Why Is It Done?
Children born with a Cleft Lip and Palate usually have a defect in the upper jaw bone (maxilla) in the area that will later hold the canine tooth. Alveolar Bone Grafting fills this gap and gives the canine tooth bone to grow into.
When Is It Done?
Usually between 7 and 11 years of age — more precisely, when the canine tooth starts to erupt. Done too early, the graft is absorbed before the tooth arrives; done too late, the tooth has no support and can be lost. Your surgeon and orthodontist decide the timing by monitoring jaw growth. Some orthodontic treatment (braces) is needed before and after the operation.
Tests Before Surgery
A cone beam CT scan may be done to measure the size of the defect.
What the Surgery Involves
Your child is seen by the paediatric anaesthetist before surgery and admitted on the day of the operation, which takes about 60–90 minutes under general anaesthesia.
The gap is filled with cancellous and cortical bone taken from the hip (iliac crest), and the wound is closed with absorbable stitches. A small drain may be placed in the hip and removed after a couple of days. Children usually go home after about 2 days.
After Surgery
- Mild oozing of blood from the mouth is normal.
- Soft diet for 3 weeks, with regular mouthwashes to keep the mouth clean.
- Wound check after 1 week; the stitches are absorbable.
- Once healed, orthodontic treatment continues to shape the upper dental arch.
Possible Complications
Infection, bleeding, swelling and pain are the common complications. Pain in hospital is managed by the acute pain service team; the hip is usually more sore than the mouth, and a simple painkiller is generally enough at home. Very rarely the wound can come apart and the graft may have to be repeated later.
Frequently Asked Questions
At what age is Alveolar Bone Grafting done?
Usually between 7 and 11 years, when the canine tooth starts to erupt. Your surgeon and orthodontist time it by monitoring jaw growth.
Will my child need braces?
Yes — some orthodontic treatment before and after the operation, and more once healed to shape the upper dental arch.
Which hurts more, the hip or the mouth?
Usually the hip. A simple painkiller is generally enough after discharge.
Related Cleft Lip and Palate Procedures
- Cleft Lip Repair — Lip repair at 3–6 months: the operation, feeding and scar care.
- Cleft Palate Repair — Palate repair at 9–12 months, with speech and hearing follow-up.
- Speech Surgery — For nasal speech that persists after therapy, usually from age 5–6.
- Jaw Surgery After Cleft — Le Fort I or Double-Jaw Surgery after 16 for a flat midface and underbite.
- Cleft Rhinoplasty — Nose and septum correction after 18 — usually the last cleft operation.
This page is general information written by Dr Vybhav Deraje for patients and families. It does not replace an individual consultation; treatment depends on clinical assessment.