BONE HEALING AND OPERATIVE MORBIDITY IN SECONDARY ALVEOLAR BONE GRAFTING FOR CLEFT LIP AND PALATE: SYNTHETIC MATRICES VERSUS ILIAC CREST

Abstract

Objective: To analyze the clinical, surgical and orthodontic outcomes of secondary alveolar bone grafting (EOAS) in the treatment of patients with cleft lip and palate (CLP). Methodology: A systematic review of the literature was carried out based on the PRISMA guidelines, covering studies published in the PubMed/MEDLINE, Web of Science, Scopus and SciELO databases between the years 2025 and 2026. The search used controlled descriptors and free terms combined by Boolean operators. Clinical trials, cohort studies, systematic reviews and scoping reviews focused on volumetric assessment by cone beam computed tomography (CBCT), biomaterials, surgical techniques, ERAS protocols, photobiomodulation and orthodontic repercussions were included. Studies with insufficient samples, duplicates and isolated case reports were excluded. The selection followed screening by title, abstract and reading in full by two independent reviewers. Results and Discussion: The use of CBCT confirmed the effectiveness of EOAS in bone integration, with volumetric variations influenced by surgical timing, stage of eruption of the permanent canine and choice of biomaterials. Synthetic biomaterials and bioengineering have demonstrated a success rate comparable to autologous bone, reducing donor site morbidity. ERAS and photobiomodulation protocols accelerated recovery and reduced postoperative pain. Conclusion: EOAS is consolidated as a fundamental procedure, being optimized by modern biomaterials and digital planning.