Iatrogenic tooth displacement is a rather unusual but significant complication during extractions' procedures. The most common anatomic positions of displacement for the lower teeth include the pterygomandibular, submandibular, sublingual, and lateral pharyngeal spaces. A retrospective analysis of three cases of tooth displacement to adjacent anatomic sites is presented. These patients were treated at the Oral and Maxillofacial Surgery Department, G. Papanikolaou General Hospital of Thessaloniki, Greece. Two cases refer to displaced roots in the submandibular space, and one refers to a lower third molar displaced in the lateral pharyngeal space. Third molar displacement is a clinical complication that should be considered during mandibular third molar extraction, and proper preventive measures should be taken into consideration.
Objectives To present a case of subcutaneous cervicofacial emphysema of a patient with a closed mandibular angle fracture after interpersonal violence. Case Report A 36-year-old male was transferred from a regional hospital after a referred interpersonal violence incident. The patient sustained a fracture of the left mandibular angle, as well as a right clavicular fracture, which was treated conservatively by the referring hospital. As depicted by the CT scan, a large emphysema involving the buccal, submandibular, pterygomasseterial and lateral pharyngeal spaces of the left side. Clinically the patient had a positive Hamman’s sign. An open reduction was decided with internal rigid fixation. The postoperative course was uneventful. Conclusions Cervicofacial emphysema, despite not unusual in fractures involving the midface, due to communication with the paranasal sinuses, is a rather rare complication of mandibular fractures. Proper clinical and imaging examination is required to exclude expansion of the air to the mediastinum, which can be a life-threatening complication.
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