Dental and Medical Problems

Dent Med Probl
Index Copernicus (ICV 2020) – 128.41
MEiN – 70 pts
CiteScore (2021) – 2.0
JCI – 0.5
Average rejection rate (2021) – 81.35%
ISSN 1644-387X (print)
ISSN 2300-9020 (online)
Periodicity – quarterly

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Dental and Medical Problems

2019, vol. 56, nr 2, April-June, p. 203–207

doi: 10.17219/dmp/108615

Publication type: clinical case

Language: English

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Creative Commons BY-NC-ND 3.0 Open Access

Cervicofacial and mediastinal emphysema after dental extraction

Odma szyjno-twarzowa oraz śródpiersia po usunięciu zęba

Antonino Marco Cuccia1,A,D, Agostino Geraci2,E,F

1 Department of Dental Sciences “G. Messina”, Faculty of Surgery, Oncology and Stomatology, University of Palermo, Italy

2 Department of Emergency Medicine, Civic Hospital of Palermo, Italy

Abstract

Subcutaneous emphysema (SE) is a rare but potentially life-threatening complication in dental procedures. The development of SE and pneumomediastinum (P) during tooth extraction is an uncommon complication. The roots of the second and third lower molars (and, rarely, of the premolar and first molar) communicate directly with the sublingual and submandibular spaces. Occasionally, after a dental operation, the pressurized air from the drill is forcefully injected into the surrounding subcutaneous tissues proximal to the extraction site in the facial planes. The air might pass through the sublingual and submandibular spaces to the pterygomandibular, parapharyngeal and retropharyngeal spaces, and to the mediastinum. Molar extraction is a common procedure in dental surgery. We report a rare case of extensive cervicofacial SE as well as P, following mandibular second molar extraction with the use of a high-speed dental handpiece, which is specifically designed for restorative treatment. Careful observations of the symptoms and clinical course, and an early initiation of pharmacologic therapy are recommended.

Key words

pneumomediastinum, subcutaneous emphysema, dental extraction

Słowa kluczowe

odma śródpiersia, odma podskórna, usunięcie zęba

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