Alveolar Cleft Repair

An Alveolar Cleft is an opening in the bone of the upper jaw that results from a developmental defect and is present at birth. This area of the jaw that is missing bone is otherwise covered by normal mucosa and may contain teeth. The absence of bone in this area results in an incomplete nasal floor thereby affecting the normal support and function of the nose. Food and liquids can easily leak into the nasal cavity as a result. If this is defect of the jaw is not repaired, patients are subject to severe rhinitis (inflammation of the lining of the nose causing pain, irritation, and constant drainage) among a number of other complications. Often these clefts require repair of the nasal floor and restoration of the dental arch by way of a bone graft around 6 years of age. Placement of bone in the area of the cleft at an early age ensures appropriate healing which is essential for the eruption and maintenance of the permanent teeth as well as normal nasal function. An alveolar cleft bone graft is basically the repair of the cleft within the gingiva (gums) with placement of bone from the patients’ own hip (iliac crest). The graft is obtained through a small incision near the hip bone. The bone is then packed into the cleft area in the mouth as well as the floor of the nose and gingiva. The incision is then closed with sutures and allowed to heal for several of months. Any unerupted teeth within the cleft are anticipated to erupt into the dental arch and normal nasal function is expected if the graft is successful. Dr Tien and Dr. Rothenberg have extensive knowledge and experience in repairing alveolar clefts with traditional bone grafts and alternatively with special bone proteins (BMP). Obtaining copies of adequate radiographs and pictures from your orthodontist will allow Dr. Tien and Dr. Rothenberg to create a complete treatment plan to repair the cleft defect.