Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Clinical
  • Published:

Extensive subcutaneous emphysema secondary to endodontic treatment

Abstract

Subcutaneous emphysema is a relatively rare phenomenon, in the context of dentistry related to iatrogenic injury, with only 32 cases reported between 1993 and 2008. This article aims to discuss the relevance and importance of this issue to dentists, including how to identify the condition and its management.

Key points

  • We present a case of subcutaneous emphysema secondary to endodontic treatment presenting to an oral and maxillofacial surgery department.

  • Subcutaneous emphysema more commonly occurs following the use of conventional high-speed handpieces during surgical dentistry.

  • Active prevention of subcutaneous emphysema during dental treatment is important as it may lead to serious complications, such as airway compromise and life-threateninga sepsis.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. McKenzie W S, Rosenberg M. Iatrogenic Subcutaneous Emphysema of Dental and Surgical Origin: A Literature Review. J Oral Maxillofac Surg 2009; 67: 1265-1268.

  2. Rojas M A G, Rojas P E G, Toro C G Z et al. Subcutaneous emphysema after ultrasonic treatment: a case report. Int J Odontostomat 2009; 3: 66-70.

  3. Mather A, Stoykewych A A, Curran J B. Cervicofacial and mediastinal emphysema complicating a dental procedure. J Can Dent Assoc 2006; 72: 565-568.

  4. Snyder M B, Rosenberg E S. Subcutaneous emphysema during periodontal surgery: report of a case. J Periodontol 1977; 48: 790-791.

  5. Smatt Y, Browaeys H, Genay A, Raoul G, Ferri J. Iatrogenic pneumomediastinum and facial emphysema after endodontic treatment. Br J Oral Maxillofac Surg 2004; 42: 160-162.

  6. Olate S, Assis A, Freire S, de Moraes M, de Albergaria-Barbosa J R. Facial and cervical emphysema after oral surgery: a rare case. Int J Clin Exp Med 2013; 6: 840-844.

  7. Rubinstein A, Riddell C E, Akram I, Ahmado A, Benjamin L. Orbital emphysema leading to blindness following routine functional endoscopic sinus surgery. Arch Ophthalmol 2005; 123: 1452.

  8. Smatt Y, Browaeys H, Genay A, Raoul G, Ferri J. Iatrogenic pneumomediastinum and facial emphysema after endodontic treatment. Br J Oral Maxillofac Surg 2004; 42: 160-162.

  9. Pynn B R, Amato D, Walker D A. Subcutaneous emphysema following dental treatment: a report of two cases and review of the literature. J Can Dent Assoc 1992; 58: 496-499.

  10. Mather A J, Stoykewych A A, Curran J B. Cervicofacial and mediastinal emphysema complicating a dental procedure. J Can Dent Assoc 2006; 72: 565-568.

  11. Jeong C-H, Yoon S, Chung S-W et al. Subcutaneous emphysema related to dental procedures. J Korean Assoc Oral Maxillofac Surg 2018; 44: 212-219.

  12. Gulati A, Baldwin A, McIntosh I, Krishnan A. Pneumomediastinum, bilateral pneumothorax, pleural effusion, and surgical emphysema after routine apicectomy caused by vomiting. Br J Oral Maxillofac Surg 2008; 46: 136-137.

  13. Reiche-Fischel O, Helfrick J. Intraoperative life-threatening emphysema associated with endotracheal intubation and air insufflation devices. J Oral Maxillofac Surg 1995; 53: 1103-1107.

  14. Maloney W J. Subcutaneous Air Emphysema in Dentistry. Biomed J Sci Tech Res 2018.

  15. Keiichi O, Hitoshi Y, Takashi R et al. Investigation of the Electric Handpiece-related Pneumomediastinum and Cervicofacial Subcutaneous Emphysema in Third Molar Surgery. J Hard Tissue Biol 2019; 28: 79-86.

  16. Wong P, Palacios S, Kashtari D. Managing Subcutaneous Emphysema Following Dental Procedures. 2017. Available at https://decisionsindentistry.com/article/managing-subcutaneous-emphysema-following-dental-procedures/ (accessed December 2022).

  17. Nishimura T, Sawai T, Kadoi K et al. Iatrogenic subcutaneous emphysema and pneumomediastinum following a High-speed air drill dental treatment procedure. Acute Med Surg 2015; 2: 253-256.

  18. Kurtzman G M. Electric Handpieces: An Overview of Current Technology. 2007. Available at https://www.aegisdentalnetwork.com/id/2007/02/focus-on-electric-handpieces-an-overview-of-current-technology (accessed December 2022).

Download references

Author information

Authors and Affiliations

Authors

Contributions

Nirmal Shah, Bobby Sharma, Nicola Campbell and Ahad Shafi discussed the case and contributed towards the preparation of the final manuscript.

Corresponding author

Correspondence to Nirmal Shah.

Ethics declarations

The authors declare no conflict of interests.

Written consent to publish was obtained from the patient to publish data included within the case report.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Shah, N., Sharma, B., Campbell, N. et al. Extensive subcutaneous emphysema secondary to endodontic treatment. Br Dent J 234, 88–91 (2023). https://doi.org/10.1038/s41415-022-5407-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41415-022-5407-z

Search

Quick links