case_images: PMC10787179_01
case_images: Clinical images of the patient's face at presentation exhibiting significant right-sided hemifacial edema and ecchymosis consistent with a facial hematoma. The edema is characterized by a notable swelling, extending from the submandibular region to the periorbital tissues, predominantly affecting the right side of the face. The ecchymosis, evident as purplish discoloration, further emphasizes the extent of soft tissue damage
case_images: IEJ-19-46-g001.jpg
case_images: PMC10787179_01_IEJ-19-46-g001.jpg
case_images: F1
case_images: Upon examination, the patient displayed significant right-sided facial edema and ecchymosis, extending from the submandibular region to the periorbital tissues (Figure 1).
case_images: A) Axial and B) Coronal computed tomography (CT) scan performed in the emergency setting highlights a substantial increase in density of the right hemifacial soft tissues, showing a diffuse reticular pattern of increased fat density. A more concentrated area of higher density is observed in the right zygomatic and paramandibular regions compatible with a hematoma; C) Additionally, two gas bubbles, indicative of emphysema, are seen within the right retromaxillary buccal fat, further emphasizing the involvement of this region (A and B, red arrow). On the angiographic CT image, no contrast extravasation was observed, suggesting the absence of active bleeding at the time of examination
case_images: IEJ-19-46-g002.jpg
case_images: PMC10787179_01_IEJ-19-46-g002.jpg
case_images: F2
case_images: A computed tomography (CT) examination was performed to assess the deep tissue structures and extension, revealing a hematoma involving the facial region, with buccal and periorbital extension, without signs of active bleeding on the angiographic images (Figure 2).
case_images: A) Sagital and B) axial CT image with bone algorithm reconstruction captures the region of tooth number 16, revealing significant post-intervention changes consistent with the root canal treatment that the tooth underwent. Within the tooth structure, a well-defined radiolucent center is observed, indicating the presence of the root canal space (A and B, red arrow)
case_images: IEJ-19-46-g003.jpg
case_images: PMC10787179_01_IEJ-19-46-g003.jpg
case_images: F3
case_images: Bony algorithm images revealed post-intervention changes on tooth number 16, consistent with the root canal treatment the tooth underwent (Figure 3).