Bai YP, Sha JJ, Chai CC, Sun HP. With two episodes of right retromandibular angle subcutaneous emphysema during right upper molar crown preparation: A case report. World J Clin Cases 2023; 11(19): 4698-4706 [PMID: 37469734 DOI: 10.12998/wjcc.v11.i19.4698]
Corresponding Author of This Article
Hai-Peng Sun, PhD, Professor, Department of Prosthodontics and Implantology, Shenzhen University Affiliated Shenzhen Stomatology Hospital, Guiyuan North Street 70th, Luohu, Shenzhen 518001, Guangdong Province, China. shplysz@126.com
Research Domain of This Article
Dentistry, Oral Surgery & Medicine
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Jul 6, 2023; 11(19): 4698-4706 Published online Jul 6, 2023. doi: 10.12998/wjcc.v11.i19.4698
With two episodes of right retromandibular angle subcutaneous emphysema during right upper molar crown preparation: A case report
Yun-Peng Bai, Jing-Jing Sha, Chang-Chang Chai, Hai-Peng Sun
Yun-Peng Bai, Chang-Chang Chai, Hai-Peng Sun, Department of Prosthodontics and Implantology, Shenzhen University Affiliated Shenzhen Stomatology Hospital, Shenzhen 518001, Guangdong Province, China
Jing-Jing Sha, Department of Endodontics, Shenzhen University Affiliated Shenzhen Stomatology Hospital, Shenzhen 518001, Guangdong Province, China
Author contributions: Bai YP and Sun HP contributed to the conceptualization and visualization of the manuscript; Bai YP, Sha JJ, and Sun HP involved in the funding acquisition, original draft writing; Bai YP investigated; Bai YP, Sha JJ, and Chai CC contributed to the methodology of the manuscript; Bai YP and Sha JJ contributed to the supervision, writing-review and editing of this manuscript; and all authors have read and agreed to the published version of the manuscript.
Supported byShenzhen Science and Technology Program, No. JCYJ20220530165409022.
Informed consent statement: Informed consent was obtained from all subjects involved in the study. Written informed consent has been obtained from the patient(s) to publish this paper.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hai-Peng Sun, PhD, Professor, Department of Prosthodontics and Implantology, Shenzhen University Affiliated Shenzhen Stomatology Hospital, Guiyuan North Street 70th, Luohu, Shenzhen 518001, Guangdong Province, China. shplysz@126.com
Received: March 25, 2023 Peer-review started: March 25, 2023 First decision: April 20, 2023 Revised: April 29, 2023 Accepted: June 6, 2023 Article in press: June 6, 2023 Published online: July 6, 2023 Processing time: 97 Days and 7 Hours
Abstract
BACKGROUND
Subcutaneous emphysema is a well-known complication of oral surgery, especially during mandibular wisdom tooth extraction. However, subcutaneous emphysema secondary to dental procedures such as crown preparation is rare. The main symptom of emphysema is swelling and crepitus on palpation. Uncontrolled emphysema may spread along the fascial planes and cause deep space infections or a pneumomediastinum.
CASE SUMMARY
In this paper, we report a 34-year-old female who underwent upper molar tooth preparation for crowns and subsequently developed extensive subcutaneous emphysema on the retromandibular angle on two different occasions. The treatment plan for this patient involved close observation of the airway, and administration of dexamethasone and antibiotics via intravenous drip or orally. Ice bag compression was quickly applied and medication was prescribed to alleviate discomfort and promote healing. Although the main reason is unclear, the presence of a fissure in the molar is an important clue which may contribute to the development of subcutaneous emphysema during crown preparation. It is imperative for dental professionals to recognize such pre-disposing factors in order to minimize the risk of complications.
CONCLUSION
This case highlights the need for prompt diagnosis and management of subcutaneous emphysema because of the risk of much more serious complications. Awareness of relatively “benign” subcutaneous emphysema during any dental procedure is critical not only for inexperienced dentists, but also for those who work in rural and remote settings as members of surgical teams. In this study, we review the clinical presentation, mechanism, and differential diagnosis of subcutaneous emphysema.
Core Tip: Subcutaneous emphysema secondary to dental procedures such as crown preparation is rare. In this paper, we report a 34-year-old female who underwent upper molar tooth preparation for crowns and subsequently developed extensive subcutaneous emphysema on the retromandibular angle on two different occasions. Prompt diagnosis and management of subcutaneous emphysema is necessary for dentist.
