We have found that this is the main reason for children to have to spend more than one night in hospital. Using a trephine or tube to harvest the bone causes fewer problems. We have also opted for taking the bone from the shin bone below the knee. We have found far fewer complications for the children both at the site of the graft and also in terms of pain and time in hospital. Virtually all go home the next morning.
Complications are rare and minor.
This phase of the treatment requires a lot of patience. During this time orthodontic treatment may continue to align the teeth, but full braces cannot be placed until all the permanent teeth have erupted into the mouth. In the US there is a tendency to operate a little younger and indeed British surgeons may choose this option as there may be some benefits. There are promising developments using special growth factors to make new bone without the need for bone grafts. This has been done in animals and in some non-cleft situations.