Jaw Orthopedics

Jaw Orthopedics is the topic within orthodontics dealing with growth and growth adaptation. The largest group of patients have congenital malformations most often cleft lip and/or palate CL/P.

Principal Investigator

Agneta Karsten DDS., Spec. Ortho., MSc., PhD., Associate Professor, Head of the Division of Orthodontics, Karolinska Institutet, Huddinge. 



Genetic factors in the ethiology of cleft lip and palate

Which genetic factors regulates the development of a cleft lip and palate defect? We have ongoing studies on patients with van der Woude syndrome where known mutations have been found in the IRF6 and GRHL3 genes.


  • Marie Pegelow, DDS., Spec. Ortho., PhD., Division of Orthodontics, Karolinska Institutet, Huddinge.
  • Malin Vesterbacka DDS., MSc., Spec. Ortho., Research student, Section for Jaw Orthopedics at the Stockholm Craniofacial Team, Karolinska University Hospital, Solna.

Collaborators: Section for Jaw Orthopedics at the Stockholm Craniofacial Team, Karolinska University Hospital, Solna, Centre for Molecular Medicine, Karolinska Institutet and the Division of Plastic and Reconstructive Surgery, Karolinska Hospital, Solna.

Financing: Karolinska Institutet, Svenska Tandläkare-Sällskapet, Stiftelsen Frimurare barnhuset i Stockholm.

Studies on growth of the jaws, positions of teeth in the jaws, reconstruction of alveolar clefts with bonegrafts, speech, communication and self perceived quality of life are studied in patients born with cleft lip and palate

Patients born and treated in the Stockholm Craniofacial Team, with unilateral cleft lip and palate have been operated with three different surgical protocols. The children have been followed by the CLP team up til 19 years of age. We analyse lateral cephalograms with cephalometrics and dental casts with the GOSLON yardstick at 5, 10, 16 and 19 years of age and compare the three groups statistically. The results will be compared with children without a cleft and children treated in other centers with other techniques. We also evaluate what has happened in the grafted area at 19 years of age. The patients are given a questionnaire at 19 years of age based on self perceived questions on quality of life. The speech will be evaluated by professionals from other centers and peers.


  • Petra Peterson MD., PhD, Department for Plastic and Reconstructive Surgery, Stockholm Craniofacial Team, Karolinska University Hospital, Solna.
  • Mathias Lemberger DDS., Spec. Ortho., PhD-student, Division of Orthodontics, Karolinska Institutet, Huddinge. 

Collaborators: Anette Lohmander, Speech pathologist, Professor in Speech and language, Karolinska Institutet. Reinhilde Jacobs DDS., PhD., Master in Dental Radiology, Professor at the University of Leuven. Daniel Benchimol DDS., PhD., Divisioin of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet. Co-supervisor for Mathias Lemberger. 

Financing: Karolinska Institutet, Svenska Tandläkare Sällskapet, Stiftelsen Frimurare barnhuset i Stockholm, European Orthodontic Society research funds.

Scandcleft – a multidisciplinary prospective multicentre study

Three parallel randomized clinical trials with ten participating CLP-teams are performed since 1997 to evaluate four different surgical protocols for the treatment of patients with CLP. The primary outcomes are surgical complications, craniofacial growth, dentoalveolar status and speech. The children have been evaluated up til ten years of age. They will be followed til 19 years of age with various registrations. 450 children are included in the study. 75 in each group.

Collaborators: CLP-teams in Oslo, Bergen, Norway, Copenhagen, Århus, Denmark, Helsinki, Finland, Manchester, Belfast UK, Gothenburg and Linköping, Sweden.

Financing: Karolinska Institutet, NIH, ADSS

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