Subcutaneous Facial Emphysema and Pneumomediastinum Following a Class V Dental Restoration: A Case Report

Authors

Jonathan Tran DDS, Oral & maxillofacial surgery resident, University of California Los AngelesFollow
Brian M. Will, New York Presbyterian Columbia University Irving Medical CenterFollow
Sidney B. Eisig D.D.S., FACS, Chairman of Hospital Dentistry and director of Oral & Maxillofacial Surgery at New York Presbyterian Columbia University Irving Medical CenterFollow

Keywords

Cervicofacial subcutaneous emphysema, Facial swelling, Class V restoration

Abstract

Cervicofacial subcutaneous emphysema is an uncommon but potentially life-threatening complication of dental procedures. While classically associated with surgical extractions performed with dental high-speed handpieces instead of surgical rear-exhaust handpieces, it has been documented following other dental procedures, including restorative and endodontic treatments. As cervicofacial air emphysema spreads, it may reach the retropharyngeal space, which connects to the mediastinum, leading to pneumomediastinum and a risk for mediastinitis, which carries a high mortality rate. We present a case of cervicofacial subcutaneous emphysema leading to pneumomediastinum following a Class V restoration on tooth #28 to highlight the importance of recognizing this underdiagnosed complication.

Recommended Citation

Tran, Jonathan DDS; Will, Brian M.; and Eisig, Sidney B. D.D.S., FACS (2025) "Subcutaneous Facial Emphysema and Pneumomediastinum Following a Class V Dental Restoration: A Case Report," The New York State Dental Journal: Vol. 91: No. 5, Article 4.
Available at: https://commons.ada.org/nysdj/vol91/iss5/4