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<p>Surgical emphysema (SE) is a rare and often self-limiting phenomenon defined as air entrapment in the subcutaneous space or deeper fascial planes. Surgical extractions may result in this phenomenon; however, it is less commonly known that SE may arise from minor dental procedures. True incidence rates remain unclear as it is often undiagnosed or unreported. We report a gravely underestimated case – a near miss – where radiographic investigation uncovered extensive pneumomediastinum from air-powered dental prophylaxis (APDP).</p><p>We highlight subtle presentation of this pathology, the importance of forming a definitive diagnosis using computed tomography imaging, and the importance of involving relevant specialist teams in management. Early multidisciplinary involvement should shape management protocols for all cases, irrespective of benign presentation or unexpected origin from non-surgical dental procedures. This report also sheds light on the dangers of APDP which are understated in the current literature. There is an unmet need for evidence-based recommendations for safe usage of air-powder abrasive devices.</p>

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An unsuspecting presentation of extensive pneumomediastinum following dental air-polishing

  • 期刊论文

  • 发表日期：

    2025年10月24日

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  • Vanessa Mordi,
  • Billy Leung,
  • Alam Peyman,
  • Walid El Kininy

摘要

Surgical emphysema (SE) is a rare and often self-limiting phenomenon defined as air entrapment in the subcutaneous space or deeper fascial planes. Surgical extractions may result in this phenomenon; however, it is less commonly known that SE may arise from minor dental procedures. True incidence rates remain unclear as it is often undiagnosed or unreported. We report a gravely underestimated case – a near miss – where radiographic investigation uncovered extensive pneumomediastinum from air-powered dental prophylaxis (APDP).

We highlight subtle presentation of this pathology, the importance of forming a definitive diagnosis using computed tomography imaging, and the importance of involving relevant specialist teams in management. Early multidisciplinary involvement should shape management protocols for all cases, irrespective of benign presentation or unexpected origin from non-surgical dental procedures. This report also sheds light on the dangers of APDP which are understated in the current literature. There is an unmet need for evidence-based recommendations for safe usage of air-powder abrasive devices.