The cyclooxygenase-2 inhibitor celecoxib and alveolar osteitis

The purpose of this study was to report our clinical experience, in a pilot study, of the use of the selective cyclooxygenase-2 (COX-2) inhibitor celecoxib, pre-emptively, to control pain in patients after surgical extraction of a mandibular molar tooth.

This randomised, double-blind, placebo-controlled, prospective clinical trial was conducted over an eight-month period. Participants were randomly allocated to receive a standard oral dose of 200 mg celecoxib, 400 mg ibuprofen, or a placebo containing lactose, pre-emptively, one hour before surgery. Each patient was prescribed amoxycillin 500 mg three times per day postoperatively for seven days. The participants were given standardised participant information sheets, and written informed consent was subsequently obtained from the participants prior to the commencement of the study.

The results showed that 13% of the patients who had ibuprofen had severe pain two to three days postoperatively. This was diagnosed as alveolar osteitis, which is in line with the universally accepted outcome for the surgical extraction of mandibular molar teeth. Statistical analysis (Chi-square test) confirmed that the ibuprufen group had a significantly higher alveolar osteitis incidence than the celecoxib group (p < or = 0.05) and the placebo group (p < or = 0.05).

This is the first reported study to demonstrate that the use of celecoxib resulted in a significant decrease in the occurrence of alveolar osteitis.