Effects of Anterior Bite Turbos on Deep Bite Treatment and Chewing Muscles

September 30, 2026 updated by: Hilal Algul, Ankara University

Evaluation of the Effects of Anterior Bite Turbo Application During Deep Bite Treatment on Dentoalveolar and Skeletal Structures and Masticatory Muscles

This study evaluated how anterior bite turbos used during orthodontic treatment of deep bite affect chewing muscle activity and dental and skeletal measurements. Participants were followed in two nonrandomized groups: one received anterior bite turbos as part of orthodontic treatment, and the other received orthodontic treatment without bite turbos. Surface electromyography (EMG) was used to measure muscle activity over time. Cephalometric measurements were also evaluated to assess treatment-related changes.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

This prospective, nonrandomized, two-group study examined patients undergoing orthodontic treatment for deep bite. Anterior bite turbos were applied in one group; the comparison group underwent orthodontic treatment without anterior bite turbos during the study period.

Surface EMG recordings of the right and left masseter, anterior temporalis, and anterior digastric muscles were obtained at rest and during maximum voluntary clenching. Both groups were assessed before treatment, at approximately one month, and at approximately six months. The bite turbo group also underwent an EMG assessment immediately after bite turbo placement. Cephalometric measurements were evaluated at baseline and approximately six months.

Study Type

Interventional

Enrollment (Actual)

28

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Turkey (Türkiye)
      • Ankara, Turkey (Türkiye), 06560
        • Ankara University, Faculty of Dentistry, Department of Orthodontics

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Permanent dentition.
  • Angle Class I or Class II malocclusion.
  • Mild to moderate dental crowding (≤6 mm).
  • Non-extraction fixed orthodontic treatment planned.
  • No missing teeth, excluding third molars.
  • For the anterior bite turbo group: increased overbite (>4 mm).
  • For the control group: normal anterior overbite (2-3 mm).

Exclusion Criteria:

  • Bruxism or other oral parafunctional habits.
  • Temporomandibular joint disorder.
  • Craniofacial asymmetry, craniofacial syndrome, or cleft lip and/or palate.
  • Dental anomalies, including missing teeth other than third molars or abnormalities of tooth shape.
  • Previous orthodontic or myofunctional treatment.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Non-Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Anterior Bite Turbo Group

Participants received anterior bite turbos as part of fixed orthodontic treatment for deep bite. Surface EMG and orthodontic measurements were obtained during follow-up.
Device: Anterior Bite Turbo

Composite resin bite turbos were bonded to the palatal surfaces of the maxillary central incisors during fixed orthodontic treatment. The bite turbos were used to disclude the posterior teeth during deep bite treatment.

Procedure: Fixed Orthodontic Treatment

Participants received fixed orthodontic treatment for deep bite.
Active Comparator: No Bite Turbo Group

Participants received fixed orthodontic treatment without anterior bite turbos during the study period. Surface EMG and orthodontic measurements were obtained during follow-up.
Procedure: Fixed Orthodontic Treatment

Participants received fixed orthodontic treatment for deep bite.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in Mean Bilateral Masseter Muscle Activity at Rest
Time Frame: Baseline (before bite turbo placement), 1 month, and 6 months

Surface electromyographic activity of the right and left masseter muscles was recorded at rest. The mean of the two sides, measured in microvolts (µV), was evaluated at baseline, 1 month, and 6 months. Changes over time were compared between the anterior bite turbo and no bite turbo groups.
Baseline (before bite turbo placement), 1 month, and 6 months
Change in Mean Bilateral Anterior Digastric Muscle Activity During Maximum Voluntary Clenching
Time Frame: Baseline (T0), 1 month (T2), and 6 months (T3).

Surface EMG amplitude of the right and left anterior digastric muscles during maximum voluntary clenching was averaged for each participant and measured in microvolts (µV). Change over time was compared between groups.
Baseline (T0), 1 month (T2), and 6 months (T3).
Change in Mean Bilateral Anterior Digastric Muscle Activity at Rest
Time Frame: Baseline (T0), 1 month (T2), and 6 months (T3).

Surface EMG amplitude of the right and left anterior digastric muscles at rest was averaged for each participant and measured in microvolts (µV). Change over time was compared between groups.
Baseline (T0), 1 month (T2), and 6 months (T3).
Change in Mean Bilateral Anterior Temporalis Muscle Activity During Maximum Voluntary Clenching
Time Frame: Baseline (T0), 1 month (T2), and 6 months (T3).

Surface EMG amplitude of the right and left anterior temporalis muscles during maximum voluntary clenching was averaged for each participant and measured in microvolts (µV). Change over time was compared between groups.
Baseline (T0), 1 month (T2), and 6 months (T3).
Change in Mean Bilateral Anterior Temporalis Muscle Activity at Rest
Time Frame: Baseline (T0), 1 month (T2), and 6 months (T3).

Surface EMG amplitude of the right and left anterior temporalis muscles at rest was averaged for each participant and measured in microvolts (µV). Change over time was compared between groups.
Baseline (T0), 1 month (T2), and 6 months (T3).
Change in Mean Bilateral Masseter Muscle Activity During Maximum Voluntary Clenching
Time Frame: Baseline (T0), 1 month (T2), and 6 months (T3).

Surface EMG amplitude of the right and left masseter muscles during maximum voluntary clenching was averaged for each participant and measured in microvolts (µV). Change over time was compared between groups.
Baseline (T0), 1 month (T2), and 6 months (T3).

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in Overbite
Time Frame: Baseline and 6 months.

Vertical overlap of the maxillary and mandibular central incisors was measured on lateral cephalograms in millimeters (mm). Change from baseline to 6 months was compared between groups.
Baseline and 6 months.
Change in Overjet
Time Frame: Baseline and 6 months.

Horizontal distance between the maxillary and mandibular central incisors was measured on lateral cephalograms in millimeters (mm). Change was compared between groups.
Baseline and 6 months.
Change in SN-GoGn Angle
Time Frame: Baseline and 6 months.

The angle between the Sella-Nasion and mandibular planes was measured on lateral cephalograms in degrees. Change was compared between groups.
Baseline and 6 months.
Change in Overbite
Time Frame: Baseline and 6 months.

The distance from anterior nasal spine to Menton was measured on lateral cephalograms in millimeters (mm). Change was compared between groups.
Baseline and 6 months.
Change in ANB Angle
Time Frame: Baseline and 6 months.

The A point-Nasion-B point angle was measured on lateral cephalograms in degrees. Change was compared between groups.
Baseline and 6 months.
Change in Upper Incisor to NA Distance
Time Frame: Baseline and 6 months.

The linear distance from the maxillary central incisor to the Nasion-A point line was measured in millimeters (mm). Change was compared between groups.
Baseline and 6 months.
Change in Upper Incisor to NA Angle
Time Frame: Baseline and 6 months.

The angle between the maxillary central incisor long axis and the Nasion-A point line was measured in degrees. Change was compared between groups.
Baseline and 6 months.
Change in IMPA
Time Frame: Baseline and 6 months.

The angle between the mandibular central incisor long axis and mandibular plane was measured in degrees. Change was compared between groups.
Baseline and 6 months.
Change in Interincisal Angle
Time Frame: Baseline and 6 months

The angle between the long axes of the maxillary and mandibular central incisors was measured in degrees. Change was compared between groups.
Baseline and 6 months
Change in Upper Lip to S Line Distance
Time Frame: Baseline and 6 months

The distance from the upper lip to Steiner's S line was measured in millimeters (mm). Change was compared between groups.
Baseline and 6 months
Change in Lower Lip to S Line Distance
Time Frame: Baseline and 6 months

The distance from the lower lip to Steiner's S line was measured in millimeters (mm). Change was compared between groups.
Baseline and 6 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Ankara University

Investigators

  • Principal Investigator: Ayşe T Altuğ Demiralp, DDS, PhD, Professor, Ankara University Faculty of Dentistry Department of Orthodontics

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

October 20, 2025

Primary Completion (Actual)

August 28, 2026

Study Completion (Actual)

August 28, 2026

Study Registration Dates

First Submitted

September 25, 2026

First Submitted That Met QC Criteria

September 30, 2026

First Posted (Actual)

October 1, 2026

Study Record Updates

Last Update Posted (Actual)

October 1, 2026

Last Update Submitted That Met QC Criteria

September 30, 2026

Last Verified

September 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 2025-755

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

There is currently no plan to share individual participant data with other researchers.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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