Subcutaneous emphysema during fracture line inspection: case report

Min-Young Kim; Sung-Ho Park; Yoo-Seok Shin; Euiseong Kim

doi:10.5395/JKACD.2011.36.6.506

Journal List > J Korean Acad Conserv Dent > v.36(6) > 1056495

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Kim, Park, Shin, and Kim: Subcutaneous emphysema during fracture line inspection: case report

Case Report

Journal of Korean Academy of Conservative Dentistry

Journal of Korean Academy of Conservative Dentistry 2011; 36(6): 506-509.

Published online: 30 November 2011

DOI: https://doi.org/10.5395/JKACD.2011.36.6.506

Subcutaneous emphysema during fracture line inspection: case report

Min-Young Kim, DDS, Sung-Ho Park, DDS, MSD, PhD, Yoo-Seok Shin, DDS, MSD, Euiseong Kim, DDS, MSD, PhD

Graduate student

Professor

Clinical assistant professor

Professor

Department of Conservative Dentistry, Microscope Center, Yonsei University College of Dentistry, Seoul, Korea.

Correspondence to Euiseong Kim, DDS, MSD, PhD. Professor, Department of Conservative Dentistry, Microscope Center, Yonsei University College of Dentistry, 50 Yonsei-ro, Seodaemun-gu, Seoul, Korea 120-752. TEL, +82-2-2228-8700; FAX, +82-2-313-7575; andyendo@yuhs.ac

Received 30 June 2011 Revised 23 August 2011 Accepted 29 August 2011

Abstract

The development of subcutaneous emphysema is a well-known complication that has been reported after dental extraction, endodontic treatment, or restorative preparation. Gaseous invasion, leading to swelling, crepitus on palpation, is commonly restricted to the connective tisssues immediately adjacent to the entry site. However, the use of compressed air- and water-cooled turbines may allow large amounts of air and water to be driven through the fascial planes into the mediastinum, pleural space, or even the retroperitoneum.

This case report is about the patient who presented with subcutaneous emphysema that occurred after fracture line inspection. Possible cause, treatment, and prevention of emphysema will be discussed.

Keywords: Dental treatment, Subcutaneous emphysema

Figures and Tables

Figure 1

Preoperative clinical photograph and radiograph

: Buccal surface of mesial root is exposed due to severe gingival recession. Periapical radiograph revealed periapical radiolucency around mesial root of #36.

Figure 2

Extraoral and intraoral photographs after onset of subcutaneous emphysema

: Sudden onset of swelling on left infraorbital, buccal, vestibular area.

Figure 3

Methylene blue staining procedure.

Figure 4

Schematic of the pathogenesis of subcutaneous emphysema.

Notes

Conflict of Interest: No potential conflict of interest relevant to this article was reported.

References

1. Gamboa Vidal CA, Vega Pizarro CA, Almeida Arriagada A. Subcutaneous emphysema secondary to dental treatment: case report. Med Oral Patol Oral Cir Bucal. 2007. 12:E76–E78.

2. Smatt Y, Browaeys H, Genay A, Raoul G, Ferri J. Iatrogenic pneumomediastinum and facial emphysema after endodontic treatment. Br J Oral Maxillofac Surg. 2004. 42:160–162.

3. Zemann W, Feichtinger M, Kaärcher H. Cervicofacial and mediastinal emphysema after crown preparation: a rare complication. Int J Prosthodont. 2007. 20:143–144.

4. Heyman SN, Babayof I. Emphysematous complications in dentistry, 1960-1993: an illustrative case and review of the literature. Quintessence Int. 1995. 26:535–543.

5. McKenzie WS, Rosenberg M. Iatrogenic subcutaneous emphysema of dental and surgical origin: a literature review. J Oral Maxillofac Surg. 2009. 67:1265–1268.

6. Szubin L, La Bruna A, Levine J, Komisar A. Subcutaneous and retropharyngeal emphysema after dental procedures. Otolaryngol Head Neck Surg. 1997. 117:122–123.

7. Arai I, Aoki T, Yamazaki H, Ota Y, Kaneko A. Pneumomediastinum and subcutaneous emphysema after dental extraction detected incidentally by regular medical checkup: a case report. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009. 107:e33–e38.

8. Reiche-Fischel O, Helfrick JF. Intraoperative lifethreatening emphysema associated with endotracheal intubation and air insufflation devices: report of two cases. J Oral Maxillofac Surg. 1995. 53:1103–1107.

9. Horowitz I, Hirshberg A, Freedman A. Pneumomediastinum and subcutaneous emphysema following surgical extraction of mandibular third molars: three case reports. Oral Surg Oral Med Oral Pathol. 1987. 63:25–28.

10. Aragon SB, Dolwick MF, Buckley S. Pneumomediastinum and subcutaneous cervical emphysema during third molar extraction under general anesthesia. J Oral Maxillofac Surg. 1986. 44:141–144.

11. Gulati A, Baldwin A, Intosh IM, Krishnan A. Pneumomediastinum, bilateral pneumothorax, pleural effusion, and surgical emphysema after routine apicectomy caused by vomiting. Br J Oral Maxillofac Surg. 2008. 46:136–137.

TOOLS

Similar articles