ABSTRACT
Repair of the alveolar cleft with bone is an important procedure for children with congenital clefts of the embryological primary palate. The technique was developed and popularised in the 1970s and remains an essential component of the treatment pathway. The alveolar cleft can be considered as an inverted four-sided pyramid with labiobuccal, medial, distal, palatal and nasal floor aspects. While the medial and distal margins of the defect are provided by the alveolar segments, the labiobuccal, palatal and superior margins are often incomplete or discontinuous and require soft tissue repair. To facilitate future tooth eruption, the alveolar soft tissue is repaired preferably with keratinised mucosa. Secondary alveolar bone grafting is usually carried out before eruption of the ipsilateral permanent canine tooth. If required, cleft lip revision can be combined with alveolar bone grafting in unilateral cases.
