What Is Alveolar Bone Graft Surgery?

What Is Alveolar Bone Graft Surgery?

If your child's cleft lip extends into their gum line, one of the surgeries they will need is called an alveolar bone graft.

For children with cleft lip, orthodontists normally move your child's gum line by using palate expansion devices. But depending on how your child's face grows, your child's gum line (also known as the alveolar ridge) may not need to be moved.

After your child's dentist and orthodontist make sure your child's gum lines are in the correct place, most children will need bone grafts on their gum line. Bone grafts allow your child’s teeth to move into the correct location.

During a bone graft surgery, surgeons also close the hole between your child's mouth and nose.


Where Does Bone in Bone Grafts Come From?

Some patients need bone harvested from their hip for a bone graft procedure. But harvesting bone from your child’s hip can be painful. It also makes your child's recovery longer.

Children often need to limit their physical activity for one to two months after a hip graft.

Easier Bone Grafts With Synthetic Bone Products


Fortunately, in many cases we can use a synthetic product like bone morphogenic protein to stimulate your child's body to create their own bone. Doctors often use this product with a synthetic bone substitute. This new product helps children avoid difficulties of recovering from a hip bone graft. 

Using a synthetic bone product has many benefits. Surgeons have used it for years and it has excellent results.

But there are also some theoretic risks. These are possible risks surgeons worry may happen even though they haven't happened in patients. Your surgeon can discuss potential risks with you.


When the protein stimulates your child's body to produce more bone, it may also cause swelling. This swelling may last longer than the usual swelling after surgery. 

If your child's upper lip swells, it won't cause breathing problems, but swelling can make your child uncomfortable. Your pediatric facial plastic & ENT surgeon can discuss the other risks and benefits with your family to help decide which treatment is right for your child.

Hip Grafts

Children who have had failed bone grafts in the past or other problems may benefit from a hip graft. During a hip graft, surgeons take a small amount of bone from your child's hip or iliac crest.

A hip graft may improve the chances that the procedure will be successful.

If your child needs a hip graft, your surgeon will talk with you about any risks.

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Will A Bone Graft Help My Child's Teeth Grow?

Sometimes the new bone in your child's gum line doesn't stay strong long enough for their teeth to erupt—or poke through—the gum line. In normal mouths, the force of teeth helps keep jaw bones strong. But if your child's teeth erupt through the new bone, your child's bone may dissolve over time.

If this happens to your child, our surgeons can help you understand how to correct the problem.

What To Expect

  • Younger children usually stay in the hospital overnight so our staff can make sure they are not in too much pain. Older children who have an alveolar bone graft without hip bone harvest usually go home the evening of surgery.
  • The sutures (or stitches) above your child’s gum line will dissolve on their own. They do not need to be removed.
  • Your child will use an antiseptic mouth wash for a week. This will help your child prevent infection.
  • Your child will take an oral antibiotic. The antibiotic will prevent an infection from developing in the graft. This will also help ensure your child’s immune system accepts the new graft.
  • If you and your surgeon decide on the synthetic product (called bone morphogenic protein), your child's upper lip and middle of their face will slowly swell over one to two weeks. This swelling happens because of how the protein stimulates bone growth. Swelling might make your child uncomfortable.
  • We will give your child pain medication. Our staff will closely monitor and adjust the amount of pain medication to make sure your child is not in too much pain.
  • We will closely monitor your child to make sure they can breathe easily. We will also watch how much they are eating and drinking.
  • Depending on your child’s age, they may wear arm straighteners. These will prevent your child from accidentally hurting themselves while they are healing.

Our nursing staff cares for many children who have cleft lip and palate surgeries. Our staff will provide you with tips as well as compassionate care after your child’s surgery.

Common Questions

Are there restrictions on how my child can eat and drink?

We don’t put restrictions on how your child eats or drinks after surgery. Most children heal well. Restricting how your child eats or drinks will not make them heal faster.

Will my child be able to eat and drink after their surgery?

Most children do well eating and drinking after jaw surgery. Your child’s jaw will be sore. Eating hard foods can sometimes make this worse.

Will my child have breathing problems after jaw surgery?

We will monitor your child closely for breathing problems after jaw surgery. But it is uncommon for your child to have a problem. 

Will my child's teeth be numb after surgery?

Some children will have temporary numbness in their upper teeth after surgery. But any numbness should not last long.

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