Investigation of the Electric Handpiece-related Pneumomediastinum and Cervicofacial Subcutaneous Emphysema in Third Molar Surgery
Por um escritor misterioso
Last updated 09 setembro 2024
![Investigation of the Electric Handpiece-related Pneumomediastinum and Cervicofacial Subcutaneous Emphysema in Third Molar Surgery](https://d3i71xaburhd42.cloudfront.net/4a1542c5f121f8cd2fa6a150f096246e93dcc638/3-Figure10-1.png)
Pneumomediastinum and/or cervicofacial subcutaneous emphysema are extremely rare but severe complications in third molar surgery and treatment with an electric handpiece that does not use the drive air is generally recommended; however, its safety has not been fully verified. Correspondence to: Dr. Hitoshi Yoshimura, Department of Dentistry and Oral Surgery, Unit of Sensory and Locomotor Medicine, Division of Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji, Fukui, 910-1193 Japan; Tel: +81-776-61-8411; Fax: +81-776-61-8128; E-mail: omfs@u-fukui.ac.jp Abstract: Pneumomediastinum and/or cervicofacial subcutaneous emphysema are extremely rare but severe complications in third molar surgery. The most common cause is compressed air exhaust from an air-driven high-speed handpiece. To prevent these complications, treatment with an electric handpiece that does not use the drive air is generally recommended; however, its safety has not been fully verified. In this study, we investigated electric handpiece-related emphysema during third molar surgery. We evaluated patients who visited our hospital in relation to third molar surgery between January 2008 and December 2017. Of the 2938 patients examined, 2 patients were complicated with electric handpiece-related pneumomediastinum and cervicofacial subcutaneous emphysema during sectioning the mandibular third molar. In these cases, a straight motor handpiece and a 1:5 speed increasing contra-angle motor handpiece were used, respectively. Both patients received antibiotics and follow-up examination under hospitalization. Although the air flow and pressure of an electric handpiece are lower than those for air-driven high-speed handpieces, the air expelled from electric handpieces could cause cervicofacial emphysema and/or pneumomediastinum. It should be noted that electric handpieces do not use the drive air; however, most of these handpieces have air/water nozzles and use tip air. Before treatment, an informed consent to patients about the risk of emphysema is mandatory. With regard to the surgical technique, elevation of the mucoperiosteal flap should be minimal. Attention should be also paid to the possibility that the air inflow route is made through removal or perforation of the cortical bone. To prevent emphysema, an electric surgical handpiece with an external water spray may be preferable for removing the bone and cutting the tooth, because this type of surgical handpiece has a separate water drip for cooling instead of combined water and air spray, and it does not use the flux of air.
![Investigation of the Electric Handpiece-related Pneumomediastinum and Cervicofacial Subcutaneous Emphysema in Third Molar Surgery](https://www.researchgate.net/profile/Sergio-Olate/publication/258216464/figure/fig1/AS:297637581475840@1447973737313/A-Mild-erythematous-swelling-with-crepitus-over-the-right-orbital-area-cheek_Q320.jpg)
A: Mild erythematous swelling with crepitus over the right orbital
![Investigation of the Electric Handpiece-related Pneumomediastinum and Cervicofacial Subcutaneous Emphysema in Third Molar Surgery](https://jsms.sch.ac.kr/upload//thumbnails/sms-25-2-125f1.gif)
Pneumomediastinum and Subcutaneous Emphysema after Use of a High-Speed Dental Handpiece
![Investigation of the Electric Handpiece-related Pneumomediastinum and Cervicofacial Subcutaneous Emphysema in Third Molar Surgery](https://ars.els-cdn.com/content/image/1-s2.0-S2213007119301807-gr3.jpg)
Cervicofacial subcutaneous emphysema and pneumomediastinum secondary to dental treatment in a young man - ScienceDirect
![Investigation of the Electric Handpiece-related Pneumomediastinum and Cervicofacial Subcutaneous Emphysema in Third Molar Surgery](https://d3i71xaburhd42.cloudfront.net/ca66c958e9aaa183fe9c8ae3b80eccfcf2b09321/2-Figure1-1.png)
PDF] Subcutaneous Emphysema as A Rare Complication Dental Implant Treatment: A Case Report
![Investigation of the Electric Handpiece-related Pneumomediastinum and Cervicofacial Subcutaneous Emphysema in Third Molar Surgery](https://casereports.bmj.com/content/bmjcr/14/6/e243489/F1.large.jpg)
Patient-induced progressive facial subcutaneous emphysema masquerading as odontogenic abscess
![Investigation of the Electric Handpiece-related Pneumomediastinum and Cervicofacial Subcutaneous Emphysema in Third Molar Surgery](https://ars.els-cdn.com/content/image/1-s2.0-S2049080121009894-gr4.jpg)
Subcutaneous emphysema during mandibular wisdom tooth extraction: Cases series - ScienceDirect
![Investigation of the Electric Handpiece-related Pneumomediastinum and Cervicofacial Subcutaneous Emphysema in Third Molar Surgery](https://d3i71xaburhd42.cloudfront.net/9c6656bd4b9a428578ae4bd574a9a85508ea09ba/5-TableIII-1.png)
PDF] Thoracic complications associated with utilization of the air turbine dental drill.
![Investigation of the Electric Handpiece-related Pneumomediastinum and Cervicofacial Subcutaneous Emphysema in Third Molar Surgery](https://d3i71xaburhd42.cloudfront.net/4a1542c5f121f8cd2fa6a150f096246e93dcc638/3-Figure7-1.png)
Investigation of the Electric Handpiece-related Pneumomediastinum and Cervicofacial Subcutaneous Emphysema in Third Molar Surgery
![Investigation of the Electric Handpiece-related Pneumomediastinum and Cervicofacial Subcutaneous Emphysema in Third Molar Surgery](https://www.longdom.org/articles-images-2022/Essences-Dentistry-facial-14-5-234-g002.png)
Subcutaneous Emphysema Development Following Molar Surgery
![Investigation of the Electric Handpiece-related Pneumomediastinum and Cervicofacial Subcutaneous Emphysema in Third Molar Surgery](https://onlinelibrary.wiley.com/cms/asset/592d58fb-a58a-4ceb-a872-7795d16c0d61/adj12537-fig-0002-m.jpg)
Subcutaneous emphysema related to air‐powder tooth polishing: a report of three cases - Alonso - 2017 - Australian Dental Journal - Wiley Online Library
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