Surgical technique for primary alveolar bone grafting.

Bone grafting of the alveolar cleft is an important component of the comprehensive care of the cleft lip and palate patient. Although debate exists regarding the optimal timing of the procedure, one approach is the placement of a rib graft in the alveolar cleft before eruption of the deciduous canine (primary alveolar bone graft). Since 1982, primary alveolar bone grafting has been performed at our institution in more than 300 patients. Because little is reported in the literature on primary alveolar bone grafting in general, an experienced surgical technique and protocol are lacking. Our surgical technique for rib graft harvest as well as alveolar bone graft placement in the infant cleft alveolus is described.