Open Journal of Stomatology, 2015, 5, 217-225 Published Online August 2015 in SciRes. http://www.scirp.org/journal/ojst http://dx.doi.org/10.4236/ojst.2015.58027 How to cite this paper: Mahfouz, Y. and Mahfouz, M. (2015) Subcutaneous Emphysema Is Iatrogenic Complication in Den- tal Surgery. Open Journal of Stomatology, 5, 217-225. http://dx.doi.org/10.4236/ojst.2015.58027 Subcutaneous Emphysema Is Iatrogenic Complication in Dental Surgery Yara Mahfouz 1 , Maen Mahfouz 1,2 1 Dental Department, Al Zafer Hospital, Najran, Saudi Arabia 2 Department of Orthodontics and Pediatric Dentistry, Arab American University, Jenin, Palestine Email: dr_cuteee@yahoo.com , maenmahfouz@gmail.com Received 24 July 2015; accepted 14 August 2015; published 17 August 2015 Copyright © 2015 by authors and Scientific Research Publishing Inc. This work is licensed under the Creative Commons Attribution International License (CC BY). http://creativecommons.org/licenses/by/4.0/ Abstract Subcutaneous emphysema in the head and neck is a well known clinical condition. It is an un- common clinical complication of dental treatment caused by forceful injection of air into the loose connective tissue below the dermal layer. The trapped air is often limited by subcutaneous space in the head and neck. This paper presents a clinical case in which subcutaneous emphysema de- veloped immediately during surgical extraction of third molar. Keywords Subcutaneous, Emphysema, Surgical Complication 1. Introduction Subcutaneous emphysema is a rare occurrence in dental practice. It is usually benign and self-limiting [1]; nev- ertheless, severe consequences can result from surgical treatment. Emphysema occurs when air is injected into the subcutaneous layer of the tissue, this may come from either an air turbine handpiece or air syringe [2]. Due to the danger of developing emphysema, procedures using compressed air are not recommended in dental ex- tractions involving the raising of a skin flap and bone sectioning. Early diagnosis and treatment are critical to prevent the trapped air leaking into other areas [3]. The first case of subcutaneous emphysema associated with a dental procedure was reported in 1900 [4]. Since then, it has been associated with air-generating dental instruments during restoration [5], surgical extraction [6]-[8], endodontic treatments [9], trauma from biopsy [10] and cheek biting [11]. The clinical presentation is characterized by a sudden onset of hemifacial swelling with fullness of the face and the eyelids on the involved side. Crepitation is noted on palpation and is almost pathognomonic for subcu- taneous emphysema.