COMPARATIVE STUDY ON LOW PRIMITIVE ORAL CELECOXIB AND NABUMETONE FOR PAIN MANAGEMENT AFTER THIRD MOLAR EXTRACTIONS

Abstract Background: Surgical extraction of impacted mandibular third molars is frequently associated with postoperative pain, swelling, and trismus. Effective pre-emptive analgesia can minimize these complications by suppressing central sensitization before tissue injury occurs. Selective COX-2 inhibitors like celecoxib and nonselective NSAIDs such as Nabumetone are commonly used, yet their comparative efficacy in third molar surgery remains underexplored. Aim: To evaluate and compare the analgesic effectiveness of pre-emptive oral administration of celecoxib (200 mg) and Nabumetone (500 mg) in patients undergoing mandibular third molar Disimpaction. Materials and Methodology: This prospective study included 40 healthy individuals (ASA I or II), aged 20–50 years, with Mesioangular Class I Position A impactions. Participants were randomly allocated into two groups: Group A received celecoxib 200 mg, and Group B received Nabumetone 500 mg, administered one hour prior to surgery. All extractions were performed under standardized local anesthesia and surgical technique by the same operator. Postoperative pain intensity was assessed using an 11-point Visual Analog Scale (VAS) at 2, 4, 6, 8, 12, and 24 hours. Ibuprofen 300 mg was prescribed as rescue analgesia, and consumption within 24 hours was recorded. Results: Celecoxib demonstrated significantly lower mean VAS scores compared to Nabumetone at 2, 4, 6, 8, and 12 hours postoperatively (p < 0.05), with the highest difference observed at 6 hours (p = 0.004). At 24 hours, no significant difference was observed. Patients in the celecoxib group required fewer rescue analgesic doses and reported greater comfort during the first 12 hours post-surgery. Conclusion: Pre-emptive administration of celecoxib 200 mg provided superior and more sustained pain relief compared to Nabumetone 500 mg following third molar extraction. Celecoxib’s favourable efficacy and safety profile support its use as a reliable option for managing acute postoperative pain in minor oral surgical procedures. Keywords: Pre-emptive analgesia, celecoxib, Nabumetone, third molar surgery, postoperative pain, COX-2 inhibitor