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      ¿Es inocua la ortopedia dentofacial? Translated title: Is dentofacial orthopedics harmless?

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          Abstract

          Resumen El enfisema subcutáneo es el proceso por el cual el aire penetra en el espacio subcutáneo, produciendo distensión de las partes blandas. Puede ser de origen traumático, iatrogénico o producirse de forma espontánea. Es infrecuente su aparición tras procedimientos dentales y no ha sido descrito asociado a la ortopedia dentofacial. Presentamos el caso de una paciente con enfisema subcutáneo tras un traumatismo por un aparato de avance mandibular tipo Herbst.

          Translated abstract

          Abstract Subcutaneous emphysema is the condition in which air penetrate the subcutaneous space causing soft-tissue distention. It may be traumatic, iatrogenic or may occur spontaneously. Its appearance is rare after dental procedures and has not been reported associated to dentofacial orthopedics. We report the case of a patient who developed subcutaneous emphysema after a trauma from a Herbst-type mandibular advancement appliance.

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          Iatrogenic subcutaneous emphysema of dental and surgical origin: a literature review.

          Subcutaneous emphysema arises when air is forced beneath the tissue, leading to swelling, crepitus on palpation, and potential to spread along the fascial planes. The goal of this literature review is to alert the oral and maxillofacial surgeon to the inciting factors, diagnosis, and management of subcutaneous emphysema.
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            Subcutaneous emphysema related to dental procedures

            Objectives The objective of this study was to analyze 11 cases of subcutaneous emphysema associated with dental procedures from a single hospital and discuss approaches for accurate diagnosis and treatment of the condition. Materials and Methods The medical records of 11 patients who were treated for subcutaneous emphysema related to dental procedures between January 2009 and April 2017 were analyzed retrospectively. Patients with subcutaneous emphysema within the facial area or that spread to the neck and beyond, including the facial region, were assigned to two groups and compared in terms of age, sex, and durations of antibiotic use, hospitalization, and follow-up until improvement. The correlation between location of the origin tooth and range of emphysema spread was analyzed. Results The average durations of antibiotic use during conservative treatment and follow-up until improvement were 8.55 days (standard deviation [SD], 4.46 days) and 1.82 weeks (SD, 1.19 weeks), respectively. There was no intergroup difference in duration of antibiotic use (P=0.329) or follow-up (P=0.931). Subcutaneous emphysema was more common after dental procedures involving the maxilla or posterior region than after those involving the mandible or anterior region. There was no significant difference in air distribution according to location of the air orifice (maxilla, mandible, or both; P=0.106). Conclusion Upon adequate conservative treatment accompanied by prophylactic antibiotic treatment considering the risk of infection, patients showed signs of improvement within a few days or weeks. There was no significant difference in treatment period between patients with subcutaneous emphysema localized to the facial region and those with subcutaneous emphysema spreading to the neck or beyond. These findings need to be confirmed by analysis of additional cases.
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              Retrospective study of clinical complications during orthodontic treatment with either a removable mandibular acrylic splint Herbst or with a cantilever Herbst.

              To compare the clinical complications during treatment with either a removable mandibular acrylic splint (RMS) or with a cantilever (HC) Herbst appliance.
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                Author and article information

                Journal
                pap
                Pediatría Atención Primaria
                Rev Pediatr Aten Primaria
                Asociación Española de Pediatría de Atención Primaria (Madrid, Madrid, Spain )
                1139-7632
                June 2020
                : 22
                : 86
                : 161-163
                Affiliations
                [1] Madrid orgnameCentro de Salud Canillejas España
                [2] Madrid orgnameCentro de Salud Canillejas España
                [3] Las Palmas de Gran Canaria orgnameFarmacia San José España
                Article
                S1139-76322020000300007 S1139-7632(20)02208600007
                2e796468-3d44-4e9b-9f24-6545ff7e8e54

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

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                Figures: 0, Tables: 0, Equations: 0, References: 7, Pages: 3
                Product

                SciELO Spain

                Categories
                Notas Clínicas

                Enfisema subcutáneo,Subcutaneous emphysema,Orthodontic appliance,Malocclusion,Maloclusión,Aparato ortodóncico

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