J Korean Acad Conserv Dent.  2011 Nov;36(6):506-509. 10.5395/JKACD.2011.36.6.506.

Subcutaneous emphysema during fracture line inspection: case report

• Kim MY
• Park SH
• Shin YS
• Kim E

• KMID: 2176606
• DOI: http://doi.org/10.5395/JKACD.2011.36.6.506

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.

Keyword

Dental treatment; Subcutaneous emphysema

MeSH Terms

Emphysema
Humans
Mediastinum
Palpation
Subcutaneous Emphysema
Water
Water

Figure

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  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.

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  Figure 2 Extraoral and intraoral photographs after onset of subcutaneous emphysema : Sudden onset of swelling on left infraorbital, buccal, vestibular area.

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  Figure 3 Methylene blue staining procedure.

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  Figure 4 Schematic of the pathogenesis of subcutaneous emphysema.

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