Agneta Karsten

Agneta Karsten

Professor/Senior Dentist

Professor of Orthodontics focusing on cleft research, multidisciplinary studies and specialist training. Course director, examiner, and active in national and international networks.

Telephone: +46852488340
Visiting address: Alfred Nobels Allé 8, 14104 Huddinge
Postal address: OF Odontologi, OF Ortodonti, 171 77 Stockholm
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About me

  • Professor in Orthodontics and Head of the Division of Orthodontics, Department of Dental Medicine, Karolinska Institutet.

    I am a Professor of Orthodontics and Head of the Division of Orthodontics at the Department of Dental Medicine, Karolinska Institutet. I became a specialist in orthodontics in 1990, completed my PhD in 1995, and was appointed Associate Professor in 2005. In 2024, I was appointed Professor of Orthodontics.

    Between 1998 and 2021, I was responsible for the orthodontic and dentofacial orthopedic activities within the Stockholm Craniofacial Team at Karolinska University Hospital. I previously served as Head of the Orthodontic Division (2012–2017) and, following the departmental reorganization in 2017, as Unit Head and Clinical Director of the Orthodontic Clinic at the University Dental Clinic until 2021.

    At the Division of Orthodontics, I am course director for undergraduate teaching in orthodontics and dentofacial orthopedics for dental students, speech and language pathology students, and previously midwifery students. I am also responsible for specialist training in orthodontics, as well as research and doctoral education within the subject area. Clinically, I work within both orthodontics and dentofacial orthopedics.

    I have been principal supervisor for five PhD students who have completed their doctoral degrees, and I am currently initiating supervision of two new doctoral candidates. I have also served or currently serve as co-supervisor for five PhD students, four of whom have completed their doctoral theses. In addition, I supervise master’s theses and degree projects on a continuous basis.

    I am a member of the Admission Committee for Doctoral Education. I have served on the management board of the Department of Dental Medicine (2012–2017), in the programme committees for the dental and dental hygiene programmes, and as a regular member of the Regional Ethical Review Board at Karolinska Institutet (2007–2019). I represented orthodontics on the Specialist Council for Oral and Maxillofacial Diseases in Stockholm County (2015–2019) and contributed to the development of the National Clinical Guidelines in Orthodontics issued by the National Board of Health and Welfare (2011 and 2021).

    Education
    • Dental degree, Karolinska Institutet
    • Specialist training in orthodontics, University of Bergen, Norway (1990)
    • Master’s degree, University of Bergen (1990)
    • PhD, Karolinska Institutet (1995)
    • Associate Professor (Docent), Karolinska Institutet (2005)
    • Professor of Orthodontics, Karolinska Institutet (2024)
     Academic Awards and Appointments
    • Member, Regional Ethical Review Board, Karolinska Institutet (2007–2019)
    • Member, Nomination Assembly, Karolinska Institutet (since 2019)
    • Board Member, Network of Erasmus Based Orthodontic Programs in Europe (NEBEOP) (since 2021)
    • Vice Chair, NEBEOP
     Board Appointments and Professional Service

    Chair of the Scholarship Committee, Swedish Dental Society (Svenska Tandläkare-Sällskapet) and Chair of the American Dental Society of Sweden. Both chairmanships include membership in the respective boards.

Research

  • My research focuses primarily on the etiology and treatment outcomes of children born with cleft lip and/or palate. I work in a multidisciplinary framework together with plastic surgeons, speech and language pathologists, geneticists, radiologists, and oral and maxillofacial surgeons to address clinical, developmental, and functional aspects of craniofacial anomalies.

    For the past twenty years, I have been engaged in Scandcleft, an international, multidisciplinary research collaboration. Scandcleft is a longitudinal multicenter study investigating the long-term effects of different treatment protocols in 450 children across ten multidisciplinary teams. The project represents one of the most extensive international efforts to evaluate long-term outcomes in cleft care.

    I am currently leading a five-year randomized controlled trial on retention follow-up in orthodontics; we are presently in the third year of data collection. In addition, I study oral health–related quality of life before, during, and after orthodontic treatment, with the aim of integrating patient‑reported outcomes into clinical decision-making.

    I also collaborate with the Nordic Institute of Dental Materials (NIOM) and the Royal Institute of Technology (KTH) on research related to orthodontic materials, including material performance, biomechanics, and clinical applications.

Teaching

  •  
    I am course coordinator and examiner for undergraduate education in orthodontics and dentofacial orthopedics within the dentistry programme. I also oversee teaching for speech and language pathology students. 
     
    As Head of the Division of Orthodontics, I am responsible for the specialist training programme in orthodontics, currently comprising both Swedish and international residents.
     
    My educational activities further include supervision at the master’s and doctoral levels, as well as external examining for international specialist programmes.

Articles

All other publications

Grants

  • Miniscrew assisted space closure in patients with agenesis of an upper lateral incisor - clinical in vivo and experimental in vitro studies
    Karolinska Institutet
    2 March 2026 - 29 February 2032
    Congenital agenesis of the maxillary lateral incisors presents significant functional and aesthetic challenges, and there is limited evidence regarding the most effective and sustainable treatment strategy. This research project aims to evaluate orthodontic space closure using skeletal anchorage from two temporary palatal implants (the Mesialslider) and to compare this approach with space opening followed by prosthetic replacement. The project investigates treatment efficiency, changes in facial profile, health‑economic outcomes, and the mechanical properties of the palatal implants used for anchorage. The project is designed as a randomized controlled trial in which patients with agenesis of the maxillary lateral incisors receive either active or passive Mesialslider treatment over a six‑month period. Treatment outcomes are assessed using intraoral scanning, 3D facial photography, and patient‑reported measures at multiple time points. Dental and soft‑tissue changes are analyzed through digital superimposition. A comparative health‑economic analysis will evaluate cost‑effectiveness between Mesialslider‑mediated space closure and traditional space opening with subsequent prosthetic rehabilitation. An additional in vitro study will examine the mechanical strength and fracture patterns of the palatal implants by measuring insertion torque and assessing fracture surfaces via electron microscopy. This project addresses a clinically relevant knowledge gap and requires interdisciplinary expertise in orthodontics, oral radiology, clinical genetics, biomechanics, and health economics. The results are expected to strengthen evidence‑based treatment planning, improve cost‑effectiveness, and enhance patient care. The project will also contribute to postgraduate training and teaching within the dental, dental hygiene, and advanced orthodontic programmes by expanding knowledge in craniofacial genetics, evidence‑based management of anterior agenesis, patient‑reported outcome measures, intraoral scanning, 3D imaging, biomechanics, and health‑economic evaluation.
  • Miniscrew assisted space closure in patients with agenesis of an upper lateral incisor - clinical in vivo and experimental in vitro studies
    SOF
    1 January 2026 - 31 December 2028
    Congenital absence of the maxillary lateral incisors presents both functional and aesthetic challenges, particularly in growing individuals for whom prosthetic replacement may be unsuitable. This research project investigates a minimally invasive alternative for space closure using skeletal anchorage (the Mesialslider), an appliance anchored in the anterior palate that enables controlled mesial movement of molars and premolars without relying on dental anchorage. The study is conducted as a collaboration between Karolinska Institutet and Region Stockholm, with oral surgical guidance provided for the insertion of anchorage screws. The project evaluates the efficiency, predictability, and aesthetic outcomes of this treatment approach by integrating three-dimensional imaging and intraoral scanning to quantify tooth movement, anchorage stability, and changes in soft tissue contours. Collaboration with the units for oral and maxillofacial surgery, radiology, and biomechanics ensures high methodological precision. Expected outcomes include strengthened evidence to support clinical decision-making in managing anterior tooth agenesis, reduced reliance on prosthetic replacements, and improved long-term stability in young patients. The project will also contribute to the development of the dental and dental hygiene curricula—particularly within orthodontics, paediatric dentistry, and prosthodontics—and enhance knowledge of dental materials and biomechanics through collaboration with materials science.
  • A Comparative Clinical Study of Two Mandibular Fixed Retainers: Relapse, Wire Complications, and Patient Satisfaction up to Five Years After Completion of Active Orthodontic Treatment
    American Dental Society of Sweden
    1 September 2025 - 31 December 2026
    Background: Fixed retention in the mandibular anterior region is standard following orthodontic treatment to maintain alignment and prevent relapse. Two commonly used types of retainers are prefabricated gold chain retainers and technician‑manufactured multistranded coaxial stainless-steel retainers. Despite their widespread clinical use, there is a lack of long-term studies comparing their stability, durability, and patient experience. Aim: To prospectively and randomly compare a prefabricated gold chain retainer (Orthoflex‑Tech® gold chain) with a technician-manufactured multistranded stainless-steel retainer (Pentaone Masel® coaxial stainless steel) regarding tooth stability, clinical complications, and patient satisfaction over a five-year period after debonding. The null hypothesis is that no differences exist between the two retainer types. Methods: Eighty patients who had completed orthodontic treatment were randomized into two groups (n=40 per group). All retainers were bonded lingually to teeth 33–43 by the same clinician. Follow-up is conducted at T0 (debonding), and after 3, 6, 9, and 12 months, as well as annually up to five years. At each visit, clinical status, intraoral photographs, and patient-reported outcomes (VAS 1–10) are recorded. Intraoral scans are taken at T0, 6 and 12 months, and annually. Tooth movements are analyzed in OnyxCeph³™ with emphasis on Little’s Irregularity Index, tooth rotations, and intercanine/intermolar width. Annual assessments include periodontal status, gingival biotype, and gingival recession. Apical and lateral cephalometric radiographs are used to evaluate root resorption and the inclination of the mandibular incisors relative to the mandibular plane.
  • Use of Orthodontic Miniscrews as Temporary Anchorage for Space Closure in Adolescents with Missing Teeth
    American Dental Society of Sweden
    1 January 2025 - 31 December 2026
    Background: Agenesis of the maxillary lateral incisors is a common craniofacial anomaly. Clinically, two strategies are weighed: orthodontic space closure or space opening followed by prosthetic replacement. Temporary anchorage devices (orthodontic miniscrews) enable controlled tooth movement, yet knowledge gaps remain regarding safety, mechanical robustness, and cost‑effectiveness. Aim: To assess the clinical efficiency, profile/aesthetic outcomes, and cost‑effectiveness of miniscrew‑assisted space closure (Mesialslider) in adolescents with agenesis, and to elucidate miniscrew mechanical properties and the impact of pre‑drilling, bending, and corrosion. Methods: The project comprises (A) in vitro studies measuring insertion and fracture torque in multi‑layer artificial bone, plus corrosion/wear analyses after artificial saliva exposure (metal ion release via AAS). (B) A clinical RCT comparing active versus initially passive Mesialslider (activated at 6 months). Outcomes include intraoral scanning and 3D facial imaging at 0, 3, and 6 months with digital superimposition of tooth movement and soft‑tissue changes, and patient‑reported pain/discomfort. A complementary health‑economic evaluation compares space closure with space opening plus prosthetic rehabilitation. Expected significance: The study aims to define indications for minimally invasive space closure, reduce reliance on prosthetics and long‑term complications, and provide safe, standardized insertion protocols for miniscrews. Findings are expected to strengthen evidence‑based planning, optimize resource use, and support education in orthodontics, paediatric dentistry, prosthodontics, and biomechanics.

Employments

  • Professor/Senior Dentist, Department of Dental Medicine, Karolinska Institutet, 2024-
  • Senior Lecturer/Senior Dentist, Department of Dental Medicine, Karolinska Institutet, 2018-2024

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