During this period the dominant pattern centered on growth-aware, biology-informed repair of cleft lip and palate, leveraging periosteal tissue dynamics and bone regeneration to restore maxillary continuity. Researchers emphasized the biology of the facial skeleton, periosteum, and embryologic factors to guide timing, technique, and long-term growth, with a focus on safety, patient outcomes, and risk mitigation. Methodologically, there was a shift toward evaluating risks, morbidities, and quality improvement rather than relying solely on procedural prowess.