The orthodontist's role in the management of patients with cleft lip and palate undergoing alveolar bone grafting

Alveolar bone grafting (ABG) represents a major event in the treatment of patients with cleft lip and palate. ABG can provide stability to the maxillary arch thus preventing future collapse of the alveolar segments, provide adequate bone for the periodontal health and support of the teeth adjacent to the cleft, improve nasal esthetics by normalizing the piriform rim anatomy, allow for closure of nasolabial fistulas, and improve some speech parameters such as nasal air emission. It is critical for an orthodontist to understand the pertinent considerations surrounding ABG as well as how orthodontic treatment before and after the ABG can impact the overall result of the ABG. This review article provides historical background on ABG and reviews important considerations such as the timing of ABG, pregraft orthodontic treatment, the use of postoperative splints, and the evaluation of ABG results.