Conventionally, for dental reconstruction after bone grafting of the congenital residual alveolar cleft, a fixed prosthesis or removable partial denture is used. In this paper, residual alveolar cleft reconstruction with an osseointegrated implant following secondary bone grafting is described. The patient underwent secondary bone grafting of the residual alveolar cleft at the age of 18 years. One osseointegrated implant was placed in the bone bridge 8 months after bone grafting. No problems up to 1 year after the fabrication and placement of the fixed prosthesis have been observed. Keywords: oronasal fistula, osseointegrated implant, residual alveolar cleft, secondary bone grafting