Approximately three quarters of the patients with cleft lip and palate present with alveolar clefts (Guo et al., 2011). Because of the osseous defect, non-prosthodontic dental rehabilitation becomes impractical, and a prosthetic bridge is required to fill the void and treat the fragility of the upper jaw segments, notably the premaxilla in bilateral clefts. Inadequate alar base support further adds to nasal asymmetry (Bajaj et al., 2003). From the latter part of the twentieth century, bone grafting and surgical closure have been the treatment of choice to restore alveolar and dental continuity and increase lip and nasal support (Bergland O et al., 1986). Secondary alveolar bone grafting (SABG) is a standard procedure used for the reconstruction of an alveolar cleft, restoring both esthetic and functional integrity of the alveolar ridge (Bajaj et al., 2003; Fahradyan et al., 2019). Besides pain and bleeding at the recipient site, wound dehiscence is among the most common post-surgical complications following bone grafting procedures (Sanz-Sánchez et al., 2022). It can manifest as either partial or complete separation of the margins of a closed surgical incision because of failure in the wound healing process (Rosen and Manna, 2023; Sandy-Hodgetts et al., 2015). It typically undergoes healing within two weeks, primarily through secondary epithelialization over the exposed bony areas (Elsayed et al., 2021).

While autologous bone grafts, particularly from the iliac crest (iliac crest bone graft or ICBG), continue to serve as the gold standard for SABG, ongoing research is exploring alternative bioactive materials to enhance graft healing and alleviate the morbidity typically linked to donor site procedures (Dissaux et al., 2022; Liang et al., 2018; Wu et al., 2018; Xiao et al., 2020). Autologous platelet concentrates (APC) such as platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) are increasingly being utilized as the main component in bone regeneration of various cranio- and maxillofacial procedures (Al-Hamed et al., 2019; Xu et al., 2020). The significant advantage these platelet concentrates provide is the release of various bio-modulatory molecules, like transforming growth factor beta-1 and interleukins, which enhance the periosteum's capacity for healing and facilitate bone and tissue regeneration (Dohan et al., 2006). Moreover, due to its simpler manufacturing, the versatility of components, cost-effective production and reduced potential for immunogenic response, it has been gaining popularity recently (O’Sullivan and Ní Ríordáin, 2022).

Various surgical procedures have successfully utilized the application of platelet concentrates in the maxillofacial region, including for SABG (Azangookhiavi et al., 2020; Liu et al., 2019). However, evidence of their effectiveness on clinical outcomes, such as wound healing following SABG, is still lacking. An essential factor contributing to the success of a surgical procedure is the timely and sustained healing of the surgical site during the postoperative phase (Sandy-Hodgetts et al., 2015). Therefore, the objective of this systematic review is to determine whether there is a difference in the postoperative healing outcomes (O) between patients with alveolar clefts (P) who received autologous platelet concentrates in addition to ICBG (I) and those who underwent ICBG alone (C) in controlled clinical trials (S). By critically analysing the currently available evidence, this review aims to provide insights into the potential clinical benefits of using platelet concentrates as an adjuvant to prevent wound dehiscence in alveolar cleft reconstruction.