BACKGROUND A palatal cleft can be reconstructed using various palatoplasty techniques. Many techniques use local mucoperiosteal flaps to close the hard palate cleft, without closing the underlying bone defect. The purpose of this study was to explore the possibility of spontaneous bone regeneration in the remaining bone defect following 2-stage palatoplasty. The effect of this bone regeneration on transverse maxillary growth also was studied. METHODS A retrospective study of patients with unilateral cleft lip and palate was performed. Cleft size was measured at the hard-soft palate junction on plaster models obtained during palatoplasty. Residual bony cleft was evaluated at the time of alveolar process reconstruction using cone beam computed tomography images. The presence of crossbite was evaluated using clinical photographs to assess transverse maxillary growth. RESULTS Forty-six patients were included in this study. Thirteen patients (28%) presented with complete ossification of the hard palate at age 6 years. Six patients (13%) had no ossification, and 27 patients (59%) demonstrated partial closure, averaging 75% of the total hard palate length. All patients with complete closure and 89% of patients with partial closure presented without lateral crossbites. Statistical analysis revealed no significant correlation between lateral crossbites and the extent of hard palate ossification ( P = 0.4314). CONCLUSIONS A total of 87% of children presented with at least partial ossification of the hard palate after a 2-stage palatoplasty, indicating the potential for spontaneous bone regeneration. Lateral crossbites demonstrated no correlation with palatal ossification ( P = 0.1819), suggesting no detrimental impact of regenerated bone on transverse maxillary growth. METHODS Risk, III.