To evaluate the bony support around the teeth adjacent to the unilateral cleft lip and palate (ULCLP) using cone-beam computed tomography.

Cone-beam computed tomographies of 48 cleft-adjacent teeth (28 anterior and 20 posterior to the cleft) and 48 noncleft control teeth were evaluated. The alveolar bone thickness at 3 and 6 mm apical to the cement–enamel junction (CEJ), the distance between the alveolar crest and CEJ (Alv-CEJ), and the presence of fenestration were assessed in buccal, palatal, and proximal surfaces.

The alveolar bone on the buccal and palatal sides of the teeth anterior to the cleft was significantly thinner than the noncleft teeth (all P < .05). The Alv-CEJ was significantly greater on the buccal and distal surfaces of the teeth anterior to the cleft (P < .001 and P = .010, respectively) and on the palatal and mesial surfaces of the teeth posterior to the cleft (P = .024 and P = .003, respectively) when compared to the noncleft teeth. The frequency of reduced alveolar bone height (>2 mm) was higher than noncleft side for buccal and distal sides of the teeth anterior to the cleft (P = .016 and .006, respectively) and the buccal and mesial sides of the teeth posterior to the cleft (P = .008 and <.001, respectively). The teeth anterior to the cleft had a higher prevalence of fenestration (P = .004).

Reduced alveolar bone height is more common in the cleft side compared to the control side. The teeth anterior to the ULCLP have thinner alveolar bone support and higher frequency of fenestration.