Resumo

GUIMARAES, Bruno Ribeiro; MORAES, Rogério Bonfante; CAMINO JUNIOR, Rubens  e  LUZ, João Gualberto Cerqueira. Subcutaneous emphysema during removal of third molars: aspects of interest to the dental surgeon. RFO UPF [online]. 2010, vol.15, n.2, pp. 165-170. ISSN 1413-4012.

Subcutaneous emphysema is a relatively rare accident in dentistry, being caused by forced penetration of air or other gases into the soft tissues, resulting in distension of the overlying skin or mucosa. The most common causes are related to the air released from the high-speed dental hand-piece or by a dental air syringes. The treatment is usually symptomatic only, and has good resolution, but depending on the anatomical location and volume of air injected, the deep fascial spaces can be compromised to and progress to life-threatening infectious or cardiorespiratory complications. OBJECTIVE: The aim of this study is to describe a case of periorbital, subcutaneous emphysema. CASE REPORT: This cose developed in a 30 years-old woman during a surgery to remove the third molars, performed with high-speed dental hand-piece, and to warn dentists about the main aspects of this accident. The immediate diagnosis was obtained based on the rapid swelling of the affected area, associated with crepitus on palpation. The treatment comprised a drug therapy of the local discomfort and antibiotics, as well as the monitoring of possible cardiorespiratory changes. There was spontaneous remission of subcutaneous emphysema after two weeks. FINAL CONSIDERATIONS: It was concluded that although the subcutaneous emphysema requires clinical follow-up daily, its regression usually occurs without complications. Adequate knowledge of all aspects associated with subcutaneous emphysema is essential for the dentist to prevent its occurrence and adequate treatment.

Palavras-chave : Subcutaneous emphysema; Accidents; Molar third; Oral surgery.