Surgical techniques for secondary alveolar bone grafting

Secondary alveolar bone grafting is now a standard procedure for closure of alveolar clefts. In this paper we describe the details of the techniques we have successfully employed in secondary alveolar bone grafting. Our approach and surgical techniques are summarized as follows: 1. In order to preserve the attached gingiva, no attempt is made to close the alveolar cleft during either the lip or palatal repair. 2. Bone grafting is done prior to the eruption of either the cleft side lateral or medial incisor. 3. Cancellous bone is harvested from the ilium using the conventional open method. 4. An inferior turbinectomy is sometimes required to elevate the nasal floor. 5. Use of a gingival mucoperiosteal flap is essential to ensure proper coverage of the bone graft.