[Wide-spread subcutaneous emphysema after third molar extraction. Case report]. / Ausgedehntes subkutanes Emphysem nach Weisheitszahnentfernung. Ein Fallbericht.

Two days after wisdom teeth removal an eighteen-year-old man complained of a painful subcutaneous neck emphysema. CT scans showed that the air collections were expanding close to the mediastinum. A conservative intravenous medication with broadspectrum antibiotics was administered and within three days the symptoms resolved completely without any surgical intervention. Subcutaneous emphysema after dental treatment can develop into infectious, potentially lethal fasciitis and mediastinitis. Therefore it must be thoroughly examined and immediately operated on, if suspicious of an infection.

[Atypical surgical approach to the extraction of retained teeth]. / Atypische chirurgische Zugänge zur Entfernung retinierter Zähne.

Indication to extract deep impacted teeth as well as the surgical approaches is controversally discussed in the litterature. Based on a clinical case report we describe two atypical approaches, one is extraoral the other lingual for removing tow deeply impacted teeth. The revue of the litterature shows that atypical surgical approaches are only indicated in particular clinical situations. The indication to remove the teeth and the approach depends on the patient's compliance as well as the experience of the operator. In the reported case the extraoral approach is justified by the chronical dentogene infection with fistulisation and cutaneus changes in the submandibular region. Based on the much easier access to the tooth and the only minimal cutaneus modifications in this case, we recommand the extraoral approach for extraction of deep impacted teeth in some special cases like the one we present.