The current body of research regarding periodontal health across various cleft types remains inconsistent and inconclusive. Hence, this systematic review and meta-analysis aimed to evaluate and contrast the oral health status of children diagnosed with bilateral cleft lip and palate (BCLP) against those with unilateral cleft lip and palate (UCLP). A comprehensive search was performed across six electronic databases for publications available up to June 2022 that compared periodontal conditions between BCLP and UCLP patients. The meta-analysis utilized a random-effects model with inverse variance weighting. Out of 858 initially identified records, 58 were reviewed in full, and 5 studies meeting the inclusion criteria were ultimately analyzed. These studies collectively examined 86 BCLP and 132 UCLP participants from three continents, focusing on periodontal indicators such as plaque index (PI), gingival index (GI), periodontal probing depth (PPD), and clinical attachment loss (CAL). Findings indicated a statistically significant increase in CAL on the facial surface among BCLP patients (mean difference: −0.44; 95% confidence interval: 0.27–0.61; Z = 5.07; p < 0.0001), whereas other periodontal parameters showed no notable variation between groups. Given the documented relationship between cleft-related surgical management and periodontal outcomes, these aspects should be carefully considered when designing individualized treatment strategies.
