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Home / Equine Research Bank / Equine Vet J / Standing equine cheek tooth extraction: A multivariate analy...
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.

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