Subcutaneous emphysema during fracture line inspection: case report

Article information

Restor Dent Endod. 2011;36(6):506-509

Publication date (electronic) : 2011 November 30

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

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

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 2011 June 30; Revised 2011 August 23; Accepted 2011 August 29.

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

Notes

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

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Article information Continued

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.