Current Concepts in Alveolar Cleft Bone Grafting

• Published in: Current surgery reports (Philadelphia, PA) Vol. 13; no. 1
• Main Authors: Haviland, Catherine, Carver, Karen
• Format: Journal Article
• Language: English
• Published: New York Springer US 08.08.2025
• Subjects: Medicine; Medicine & Public Health; Surgery; Cleft; Alveolus; Palate; BMP; Bone graft; Iliac crest
• ISSN: 2167-4817; 2167-4817
• DOI: 10.1007/s40137-025-00464-w

Purpose of Review Successful longitudinal management of the alveolar cleft and dentition in patients with cleft lip and/or palate is an important component of comprehensive care. This review explores current advancements in alveolar cleft grafting including novel graft materials, perioperative optimization including surgical and radiographic evaluation, ideal graft timing, and pain control techniques. Recent Findings In the search for iliac crest bone graft (ICBG) alternatives, bone morphogenetic proteins such as BMP-2 currently have the most data available to support use in the pediatric population. Three dimensional imaging continues to evolve in regards to graft evaluation, and well-defined criteria for categorizing graft quality with use of 3D imaging is essential to future research on the subject. With regards to clinical procedures, additional evidence to support predictors of a successful bone graft, in addition to those already known, will help to optimize surgical outcomes. The use of a multimodal pain strategy which may incorporate suprazygomatic or other regional blocks, and liposomal bupivacaine is an important mechanism to improve recovery after ICBG surgery. Summary A successful alveolar cleft graft has a significant impact on quality of life. Although many advancements have been made, there is much work to be done moving forward with a focus on long-term follow-up, development of criteria for the use of standardized assessments and clinical biomaterials, and robust research techniques. Alveolar cleft grafting is an area of active research with many promising advancements.