Rare mediastinal complications of dental procedures

Abstract

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.