The effect of anterior bite turbos on pulpal blood flow and mobility of the lower central incisors and pain perception

Objectives: To evaluate the biological response of mandibular central incisors to anterior bite turbos (ABTs) during fixed orthodontic treatment, focusing on pulpal blood flow (PBF), tooth mobility, and pain perception. Materials and Methods: Fifty-five patients undergoing fixed appliance therapy were assigned to two groups: an experimental group (n = 29) and a control group (n = 26). All received 0.014-inch nickel-titanium arch wires. ABTs were bonded to the palatal surfaces of the maxillary central incisors in the experimental group. Lower incisor PBF was measured using laser Doppler flowmetry at baseline, 20 minutes, 1 week, and 1 month after bonding. Tooth mobility was recorded after 1 month using the Miller Index. Pain was assessed using a 10-cm Visual Analogue Scale over 7 days. Results: PBF declined after 1 week in both groups and recovered after 1 month, with no significant differences between groups (P > .05). Tooth mobility was significantly greater in the bite turbo group (P < .001), with 74.1% of patients showing Grade 2 mobility compared with 25% in the control group. Pain peaked within 24 hours and declined significantly by day 7 (P < .001) in both groups, with no significant between-groups differences. Conclusions: ABTs do not adversely affect pulpal circulation or pain perception. The increase in tooth mobility in the bite turbo group is a normal adaptive response and remains within safe clinical limits. Using ABTs to correct deep overbite is biologically safe.