Emphysematous Complications Following Third Molars Removal: Incidence among 10779 Surgeries and Report of Two Cases

作     者：Leandro E. Klüppel Fernando Antonini Alessandro Costa da Silva Márcio de Moraes Saulo Ellery Santos 

作者机构：Oral and Maxillofacial Surgery Department School of Dentistry Universidade Estadual de Campinas Piracicaba Brazil 

出 版 物：《Open Journal of Stomatology》 (口腔学期刊（英文）)

年 卷 期：2014年第4卷第7期

页      面：352-357页

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Subcutaneous Emphysema Impacted Tooth Air Hand-Piece 

摘      要：Subcutaneous emphysema is a condition that results from introduction of air into soft tissues. In head and neck, it is commonly observed following fractures of paranasal sinuses. Less frequently, it may occur during surgical procedures for tooth removal, when air from dental hand-pieces is forced into surgical site. Depending on its extension, it may involve vital spaces such as mediastinum. This specific finding may induce life-threatening situations. The aim of this article is to establish the incidence of subcutaneous emphysema among 10,779 impacted third molar surgical procedures and report the cases in which such complications had occurred. In this retrospective study, data collected from 10,779 third molar extraction procedures performed at Piracicaba School of Dentistry were evaluated for the occurrence of subcutaneous emphysema. Two cases of subcutaneous emphysema (0.018%) occurred following extraction of impacted third molars. Both were associated with mandibular tooth and related to the use of dental air hand-piece. One of the cases involved submandibular and buccal spaces while the other involved buccal and canine spaces. Regression of emphysema occurred spontaneously and postoperative recovery was uneventful. Subcutaneous emphysema following impacted third molar extractions is rare and strongly associated with the use of air turbines. Follow-up and preservation are the treatments of choice, but clinicians should be aware about the possibility of microbial spreading through facial spaces.