Management of Air Emphysema with Cyanosis Following Dental Treatment - A Case Report with Scientific Reasoning

Abstract

Air emphysema as a consequence of dental procedures is a rare but dangerous state if not diagnosed and treated timely. It can occur incidentally or iatrogenically in many dental procedures such as restorations, endodontic and periodontal treatments, surgical and non-surgical tooth extraction, and use of air or water sprays and syringes.1-6 Subcutaneous emphysema of dental origin most commonly occurs after surgical extraction of an impacted mandibular third molar.7 Several studies have reported that the use of high speed hand-piece during surgical extraction led to escape of air into the subcutaneous tissues. 7-10 Wilson (1983) reported subcutaneous emphysema in the eyelids after extraction of the maxillary molar teeth due to vigorous irrigation combined with air and water spray for 10 seconds.6 Subcutaneous emphysema in the cheek after extraction of the maxillary third molar without using high speed hand-piece is not a common phenomenon. In the present case, we demonstrate air emphysema in the cheek associated with hematoma after extraction of the impacted right maxillary 3rd molar. Since it was a soft tissue impaction, no hand-piece was used during the tooth removal. The purpose of this case report is to create awareness among the dental surgeons about the simple extraction procedures that may lead to air emphysema associated with hematoma.