Introduction
MPM, alveolar cleft bone volume, alveolar cleft repair, alveolar cleft, palate, Alveolar cleft, cleft lip, cleft teeth
SECONDARY, CREST, ERUPTION
Alveolar cleft grafting is one of the critical steps in the management of patients with cleft lip and palate. Since the twentieth century Boyne and Sands described the most common and currently utilized technique for alveolar cleft grafting. Boyne (1970) presented the concept of secondary alveolar bone grafting (SABG) which recommend the mixed dentition phase to be the preferred period of alveolar cleft grafting. Since then, several modifications for alveolar cleft grafting techniques were introduced in the literature. The main objectives of the introduced grafting techniques are gaining stability and continuity of the maxillary arch, closing of the oronasal fistula/e, preserving healthy periodontal support for the teeth adjacent to the cleft, labial and alar base support, and building the bony foundation for future implantation or eruption of the cleft teeth [Bone grafting materials for alveolar cleft repair remain controversial. Different bone grafting materials were utilized including autogenic, allogenic, xenogenic, and alloplastic bone. Nevertheless, the autogenic bone remains the standard grafting material. Several donor sites for autogenic bone harvesting in alveolar cleft repair have been reported, e.g., mandibular symphysis, rib, cortical plate of cranium, tibia, and anterior and posterior iliac crest [Many studies were published confirming the success of the gold standard techniqueMany studies that evaluated the changes in the alveolar cleft bone volume and/or labio-palatal bone width after secondary alveolar cleft grafting using cancellous bone from the anterior iliac crest found that the graft volume and/or labio-palatal width overtime was not stable and was subjected to severe reduction in the total bone volume, height, and labio-palatal width [Different levels of the clefted maxillary segments create differences in the cleft gap width and height that hinder the proper reconstruction of the bony defect. Achievement of bone grafts of proper form and adequate stability over time remains one of the main problems. Many efforts to optimize the conformation and post-grafting results of bone derived from the anterior iliac crest have been utilized, e.g., adding barrier membranes and meshes, using a cortical piece/s of bone from the ilium either by using it as a ceiling or labio-palatal walls for the cleft gap to support the cancellous graft in between or the use of the moldable mineralized plasmatic matrix [In addition to the moldability of the blood derived bone promoting products, for example, PRP (platelet-rich plasma), PRF (platelet-rich fibrin), and bone morphogenic protein (BMP), they are able to optimize the processes of osteogenesis, osteoinduction, and osteoconduction which are crucial for successful outcomes. Based on our experience with PRP and PRF, Mazzoni and Périssé developed MPM. MPM, containing liquid autologous platelets and fibrin concentrate, can bind to bone particles [