Work

Bone graft preferences and cognitive dissonance in patient counselling: a cross-sectional survey of clinicians

Year: 2026

Type: article

Abstract: BACKGROUND: To evaluate clinicians' preferences for bone graft materials and to investigate the presence of cognitive dissonance in their counselling practices during informed consent. METHODS: This cross-sectional survey of dental consultants in Pakistan assessed ranked preferences for five bone graft materials (autograft intraoral/extraoral, allograft, xenograft, and alloplast) and their influencing factors. Cognitive dissonance in counselling practice was quantified as the discrepancy between clinicians' stated beliefs and reported behaviours using an adapted discrepancy index (D = B - A) across four clinical scenarios. Statistical analyses included Friedman, Kruskal-Wallis, and Wilcoxon signed-rank tests with Bonferroni correction (p < 0.0125). RESULTS: Autologous bone grafts were most preferred, primarily due to superior integration, whereas alloplasts were least preferred due to concerns regarding failure and future complications. Preferences were consistent across specialties and experience levels. While clinicians reported high importance for all counselling domains, significant belief-behaviour discrepancies were observed in providing written information, discussing treatment costs, and incorporating patient preferences (p < 0.001). No significant discrepancy was noted in disclosing graft sources. CONCLUSIONS: Clinicians consistently prefer autologous bone grafts, aligning with evidence. However, they demonstrate belief-behavior discrepancies indicative of cognitive dissonance in key aspects of patient counselling, potentially undermining informed consent and patient autonomy. Structured consent protocols and targeted training are needed to align clinical behaviours with ethical intentions.

Source: BMC Oral Health

DOI: 10.1186/s12903-026-09526-6

Authors: Ahsan Khawaja, Nighat Naved, Zara Pervaiz, Fahad Umer

Institutions: Aga Khan University Hospital, Aga Khan University

Language: English

Topic: Ethics and bioethics in healthcare

Subfield: Public Health, Environmental and Occupational Health

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,190