Emphysema following air-powder abrasive treatment for peri-implantitis / 대한악안면성형재건외과학회지

BACKGROUND: Subcutaneous emphysema refers to swelling caused by the presence of air or gas in the interstices of loose connective tissue. In the head and neck area, it may follow the fascial planes and is characterized by sudden swelling, crepitus on palpation, infrequent pain, and air emboli on radiography. It usually occurs as a complication in dental treatment. Some reports have described subcutaneous emphysema caused by dental procedures; however, severe emphysema related to peri-implantitis after treatment has not been documented. Accordingly, the current report describes a rare case of subcutaneous cervical emphysema resulting from the use of an air-powder abrasive device to treat peri-implantitis. CASE PRESENTATION: Based on a review of the existing literature and the present case, nine cases of subcutaneous emphysema due to air-powder abrasive device have been reported. In most cases, the emphysema resolved over time after treatment with prophylactic antibiotics; among these, two were related to peri-implantitis management. CONCLUSION: Considering the frequent use of air-powder abrasive devices to treat peri-implantitis, the potential risk of iatrogenic emphysema related to this procedure needs to be addressed more extensively.

Subcutaneous emphysema after treatment through airabrasivedevice: case report / Enfisema subcutâneo gerado após tratamento com equipamento de ar comprimido: relato de caso

Subcutaneous emphysema is an event often generated by iatrogenic reason, caused by improper dissection of air into soft tissues and/ or anatomical structures, causing edema and visually noticeable volumetric change in the area of the incident. The main etiological factor for this is the use of equipment such as air syringe or high-speed handpieces in surgical procedures of greater magnitude; however, subcutaneous emphysema may also occur in simple procedures, such that presented in this case report, through using air-abrasive device usually proper for dental prophylaxis. This case report aimed to describe the care measurements to avoid such event, describing proper procedures for the correct solution of the case, as well as to alert the professionals about the risks and necessary precautions.

O enfisema subcutâneo é um evento muitas vezes de origem iatrogênica, causado pela infusão indevida de ar nos tecidos e/ou estruturas anatômicas, causando edemaciamento e alteração volumétrica visualmente perceptível na área do ocorrido. O principal fator etiológico para tal é o uso de equipamentos como seringa tríplice ou caneta de alta rotação durante procedimentos cirúrgicos de maior magnitude; no entanto, o enfisema subcutâneo também pode ocorrer diante de procedimentos mais simples, tal como o ocorrido no presente relato de caso, em que houve sua ocorrência pelo uso de equipamento de ar comprimido usualmente utilizado para execução de profilaxia. O objetivo do presente artigo foi relatar o caso, assim como descrever os cuidados para se evitar tal evento, e descrever procedimentos adequados para o correto prosseguimento e resolução adequada do caso.