Cervicofacial emphysema and pneumomediastinum after a high-speed air drill endodontic treatment procedure

Durukan, Polat; Salt, Ömer; Özkan, Seda; Durukan, M. Banu; Kavalcı, Cemil

doi:10.1016/j.ajem.2012.01.006

Cited by 21 publications

(23 citation statements)

References 4 publications

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“…Third molar tooth extrac-tion in which the tooth was sectioned using an air-turbine drill was observed as the most frequent cause, which was also seen in our second case [8,11]. Occasionally, it may also arise during restorative treatment, root canal treatment, periodontic surgery, scaling, laser irradiation, and even flashing of the air syringe, as seen in case one [12].…”

Section: Discussionsupporting

confidence: 63%

Rare mediastinal complications of dental procedures

Kumbasar¹,

Peker²,

Demircin³

et al. 2019

Curr Thorac Surg

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Dental extraction is a frequently performed procedure in daily routine. Although this procedure is associated with a low complication rate, it has the potential to cause lethal complications such as head and neck emphysema, pneumomediastinum, pharyngeal abscess, septic thrombophlebitis of internal jugular vein, descending necrotizing mediastinitis, peribronchovascular inflammation of the lung parenchyma, and septicaemia. Conservative management is sufficient in majority of patients with emphysema and/or pneumomediastinum. However, treatment of pharyngeal abscess, mediastinitis and mediastinal abscess cannot be achieved with solely antibiotic administration and surgical drainage is necessary in most of the cases. In this report, we present three cases; two cases of pneumomediastinum and one case with severe deep neck inflammation, thrombophlebitis of jugular vein, mediastinitis and empyema occurred following molar tooth extraction by using air-tribune drills. Two cases without infectious complications were treated conservatively while the other patient was treated surgically. Complete resolution was achieved in all patients during follow-up.

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Section: Discussionsupporting

confidence: 63%

Rare mediastinal complications of dental procedures

Kumbasar¹,

Peker²,

Demircin³

et al. 2019

Curr Thorac Surg

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“…Air propagation was confined along the facial planes in the majority of the cases (37/65) and in two other cases it was limited to the neck planes. Both facial and neck planes were affected in 21 cases and in 11 of these cases the air was further distributed to the thoracic region, causing a pneumomediastinum in nine of them (Lloyd 1975, Nahlieli & Neder 1991, Farfel et al 2008, Imai et al 2009, Kim et al 2010, Sainsbury & Jaiganesh 2010, Durukan et al 2012. Pneumomediastinum or mediastinal emphysema is a more serious condition than SCE; it involves the introduction of air into the mediastinum, the central compartment of the thoracic cavity .…”

Section: Managementmentioning

confidence: 99%

Subcutaneous emphysema in patients undergoing root canal treatment: a systematic review of the factors affecting its development and management

2019

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Background Subcutaneous emphysema is an infrequent mishap during root canal treatment which, in rare cases, can lead to severe complications. Aim To systematically review the literature on the factors affecting the development of subcutaneous emphysema during root canal treatment, and on its management. Data sources An electronic search was conducted in EMBASE (1947–2018), LILACS (1982–2018), PubMed (1950–2018), SciELO (1997–2018), Scopus (1970–2018), Web of Science (1900–2018) and two grey literature databases. Moreover, all issues of nine journals and four endodontic textbooks were hand‐searched. Study eligibility criteria, participants, interventions The retrieved studies were screened by two reviewers to select clinical studies, case reports or case series describing subcutaneous emphysema that developed during or immediately after root canal treatment in adult patients. Study appraisal and synthesis methods Included studies were critically appraised according to a custom list of quality requirements. The extracted data were arranged in tables, and combined through a narrative synthesis. Results The search retrieved 99 unique articles. Thirty six case reports and 15 case series describing a total of 65 cases of subcutaneous emphysema were included in this review. The methodological quality was medium. Reported cases of emphysema more often involved females and maxillary teeth. Drying of the root canal system with air under pressure, inadvertent extrusion of hydrogen peroxide through the apical foramen, the air‐water spray produced by handpieces or laser devices, and the use of ozone gas were the most commonly suspected causes. Its management involved prescription of antibiotics and NSAIDs/analgesics, local application of ice packs or compresses and hospitalization. The signs and symptoms resolved completely within 1‐17 days. Limitations Case reports and case series are a low level of evidence. Conclusions and implications of key findings Subcutaneous emphysema can develop during both nonsurgical and surgical root canal treatment. Pressurized air streams or air‐water sprays should not be directed towards the root canals or areas with mucosal discontinuity. None of the management approaches were clearly related to expedited recovery. Guidelines should be developed in order to avoid unnecessary or potentially harmful interventions.

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“…(13) It is well known that 70 to 90% of spontaneous pneumomediastinum patients experience subsequent CSE, but conversely, pneumomediastinum following CSE is very rare, though it has been reported in relation to dental procedures, head and neck surgery, and facial trauma. (12,14) The spread of air into the retropharyngeal spaces can result in potential respiratory difficulties such as pneumothorax and pneu-momediastinum due to its anatomic location. Other complications following CSE include pneumopericardium, mediastinitis and life-threatening air embolism.…”

Section: Discussionmentioning

confidence: 99%

A Facial Subcutaneous Emphysema after Using a Fish Cake Skewer: Case Report

Park

Hyun

Kim

2015

Journal of Trauma and Injury

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Cervicofacial subcutaneous emphysema is a rare complication mainly resulting from dental procedures. The majority of cases are self-limiting and benign in clinical nature. However, although entry sites may be quite small and superficial, it can result in potential respiratory difficulties, such as pneumothorax and pneumomediastinum. We present the first case in which facial subcutaneous emphysema developed in a 6-year-old boy following use of a fish cake skewer while eating. [ J Trauma Inj 2015; 28: 206-210 ]

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Cervicofacial emphysema and pneumomediastinum after a high-speed air drill endodontic treatment procedure

Cited by 21 publications

References 4 publications

Rare mediastinal complications of dental procedures

Rare mediastinal complications of dental procedures

Subcutaneous emphysema in patients undergoing root canal treatment: a systematic review of the factors affecting its development and management

A Facial Subcutaneous Emphysema after Using a Fish Cake Skewer: Case Report

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