Subcutaneuous emphysema as a complication of tooth extraction: Case Report

Abstract

Subcutaneous emphysema is an uncommon complication of dental procedures. This complication arises when air forced beneath the tissue. In dentistry it may appear with the use of high-speed bur and could cause a serious complication including airway obstruction. This case report highlights a complication during dental procedure to give information for the clinician the factors, diagnosis, and management of subcutaneous emphysema.A 33 years old male patient with difficulty in breathing and swelling at right lower jaw, neck and chest region. The swelling occurred about 2 hours before admission during tooth extraction of second right lower molar using a high-speed bur about 30 minutes, then he started to feel difficulty in breathing with swelling at right lower jaw, neck and chest region occurred and pain. Then he was transferred to Hasan Sadikin Emergency Department for further treatment. The patient was diagnosed with subcutaneous emphysema at right lower jaw, neck and chest region due to suspect iatrogenic. The management of this patient was conservative treatment with oxygenation 3 lpm, close observation vital sign and wide emphysema, IVFD ringer lactate 1500 cc/ 24 hours, medication with Ceftriaxone 1 gr, Ketorolac 30 mg, Omeprazole 20 mg intravenous and being hospitalized for 4 days. After general condition stable he was performed tooth extraction.Iatrogenic subcutaneous emphysema could be a serious and potentially life-threatening, so dentist has to be more careful while using high-speed bur for tooth extraction.