unusual cause of extensive cervical surgical emphysema

“…The process of forcing air below a reflected gingival flap allows the pressurised gas to shear through fascial planes establishing a field of loculated and trapped air within the tissues 10. On clinical examination, the findings of palpable crepitus can be elicited.…”

Proposta de um instrumento para avaliar eventos adversos em odontologia

“…This access is not limited to tooth extractions, and the air can also be introduced through root canals during endodontic treatment, through the periodontal ligament or lacerations of the intraoral soft tissues 27 .…”