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Autologous bone grafting has been considered the standard method for reconstruction of cleft maxillary alveolus.1 Secondary alveolar cleft repair with autologous bone grafting promotes reestablishment of dental arch continuity, stabiliza-tion of maxillary complex, and prevention of max-illary arch collapse after presurgical orthopedic maxilla expansion.1 However, donor-site morbidity remains a drawback1 that has driven development of new strategies, such as recombinant human bone morphogenetic protein (rhBMP)-2 based thera-py.2–12 Maxillary alveolar repair with rhBMP-2 in cleft patients immediately before cuspid or lateral inci-sor root descend seems to be a promising therapy, allowing tooth eruption and orthodontic movement, Copyright © 2015 The Authors. Published by Wolter