Surgery
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Alveolar Bone Fraft for Adults
When?
Between 8 and 10 years old.
Why?
Not all children need this operation. Children with a cleft lip can have a gap in their gum (alveolus). This gap needs filling with bone so their teeth can grow in and stay firmly in the right place.
How?
Your child will be asleep throughout the operation. We use spare bone from their hip (called the iliac crest) and make small cuts in their gums to place the bone into the gap in the upper jaw. If your child needs any teeth removed, this is usually done on the same day.
What Will Happen?
- Braces: Your child may need braces before their operation. These are usually worn for 6 to 12 months beforehand and are fitted by our cleft orthodontists.
- Toothbrushing: It is very important your child brushes their teeth twice a day before the operation. We will give you special tablets, called disclosing tablets, for your child to chew. These show areas of plaque (build-up on teeth) that still need brushing. Use these for 2 weeks before the operation.
- We will tell you exactly when your child should stop eating and drinking, depending on the time of their operation.
- Come to ward 76 if your operation is in Manchester, or [insert location] if your operation is at Alder Hey.
Some children stay one night in hospital after their operation. Others go home the same day. Your team will tell you the plan for you.
Aftercare
Eating soft food is important after an alveolar bone graft. You can find more advice on what counts as soft food here.
We advise that your child avoids PE, sports, and swimming for 4 weeks.
We provide painkillers (medicine to help with pain) to keep your child comfortable when they go home.
Brushing with a soft brush should start 1 day after the operation. This will not undo the stitches. We will ask you to use the disclosing tablets again, starting 1 week after the operation, until the stitches dissolve.
You can get the plaster on your child's hip wet 5 days after the operation. You do not need to put on a new one.
What Are the Risks?
Signs of infection (germs getting into the wound) include a high temperature, being sick, not feeding well, bleeding, or bad-smelling liquid from the wound. We can usually treat this with antibiotics (medicine that fights infection). We also give antibiotics during the operation to help stop this happening.
A little blood in saliva or coming from the nose is normal. In rare cases, there is fresh bleeding from the wound. If this does not stop within 10 minutes, bring your child to A&E (Accident and Emergency).
We want adult teeth to grow through the new bone, but sometimes they do not grow in correctly and need braces to adjust them.
Resorption means some of the new bone dissolves, which gives the teeth a weaker foundation to grow into.