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Equine veterinary journal2023; 55(6); 968-978; doi: 10.1111/evj.13905

Standing equine cheek tooth extraction: A multivariate analysis of the effect of antibiotics on the risk of post-operative complications.

Abstract: Commonly, cheek tooth extraction performed in standing horses using perioperative prophylactic antibiotics, results in low post-operative complication rates. However, no studies have documented the relevance of perioperative antibiotics to the risk of post-operative complications. Objective: To examine the association between perioperative antibiotics and post-operative complications after standing cheek tooth extraction. Methods: Retrospective cohort study. Methods: Information from clinical records and follow-up questionnaires relating to horses subjected to cheek tooth extractions between September 2016 and May 2020 was obtained. Post-operative complications and associations with perioperative antibiotics, age, sex, breed, diagnosis, tooth position, and extraction method were analysed using multivariate logistic regression. Results: A total of 305 horses were included, and of these 71 (23.3%) received perioperative antibiotics. Antibiotics were not associated with the risk of complications in 264 horses that underwent standard oral extraction; 9/49 (18.4%) that received antibiotics and 35/215 (16.3%) that did not receive antibiotics experienced postoperative complications (P = 1, RR = 0.89, OR = 1, OR CI = [0.41; 2.46]). Of 41 horses that had cheek tooth extraction through minimally invasive transbuccal cheek tooth extraction (MTE), 5/22 (22.7%) that received antibiotics and 10/19 (52.6%) that did not receive antibiotics, experienced postoperative complications. Although not statistically significant when adjusting for multiple comparisons (naïve P = 0.04, adjusted P = 0.26, RR = 2.32, OR = 4.48, OR CI = [1.05; 19.11]), this finding is clinically relevant. Younger age was also significantly associated with development of complications (P = 0.02, OR = 0.92 per year, OR CI = [0.87; 1.36]). Conclusions: The retrospective nature of the study leads to uncontrollable potential confounders and there is a relatively low number of MTE cases. Conclusions: Perioperative antibiotics were not associated with a lower complication rate in horses subjected to standard standing cheek tooth extraction. Use of perioperative antibiotics in conjunction with MTE may be merited, although further investigations are needed. 背景: 通常情况下，使用围术期预防性抗生素对站立马进行颊牙拔除，术后并发症发生率较低。然而，没有研究记录围手术期AB与术后并发症风险的相关性。 目的: 探究站立马匹CT拔除术围术期AB使用与术后并发症的关系。 研究设计: 回顾性队列研究 方法: 数据信息来自2016年9月至2020年5月期间，与CT拔除有关的马匹的临床记录和随访问卷。术后并发症及其与围术期抗生素使用、年龄、性别、品种、诊断、牙位、和拔牙方法的关系，采用多因素逻辑回归分析。 结果: 包括305匹马，其中71匹(23.3%)接受了围术期抗生素。在264匹接受标准口腔拔除术的马中，抗生素使用与并发症的风险无关；其中，9匹 9/49(18.4%)接受抗生素治疗的马匹，与35匹 35/215(16.3%)未接受抗生素治疗的马匹，发生术后并发症(P = 1，RR = 0.89， OR = 1， OR CI = [0.41；2.46])。另外41匹采用微创拔牙(MTE)进行CT拔除的马中，5匹 5/22匹(22.7%)接受了抗生素治疗的马匹，与10匹 10/19匹(52.6%)未接受抗生素治疗的马匹出现了术后并发症。尽管经过多次比较调整后，统计学意义不显著(P = 0.04，调整后P = 0.26, RR = 2.32, OR = 4.48, OR CI = [1.05；19.11])，但数据与临床相关。年龄较小也与并发症的发生率显著相关(P = 0.02, OR = 0.92 /年，OR CI = [0.87；1.36])。 主要局限性: 本研究的回顾性性质，导致不可控的潜在混杂因素，和相对较少的MTE病例数。 结论: 实验结果不支持标准站立CT拔除术的马匹在围术期使用抗生素。微创拔牙术MTE围术期使用抗生素可能是值得的，尽管还需要进一步的研究。.
© 2022 The Authors. Equine Veterinary Journal published by John Wiley & Sons Ltd on behalf of EVJ Ltd.
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Publication Date: 2023-01-12 PubMed ID: 36516304DOI: 10.1111/evj.13905Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The study investigates the relationship between use of antibiotics during and around surgery (perioperative) and post-operative complications in horses after standing cheek tooth extraction. The result shows that perioperative antibiotics do not reduce complication rates in standard standing cheek tooth extractions, but may merit consideration in minimally invasive extractions, despite the need for more research.

About the Research

  • This study utilises a retrospective cohort design, using clinical records and follow-up questionnaires of horses subjected to cheek tooth extractions from September 2016 to May 2020.
  • This afforded the researchers a considerable sample size of 305 horses, with 71 of these receiving antibiotics during their surgery – perioperative antibiotics.

The Findings

  • Out of the 305 horses, antibiotics were not associated with the risk of complications in the 264 horses that underwent the standard oral extraction procedure. Despite some of the horses receiving antibiotics, the post-operative complication rates were roughly similar for both those administered antibiotics and those that were not.
  • Out of the remaining 41 horses that underwent a minimally invasive cheek tooth extraction procedure, higher rates of postoperative complications arose in the horses that did not receive antibiotics at 52.6%, whereas those that did had less at 22.7%.

Statistical Considerations

  • This difference in the minimally invasive extractions was not statistically significant. However, the researchers argue it is still ‘clinically relevant’ – suggesting that the observed difference may still have importance in a real-world clinical setting despite the lack of statistical significance.
  • Furthermore, it was found that younger horses had significantly higher development of complications, although the precise relationship between age and complication risk was not defined.

Limitations and Conclusions

  • The researchers acknowledged the limitations of their work, particularly around the retrospective nature of the study that may lead to uncontrollable potential confounders – factors that might influence the observed results beyond what was being studied.
  • Also, there was a relatively low number of minimally invasive transbuccal cheek tooth extraction (MTE) cases, making conclusions difficult to ascertain.
  • The conclusion drawn from the experiment did not support the use of perioperative antibiotics for horses subjected to standard standing cheek tooth extraction. However, for minimally invasive procedures, the use of such antibiotics may be worth considering, although further investigations are necessary to confirm or clarify this.

Cite This Article

APA
Christiansen MS, Rosenmeier JG, Jensen DB, Lindegaard C. (2023). Standing equine cheek tooth extraction: A multivariate analysis of the effect of antibiotics on the risk of post-operative complications. Equine Vet J, 55(6), 968-978. https://doi.org/10.1111/evj.13905

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English
Volume: 55
Issue: 6
Pages: 968-978

Researcher Affiliations

Christiansen, Mathias Schach
  • Hestetandklinikken, Ringsted, Denmark.
Rosenmeier, Jesper Grud
  • Hestetandklinikken, Ringsted, Denmark.
Jensen, Dan Børge
  • Department of Veterinary and Animal Sciences, University of Copenhagen, Frederiksberg C, Denmark.
Lindegaard, Casper
  • Department of Veterinary Clinical Sciences, Section of Medicine & Surgery, University of Copenhagen, Taastrup, Denmark.

References

This article includes 44 references
  1. World Health Organization. The evolving threat of antimicrobial resistance: Options for action.. World Health Organization 2012.
  2. World Health Organization. Thirteenth general programme of work (GPW13) methods for impact measurement.. 2020.
  3. Dixon PM, Dacre I, Dacre K, Tremaine WH, McCann J, Barakzai S. Standing oral extraction of cheek teeth in 100 horses (1998-2003).. Equine Vet J 2005;37(2):105-12.
    doi: 10.2746/0425164054223822google scholar: lookup
  4. Kennedy R, Reardon RJR, James O, Wilson C, Dixon PM. A long-term study of equine cheek teeth post-extraction complications: 428 cheek teeth (2004-2018).. Equine Vet J 2020;52(6):811-22.
    doi: 10.1111/evj.13255google scholar: lookup
  5. Tremaine WH. Oral extraction of equine cheek teeth.. Equine Vet Educ 2004;16(3):151-8.
    doi: 10.1111/j.2042-3292.2010.00173.xgoogle scholar: lookup
  6. Caramello V, Zarucco L, Foster D, Boston R, Stefanovski D, Orsini JA. Equine cheek tooth extraction: comparison of outcomes for five extraction methods.. Equine Vet J 2020;52(2):181-6.
    doi: 10.1111/evj.13150google scholar: lookup
  7. Kern I, Bartmann CP, Verspohl J, Rohde J, Bienert-Zeit A. Bacteraemia before, during and after tooth extraction in horses in the absence of antimicrobial administration.. Equine Vet J 2017;49(2):178-82.
    doi: 10.1111/evj.12581google scholar: lookup
  8. Townsend KS, Johnson PJ, LaCarrubba AM, Martin LM, Ericsson AC. Exodontia associated bacteremia in horses characterized by next generation sequencing.. Sci Rep 2021;11(1):1-12.
    doi: 10.1038/s41598-021-85484-zgoogle scholar: lookup
  9. Verdegaal EJMM, De HN, Maree JTM, Sloet Van Oldruitenborgh-Oosterbaan MM. A right-sided bacterial endocarditis of dental origin in a horse.. Equine Vet Educ 2006;18(4):191-5.
    doi: 10.1111/j.2042-3292.2006.tb00444.xgoogle scholar: lookup
  10. Den Danske Dyrlaegeforening. Antibiotikavejledning Til Heste, 2018.. .
  11. The Public Health Agency of Sweden. Swedish work against antibiotic resistance - A one health approach.. 2020.
  12. Sveriges Veterinärförbund. The Swedish Veterinary Association's Guidelines for the clinical use of antibiotics in the treatment of horses, 2013.. .
  13. Bellows J, Berg ML, Dennis S, Harvey R, Lobprise HB, Snyder CJ. 2019 AAHA dental care guidelines for dogs and cats.. J Am Anim Hosp Assoc 2019;55(2):49-69.
    doi: 10.5326/jaaha-ms-6933google scholar: lookup
  14. Charlier C. Oral surgery - extractions.. Wiggs's Vet Dent 2019;8:229-45.
    doi: 10.1002/9781118816219.ch11google scholar: lookup
  15. Gieche JM. Equine oral extraction techniques.. Vet Clin North Am - Equine Pract 2020;36(3):545-64.
    doi: 10.1016/j.cveq.2020.08.010google scholar: lookup
  16. Galloway SS, Earley ET. Minimizing equine tooth extraction complications.. Vet Clin North Am - Equine Pract 2020;36(3):641-58.
    doi: 10.1016/j.cveq.2020.08.004google scholar: lookup
  17. Langeneckert F, Witte T, Schellenberger F, Czech C, Aebischer D, Vidondo B. Cheek tooth extraction via a minimally invasive transbuccal approach and intradental screw placement in 54 equids.. Vet Surg 2015;44(8):1012-20.
    doi: 10.1111/vsu.12409google scholar: lookup
  18. Dixon PM, du Toit N, Dacre IT. Equine dental pathology.. 2010;p. 129-47.
  19. Nicolaisen ASK, Bendix Nygaard A, Christophersen MT, Jensen DB, Lindegaard C. Effect of head and tail rope-assisted recovery of horses after elective and emergency surgery under general anaesthesia.. Equine Vet Educ 2022;34(3):126-33.
    doi: 10.1111/eve.13397google scholar: lookup
  20. Holm S. A simple sequentially rejective multiple test procedure.. Scand J Stat 1979;6(2):65-70.
  21. Bretz F, Westfall P, Heiberger RM, Schuetzenmeister A, Scheibe S. Package ‘Multcomp’ 2017.. .
  22. R Core Team. R: A language and environment for statistical computing.. R Found Stat Comput 2020.
  23. Bates D, Mächler M, Bolker BM, Walker SC. Fitting linear mixed-effects models using lme4.. J Stat Softw 2015;67(1):2020.
    doi: 10.18637/jss.v067.i01google scholar: lookup
  24. Rice MK, Henry TJ. Standing intraoral extractions of cheek teeth aided by partial crown removal in 165 horses (2010-2016).. Equine Vet J 2018;50(1):48-53.
    doi: 10.1111/evj.12727google scholar: lookup
  25. Tremaine WH, Schumacher J. Exodontia.. 2010;p. 319-44.
  26. Gergeleit H, Bienert-Zeit A. Complications following mandibular cheek tooth extraction in 20 horses.. Front Vet Sci 2020;7:504.
    doi: 10.3389/fvets.2020.00504google scholar: lookup
  27. O'Neill HD, Boussauw B, Bladon BM, Fraser BS. Extraction of cheek teeth using a lateral buccotomy approach in 114 horses (1999-2009).. Equine Vet J 2011;43(3):348-53.
    doi: 10.1111/j.2042-3306.2010.00169.xgoogle scholar: lookup
  28. Tanner RB, Hubbell JAE. A retrospective study of the incidence and management of complications associated with regional nerve blocks in equine dental patients.. J Vet Dent 2019;36(1):40-5.
    doi: 10.1177/0898756419848165google scholar: lookup
  29. Stewart S, Richardson DW. Surgical site infection and the use of antimicrobials.. 2019;p. 77-103.
    doi: 10.1016/b978-0-323-48420-6.00007-7google scholar: lookup
  30. Chan ED, Kong PM, Fennelly K, Dwyer AP, Iseman MD. Vertebral osteomyelitis due to infection with nontuberculous mycobacterium species after blunt trauma to the back: 3 examples of the principle of locus minoris resistentiae.. Clin Infect Dis 2001;32(10):1506-10.
    doi: 10.1086/320155google scholar: lookup
  31. Toth B, Aleman M, Nogradi N, Madigan JE. Meningitis and meningoencephalomyelitis in horses: 28 cases (1985-2010).. J Am Vet Med Assoc 2012;240(5):580-7.
    doi: 10.2460/javma.240.5.580google scholar: lookup
  32. Vlaminck L. Complications following oral extraction of cheek teeth: What's next?. Equine Vet Educ 2017;29(11):600-2.
    doi: 10.1111/eve.12706google scholar: lookup
  33. Horbal AA, Reardon RJM, Froydenlund T, Jago RC, Dixon PM. Head and neck abscessation and thrombophlebitis following cheek tooth extraction in a pony.. Equine Vet Educ 2019;31(10):523-9.
    doi: 10.1111/eve.12900google scholar: lookup
  34. Bach FS, Bodo G, Kuemmerle JM, Bienert-Zeit A, Hainisch EK, Simhofer H. Bacterial meningitis after sinus surgery in five adult horses.. Vet Surg 2014;43(6):697-703.
    doi: 10.1111/j.1532-950x.2014.12132.xgoogle scholar: lookup
  35. Zetterström S, Groover E, Lascola K, Cole R, Velloso A, Boone L. Meningitis after tooth extraction and sinus lavage in a horse.. J Equine Vet Sci 2021;97:97.
    doi: 10.1016/j.jevs.2020.103323google scholar: lookup
  36. Kijima T, Masuda H, Yoshida S, Tatokoro M, Yokoyama M, Numao N. Antimicrobial prophylaxis is not necessary in clean category minimally invasive surgery for renal and adrenal tumors: a prospective study of 373 consecutive patients.. Urology 2012;80(3):570-5.
    doi: 10.1016/j.urology.2012.05.003google scholar: lookup
  37. Charlesworth TM, Sanchez FT. A comparison of the rates of postoperative complications between dogs undergoing laparoscopic and open ovariectomy.. J Small Anim Pract 2019;60(4):218-22.
    doi: 10.1111/jsap.12993google scholar: lookup
  38. Litta P, Sacco G, Tsiroglou D, Cosmi E, Ciavattini A. Is antibiotic prophylaxis necessary in elective laparoscopic surgery for benign gynecologic conditions?. Gynecol Obstet Invest 2010;69(2):136-9.
    doi: 10.1159/000267322google scholar: lookup
  39. Borg H, Carmalt JL. Postoperative septic arthritis after elective equine arthroscopy without antimicrobial prophylaxis.. Vet Surg 2013;42(3):262-6.
    doi: 10.1111/j.1532-950x.2013.01106.xgoogle scholar: lookup
  40. Shallcross LJ, Davies DSC. Antibiotic overuse: a key driver of antimicrobial resistance.. Br J Gen Pract 2014;64:604-5.
  41. Hawker JI, Smith S, Smith GE, Morbey R, Johnson AP, Fleming DM. Trends in antibiotic prescribing in primary care for clinical syndromes subject to national recommendations to reduce antibiotic resistance, UK 1995-2011: analysis of a large database of primary care consultations.. J Antimicrob Chemother 2014;69(12):3423-30.
    doi: 10.1093/jac/dku291google scholar: lookup
  42. Health Protection Agency. Management of infection guidance for primary care for consultation & local adaption.. Guidelines 2014;1-38.
  43. King C, Smith M, Currie K, Dickson A, Smith F, Davis M. Exploring the behavioural drivers of veterinary surgeon antibiotic prescribing: a qualitative study of companion animal veterinary surgeons in the UK.. BMC Vet Res 2018;14(1):1-9.
    doi: 10.1186/s12917-018-1646-2google scholar: lookup
  44. Larsen T, Poulsen AH, Helleberg M. Indikationer for anvendelse af profylaktisk antibiotikum i tandlaegepraksis.. Tandlaegebladet 2015;119(3):184-97.

Citations

This article has been cited 3 times.
  1. Hardefeldt L, Thomas K, Page S, Norris J, Browning G, El Hage C, Stewart A, Gilkerson J, Muscatello G, Verwilghen D, van Galen G, Bauquier J, Cuming R, Reynolds B, Whittaker C, Wilkes E, Clulow J, Burden C, Begg L. Antimicrobial prescribing guidelines for horses in Australia. Aust Vet J 2025 Dec;103(12):781-889.
    doi: 10.1111/avj.70003pubmed: 40903020google scholar: lookup
  2. Hardefeldt LY, Thomas K, Begg L. Antimicrobial use and prescribing practices by equine veterinarians in Australia: Insights into reproduction, dentistry, compounding and use for nonbactericidal effects. Aust Vet J 2025 Jun;103(6):307-313.
    doi: 10.1111/avj.13428pubmed: 40000246google scholar: lookup
  3. Leps A, Korsos S, Clarysse M, Vlaminck L. Dental sectioning for intraoral equine cheek teeth extractions: 29 cases. Front Vet Sci 2024;11:1367861.
    doi: 10.3389/fvets.2024.1367861pubmed: 38425840google scholar: lookup
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