The Alveolar Cleft Bone Graft surgery is usually performed between the ages of 6-12 years of age. The exact timing is determined secondary to expected tooth eruption. After the cleft lip and cleft palate are repaired, it is normal for there to be a small fistula (or hole) in the area of the teeth between the nose and the mouth. This area is not repaired until the bone graft if performed. This surgery used to always require that bone be taken from the child’s hip and placed in the area where the teeth will come in. However, now we no longer need to do this because equivalent results are obtained using a combination of cadaver bone and rhBMP (bone morphogenetic protein). The cadaver bone acts as a scaffold and the rhBMP encourages the bodies own stem cells to turn into bone cells and produce bone in the area where the cleft previously was present.