Alveolar Bone Grafting
What is alveolar bone grafting?
A child with a cleft palate may need surgery
after the first cleft palate repair to replace
missing bone in the front and the roof of the
mouth. The alveolus is the bony part of the
upper jaw and lower jaw that contains the
teeth. Placing bone in this area is called
alveolar cleft bone grafting. This involves
taking a small amount of bone from one
place (most often the hip) and placing it in
the area of the cleft near the teeth. This
gives the teeth, which may not have come in
yet, a stable support to come through. There
is also added support and an improved
contour if a bridge is needed to fill in
The best results of alveolar bone grafting are
done by widening the upper jaw before the
graft is placed. This most often makes the
hole bigger, but gives better access for the
surgeon. The widening of the upper jaw is
most often done using fixed orthodontic
braces or a palate expander. Most often this
brace is a quadhelix. These are used for
about 6-9 months before bone grafting.
What to expect after surgery
ξ There will be stitches (sutures) on the
inside of your child’s mouth. You will
not be able to see them from the outside.
ξ You can expect swelling of the lips and
cheeks and maybe some bruising. This
is normal. Most of the swelling should
go away over the first 7 to 14 days.
ξ Most often, your child will be in the
hospital overnight. This will depend on
your child’s recovery.
ξ By the time your child is ready to go
home, pain should be controlled with
pain pills such as Tylenol with codeine
or Tylenol alone.
ξ For the first 7-10 days, the site from
which the bone was taken will be sore.
Your child shouldn’t do any hard
ξ The mouth should be kept very clean
during the first 10 to 14 days to make
sure the results are good. Careful tooth
brushing with a baby toothbrush and
washing the mouth often with a special
mouthwash are needed. This
mouthwash may be prescribed. It should
be used after eating and before going to
bed. You also may use saltwater as a
mouth rinse. Good oral hygiene is vital
after the bone grafting. When the bone
is moved into the cleft it has to build a
new blood supply. During this time, it is
at risk for infection.
ξ Your child will be placed on antibiotics
during and after surgery to prevent
ξ Your child will be on a soft diet for a
ξ After eating, rinse the inside of the
mouth out with water or mouthwash.
ξ Do not use straws or eat foods served on
The Healing Process
ξ It is very important that you practice
good oral hygiene while healing.
ξ This phase will begin about 4 to 8 weeks
ξ Your child’s orthodontist will be able to
make minor changes to ensure that your
child’s new bite and teeth are aligned. It
most often takes 3 to 12 months before
your child’s orthodontic appliances are
Your child will have a clinic visit about 1
week after going home.
When to Call the Doctor
If you have any questions or concerns about
your child or if your child has:
ξ Bleeding from the incision
ξ Signs of infection which may include,
increased warmth, swelling, and redness
at the incision site or pus-like drainage
ξ Temperature greater than 101.5 θ F for
two readings taken 4 hours apart
ξ Severe or increasing pain not relieved by
medicine and rest.
ξ Vomiting that doesn’t stop
AFCH Pediatric Specialty Clinic, weekdays,
8 am to 5 pm (608) 263-6420 option 4
After hours, weekends and holidays, the
clinic number is answered by the paging
operator. Ask for the plastic surgery
resident on call. Leave your name and
phone number with the area code. The
doctor will call you back.
If you live out of the area, call toll-free 1-
Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright © 11/2017 University of Wisconsin Hospitals
and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#6027