Cleft Lip and Palate Clinic

Alveolar Bone Graft

The Surgery

An alveolar bone graft is usually performed at 8-10 years of age prior to the eruption of the permanent canine tooth. The first part of the surgery is harvesting the bone, usually from the hip. The hip incision is then closed with dissolvable sutures and covered with white steri strips. The second part of the surgery is opening the gum line surrounding the cleft. The surgeon places the collected bone into the gap in the alveolar ridge and all the oral incisions, are again closed with dissolvable sutures.

What to Expect Immediately Following Surgery

Your child will be admitted to the hospital for 1-2 days following surgery for pain control, to monitor fluid intake and to observe for problems. It is expected that your child will have some pain related to the surgery, but the pain should improve over the following 2-3 days. Your child may complain of a dull pain of the hip. Some surgeons place a small tube at the site of the hip incision to deliver local pain medicine. The tube is removed after a few days. Most pain is usually controlled with oral pain medications. It is common for the oral incisions to bleed some or cause some blood-tinged saliva for the first day after surgery. Facial swelling is also to be expected. Your child will be on a liquid diet immediately after surgery. Appropriate fluid intake is important to prevent dehydration. Your child may not want to drink immediately after surgery, but this should improve over a few days.

What to Expect in the Weeks Following Surgery

The sutures in the mouth will dissolve over a couple of weeks. During this time the body will continue to create new bone in the graft. Follow up dental x-rays with the orthodontist 3 months after surgery will determine if the bone graft was successful.

Once You Go Home

  • Activity: Light activity for 2 weeks. Avoid anything hard or sharp in the mouth. Small children may need to wear arm braces to prevent them from putting their hands or objects in their mouths.
  • Diet: Your child will be on a modified diet for 3-6 weeks following surgery (all liquid diet for 1-2 weeks, then soft food).
    • For young children, sippy cups are preferred over bottles. Rinse mouth with water after eating.
  • Pain: Tylenol or prescription pain medication may be taken for discomfort.
  • Bathing: Your child may shower after the outer hip dressing removed. Do not immerse the hip incision in water for 2 weeks, so no baths or swimming.

When to Call Your Doctor

  • Fever or chills
  • Worsening pain or discomfort
  • Breakdown or opening of the mouth or hip incisions
  • Heavy bleeding from the mouth or hip
  • Redness or drainage of pus from the incision
  • Inability to tolerate drinking fluids