<p>Multicenter study of patients&rsquo; preferences and concerns regarding the origin of bone grafts utilized in dentistry</p>

Abstract

PurposeBone graft materials can be obtained from the patient’s own body (autologous graft), animals (xenograft), human cadavers (allograft) and synthetic materials (alloplastic bone graft). Patients may have ethical, religious or medical concerns about the origin of bone grafts, which could lead them to reject the use of certain types of bone graft in their treatments. The aim of this multicenter study, which surveyed patients from five university clinics in Portugal, France, Italy, Spain and Chile, was to analyze patients’ opinions regarding the source of bone grafts.Patients and methodsA survey composed of ten questions was translated into local languages and validated. Patients were asked about the degree of acceptance/rejection of each graft and the reasons for rejection. A chi-squared test was used to analyze statistically significant differences.ResultsThree hundred thirty patients were surveyed. The grafts that elicited the highest percentage of refusal were allograft (40.4%), autologous bone graft from an extraoral donor site (34%) and xenograft (32.7%). The grafts with the lowest rate of refusal were alloplastic (6.3%) and autologous bone grafts from an intraoral donor site (24.5%). The main reason for autologous bone rejection was the fear of pain and discomfort, for xenograft it was the fear of disease transmission and the rejection of use of animals for human benefit, and for allograft it was ethical/moral motivations and the fear of disease transmission. Religious affiliation influenced patient’s preferences.ConclusionThe origin of bone grafts is still conflictive for a high percentage of patients.

Physical Characterization of Biphasic Materials With Different Granulation Sizes and Their Influence on Bone Repair and Inflammation in Rat Calvaria

“…Concerns about the risk of the possible transmission of bovine spongiform encephalopathy and religious issues may impede the use of bovine xenogeneic bone graft materials in some patients 22,23 . To the detriment of its use, the ethical aspects related to the increasing changes in the lifestyle of the segments of society, which act in the defense of animal rights and are contrary to the use and consumption of products of animal origin are also relevant 22 .…”

The choice between allograft or demineralized bone matrix is not unambiguous in trauma surgery

“…A survey study by Bucchi et. al asked 330 patients from five different countries about their opinion regarding the use and origin of bone grafts used in dental surgery [54] . One fifth would never accept allograft and one fifth would only accept it as last resort.…”

“…If so, then Bucchi et. al it revealed that 1.8% would never accept the use of synthetic bone materials (not specified), and 4.5% would only accept such as a last resort [54] . From the study by Güngörmüs et al 34.9% would reject a synthetic graft [56] .…”

A systematic review and meta-analysis on the effectiveness of xenograft to prevent periodontal defects after mandibular third molar extraction

“…In the context of periodontal regeneration therapy, bone substitutes such as autologous bone, allografts, xenografts or alloplastic grafts and occlusive membranes have been broadly studied ( 10 , 11 ). Each material is associated with some advantages and disadvantages, so their selection should depend on the clinical scenario, as well as, the preferences of the clinician and the patient ( 12 ).…”