Alveolar bone grafting: CLP series part 7

Clefts of the lip and palate also affect the alveolar area, resulting in a bony defect or gap within the lateral incisor and canine tooth region of the maxilla. The alveolar cleft may be complete or incomplete, unilateral or bilateral and, in keeping with unilateral cleft lip and palate, is twice as common on the left side as the right. Clefts involving the alveolus have significant effects on the dentition, affecting tooth development and eruption (Figures 1a and b). Bone grafting of the cleft alveolus is required in order to allow the eruption of the permanent canine tooth (and occasionally the lateral incisor) within the cleft site and to provide adequate bony support for the long-term health of the adjacent teeth. Good bone support also allows optimal orthodontic treatment within the upper arch. An oro-nasal fistula or communication may also exist within the cleft alveolus which, if symptomatic, can allow escape of foods or fluids from the mouth to the nose. Successful bone grafting will repair the fistula and close any abnormal communication.