Alveolar cleft grafting is a surgical procedure, used to repair the defect in the upper jaw that is associated with cleft lip and palate, where the bone defect is filled with bone or bone substitute, and any holes between the mouth and the nose are closed. An alveolar cleft is a failure of the premaxilla to fuse with the upper jaw leaving a defect in the bone. It is common in people with cleft palate and is also associated with holes between the mouth and the nose that affects speech, and allows fluid to move into the nose when eating and drinking.