A cleft of the alveolus can often affect the development of the primary and permanent teeth, and the jaw Itself.” The most common problems may be related to congenital absence of teeth and, ironically, supernumerary teeth
(Fig. 27-5). The cleft usually extends between the lateral . incisor and canine area. These teeth, because of their proximity to the cleft, may be absent; when present, they may be severely displaced so that eruption into the cleft margin is common. These teeth may also be morphologically
deformed or hypomineralized. Supernumerary teeth occur frequently, especially around the cleft margins. These t,ee!p usually must be removed at some point during the child’s development. However, they may be
retained if they can furnish any useful function in the patient’s overall dental rehabilitation. Frequently, supernumerary teeth of the permanent dentition are left until 2 to 3 months before alveolar cleft bone grafting, because these teeth, although nonfunctional, maintain the surrounding
alveolar one. If extracted earlier, this bone may resorb, making the alveolar cleft larger.