Annals of Maxillofacial Surgery

: 2019  |  Volume : 9  |  Issue : 1  |  Page : 1--2

The neglected aspect of applied biomaterials in medicine!

Mahdi Ebrahimi 
 Department of Prosthodontics, Prince Philip Dental Hospital, The University of Hong Kong, Hong Kong

Correspondence Address:
Mahdi Ebrahimi
Department of Prosthodontics, Prince Philip Dental Hospital, The University of Hong Kong
Hong Kong

How to cite this article:
Ebrahimi M. The neglected aspect of applied biomaterials in medicine!.Ann Maxillofac Surg 2019;9:1-2

How to cite this URL:
Ebrahimi M. The neglected aspect of applied biomaterials in medicine!. Ann Maxillofac Surg [serial online] 2019 [cited 2020 Dec 2 ];9:1-2
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Currently, there are large numbers of commercial biomaterials that are being applied or consumed for therapeutic, regenerative, preventive, or cosmetic purposes in different fields of medicine, i.e., oncology, plastic surgery, orthopedic, craniofacial, and maxillofacial surgery, traumatology, and dentistry. These biomaterials fall into different categories based on their nature and purpose of the application. The criteria for selection and application of these biomaterials are almost well defined being dependent on patient factors (i.e., age, sex, economic status, and defect/disease type) and biomaterial properties (i.e., chemical nature, bioactivity, availability, and cost).[1] However, as the patient understanding of diseases and the available treatment options are increasing, this is the time to shed the light on one of the most ignored aspects of biomaterial application which relates to the fact of the possible conflict between biomaterial nature and patient religious background.

This issue has been well addressed among different faiths including Islam, Hinduism, and Judaism when considering the religious guidelines for consumed food products. All of these religious groups apply their own teachings for the permissible type of consumed food. For example, according to Islamic teaching, the products of food consumed, used, or applied should be “halal.” The word “halal” is an Arabic word meaning lawful and permissible according to Islamic guidelines. In another word, it should be pure, clean, wholesome, and nourishing without known health hazards. The “non-halal” food or by-products have been clearly defined in Islam.[2] Similarly, the followers of the Hinduism have their own regulation concerning consuming food or products. Hindu strictly adheres to “Sattva” as a guideline where all kind of animal derivatives should be avoided. As such, they solely consume vegetarian or lacto-vegetarian kind of food.[3] The Jewish law of “kashrut” also refers to their dietary guidelines and restrictions. The word “kashrut” is a Hebrew word which literally means “fit” or “proper” to eat according to the Torah law. Hence, the word “kosher” explains the food that meets the standards of kashrut that are prepared in accordance with Jewish law. Examples of these dietary guidelines include: the prohibition of what is considered “unclean” animals (pigs, shellfish, rabbits, and reptiles) and the mixing of meat (the flesh of birds and mammals) and dairy.[4]

Considering the impact of religious teachings and restrictions on the type of the consumed food, the idea of halal, kosher, and vegetarian certification with production oversight was introduced to help consumers find the required food with the aid of trademarked symbols. However, when the type of applied biomaterials in medicine is considered, the issue of “permissible” biomaterials according to religious guidelines is entirely neglected. Furthermore, the complexity of the modern science and genetic engineering has challenged the follower of these religions, as such the continuous interpretation of the religious regulations is unavoidable.

Unfortunately, the availability of non-halal, non-sattvic, and non-kosher biomaterials in the pharmaceutical and health-care system has been largely neglected, and there are no well-known criteria among responsible bodies to address this issue.[5] India, Israel, and Indonesia being examples of countries with the huge population of religious groups are importing thousands of biomaterials that in fact have not been screened for their suitability according to their religious guidelines. This would raise a serious issue of medical ethics and the patient right of informed consent. The patient has the right to be informed by treating physician about his treatment plan, the possible health risk factors, and the success or failure rate of the treatment. Similarly, the patient has to be informed about the nature of applied or prescribed medicine or biomaterials and the possible conflict with his faith. There is an urgent need to create such awareness among health-care professionals, consumers, and patients.

Therefore, to address this issue correctly, the health-care provider should bear the main responsibility in understanding the exact nature of applied biomaterials in practice. This is to identify the possible conflict between patient faiths as part of the responsibility to share this knowledge with the patient to avoid medicolegal consequence. However, today with the huge advancements in biomedical technologies, the study of the available biomaterials from the perspective of patient faith may be a challenging task.

As such, huge responsibility is also toward national and international agencies, industries, universities, the related governmental sectors, institutes and certification bodies, organizations, and social media for setting the required criteria and policies regarding proper marketing, labeling, and monitoring of biomaterials according to the patient religious background.


1Ebrahimi M. Bone grafting substitutes in dentistry: General criteria for proper selection and successful application. IOSR J Dent Med Sci 2017;16:75-9.
2Quadri SF, Majeed M, Khan M. What Is In Our Food? Is it Permissible? 2009. Available from: [Last accessed on 2019 May 06].
3Khandelwal MS. Becoming American, Being Indian: An Immigrant Community in New York City. Ithaca: Cornell University Press, 2002. ISBN: 9780801488078.
4Blech ZY. Kosher Food Production. Oxford, UK: Wiley-Blackwell; 2009.
5Ebrahimi M. Biomaterials application in therapeutic and regenerative medicine from the perspective of patients' faith. Biomed J Sci Tech Res 2018;8:1-3.