drlena_dds

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drlena_dds Orthodontics, cosmetic and reconstructive dentistry

10/04/2026

Can we expand an adult male with just 2 TADs? I wouldn’t recommend that. We want to do what we know works well to optimize results.

09/25/2026

How to diagnose a transverse deficiency? Cbct is the answer. So many different ways to analyze the transverse and I find that the Miner et al study and the UPenn analysis give me the most accurate easement that confirms my clincheck setup every time.

Who may benefit:• Adults with thin bone or thin gum tissue• Treatment plans that call for significant expansion or tooth...
09/24/2026

Who may benefit:
• Adults with thin bone or thin gum tissue
• Treatment plans that call for significant expansion or tooth movement
• Cases where orthodontics alone would push roots past their bony support
• Patients with existing periodontal limitations

SFOT is a selective procedure. Candidacy is determined through 3D imaging (CBCT), a thorough periodontal evaluation, and a coordinated plan between the orthodontic and surgical teams.

Wondering whether your foundation is ready for the movement your smile needs? Book a consultation through the link in bio.

GumRecession Invisalign AirwayOrthodontics NYCDentist FiDiDentist DrLenaDentistry

09/23/2026

TAD placement for class 2 correction

09/23/2026

We had the best time in Vicenza learning from Dr.Maino and other brilliant educators about innovations in design and diagnostics. We also ate, we danced, we karaoked and enjoyed the beautiful streets of Benice and Vicenza. Next year plan to join the Ferrara School of Orthodontics for a year of learning. Can’t wait to come back next year! Loved traveling with you AirSync Airway + Sleep + Bio Rejuvenation, Dr. Kimberly Santiago

09/06/2026

This summer passed by so fast!

How does the size of your mouth affect tongue posture and what does this mean for your health?
08/15/2026

How does the size of your mouth affect tongue posture and what does this mean for your health?

08/12/2026

How to achieve difficult movements with Invisalign? Add TADs and SFOT

08/05/2026

Another facial trauma case. alone is high risk for fractures.

We don’t treat by age — we treat by anatomy.Two 30-year-olds walk in with the same transverse deficiency. One expands sk...
08/04/2026

We don’t treat by age — we treat by anatomy.

Two 30-year-olds walk in with the same transverse deficiency. One expands skeletally with a bone-borne appliance. The other doesn’t. Same age, same complaint, different outcome.

The variable isn’t the birthday. It’s the midpalatal suture.

Angelieri et al. (2013) gave us a CBCT-based staging system for exactly this reason — because chronological age is a poor predictor of whether the suture will open. Fusion begins posteriorly, in the palatine bone, and progresses anteriorly. Stages A through C are typically responsive to conventional or miniscrew-assisted expansion. Stage D and E patients need a different conversation, and a different force system.

You cannot see any of this on a pan. You cannot see it on a lateral ceph. You cannot palpate it.

Which is why every expansion case in my practice starts with a CBCT — not to justify the scan, but because the staging changes the appliance, the anchorage, and what I tell the patient about what’s realistic.

This is the material I teach when I lecture on skeletal expansion to other clinicians, and it’s the same conversation I have with adult patients who’ve been told expansion “isn’t possible after growth stops.” Sometimes that’s true. Often it isn’t. The scan tells us which.

Save this for your next expansion consult.

Questions about whether you or your child is a candidate? DM me.

airwayorthodontics orthodontics adultorthodontics transversedeficiency angelieri suturematuration orthodonticeducation nycorthodontist manhattandentist airwayhealth orthodontist

Address

111 Broadway Suite 1707
New York, NY
10006

Opening Hours

8am - 5pm

Telephone

+16469565463

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