At approximately what age is secondary ALVEOLAR BONE GRAFTING performed in a patient with a cleft of the lip and alveolus?

Correct answer: C. 8 to 10 years

• A. Around 3 months is the timing for LIP repair (the rule of tens).
• B. 12–18 months is the timing for PALATE repair, done before major speech development.
• C. Correct. Secondary ALVEOLAR BONE GRAFTING is performed at roughly AGE 8–10, timed to the stage when the permanent CANINE root is one half to two thirds formed but has not yet erupted. Grafting at this point allows the canine to erupt into grafted bone, provides bony support for the alar base, closes any residual oro-nasal fistula, and stabilises the maxillary arch. Cancellous bone from the iliac crest is the usual donor site.
• D. By 16–18 the canine has long since erupted and the graft opportunity is lost; this is the age for orthognathic surgery if needed.