Multicenter study of patients’ preferences and concerns regarding the origin of bone grafts utilized in dentistry
Received 7 September 2018
Accepted for publication 8 November 2018
Published 18 January 2019 Volume 2019:13 Pages 179—185
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 3
Editor who approved publication: Dr Johnny Chen
Cristina Bucchi,1,2 Massimo del Fabbro,3,4 Alain Arias,2 Ramón Fuentes,2 José Manuel Mendes,5 Marie Ordonneau,6 Valérie Orti,7 María-Cristina Manzanares-Céspedes6
1PhD Program in Medicine and Translational Research, Universitat de Barcelona, Barcelona, Spain; 2Department of Integral Adults Dentistry, Research Centre for Dental Sciences (CICO), Dental School, Universidad de La Frontera, Temuco, Chile; 3Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy; 4IRCCS Orthopedic Institute Galeazzi, Milan, Italy; 5CESPU, IINFACTS, Institute of Research and Advanced Training in Health Sciences and Technologies, Department of Dental Sciences, Portugal; 6Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain; 7Department of Periodontology, Dental School, University of Montpellier, Montpellier, France
Purpose: Bone 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 methods: A 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.
Results: Three 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.
Conclusion: The origin of bone grafts is still conflictive for a high percentage of patients.
Keywords: survey, patient’s concerns, bone graft materials, animal products, tissue donation
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