Alveolar clefts bone grafting: on the issue of modern treatment paradigm

Relevance. One of the most common birth defects is congenital cleft lip, palate and alveolar ridge. Modern aspects of surgical correction of alveolar clefts are discussed in this literature review. Approaches to performing this operation have changed significantly over time. A unified concept does not exist to this day due to the fact that the intervention can affect the growth of the upper jaw, and the fact that approaches used in pediatric surgery may not be effective in adult patients. The choice of osteoplastic materials also remains a very pressing issue, since the results of using these materials for other pathologies vary. The aim of the study is to systematize data on osteoplastic surgeries for alveolar clefts in patients of different ages and analyze of published scientific works. Materials and Methods. The authors analyzed scientific data in the search engines PubMed, Google Scholar and eLibrary. Scientific literature published from 1901 to 2024 was analyzed. Results and Discussion. At the moment, most authors are inclined to perform the operation during the period of early mixed dentition in the presence of a lateral incisor rudiment, or late mixed dentition (before the eruption of the canine) in its absence. Performing surgery in adult patients is associated with a greater degree of graft resorption and additional difficulties. Among osteoplastic materials, preference is given to autologous bone. The most popular remains an avascular autograft from the iliac crest region. Attempts are being made to avoid the use of autologous materials and to reduce its quantity in order to reduce donor morbidity. In complex cases, it may be necessary to use techniques using revascularized autografts or prosthetics. Great importance is attached to the orthodontic preparedness of patients. Conclusion. The approach to patients with alveolar cleft should be differentiated. It is important to take into account the patient’s age, somatic and dental status to select the most correct management tactics.