The lower brackets are ready to go on, but the upper teeth meet the space where those brackets need to sit. In some deep-bite cases, a small bonded buildup can create the clearance needed to begin treatment.
Bite turbos serve that purpose. Choosing where to place them, checking how the teeth contact them and reviewing changes over time are just as important as placing the material.
What Do Bite Turbos Do?
Composite bite turbos are temporary resin buildups bonded to selected teeth to create bite separation, or disocclusion. They can protect appliances from opposing teeth, unlock selected crossbites or support planned bite correction.
The separation happens immediately. Subsequent changes in tooth position develop during treatment.
A randomized clinical trial comparing anterior turbos with reverse-curve archwires found greater lower posterior tooth extrusion in the turbo group. The biological response therefore depends on the complete force system; turbos do not automatically intrude both sets of incisors.
Anterior or Posterior Bite Turbos?
| Placement | Typical location | Intended effect |
|---|---|---|
| Anterior | Palatal surfaces of selected upper front teeth | Contact with opposing incisors separates posterior teeth |
| Posterior | Biting surfaces of selected upper or lower back teeth | Creates clearance from posterior contact points for the planned mechanics |
The choice depends on diagnosis, facial pattern, supporting teeth and intended movement. Anterior and posterior placement are not interchangeable treatment decisions.
Turbos can also be prefabricated metal devices. This article focuses on bonded resin buildups, whose adjustment and cleanup require a material-specific approach.
How Are Height, Contacts and Material Planned?
The aim is to create enough clearance for the treatment objective without unnecessary opening or an unwanted closure shift.
Before placement, assess overjet, incisor inclination, tooth integrity, periodontal support and relevant movements of the jaw. Where paired contacts are intended, check their relationship during closure. Some specialist plans deliberately use unilateral turbos, so symmetry alone is not a universal endpoint.
A mould can help control resin form. In their published technique report, Alsheikho and Jomah highlighted how variable buildup dimensions can change contact relationships. Their experience supports careful control of form, but does not establish one best technique. Mould length is not the same as the separation produced between the arches.
Select a material indicated for the intended use. Viscosity alone does not determine suitability: some low-viscosity materials specifically include bonded bite turbos in their indications. Coloured materials may help distinguish resin from enamel during placement and cleanup, although visibility does not guarantee damage-free removal.
Placement and Monitoring
The following sequence summarises clinical considerations; surface preparation and curing must follow the selected material's instructions.
- Clean and isolate. Establish access and control contamination at the bonding site.
- Prepare the surface. Follow the specified conditioning and bonding steps for enamel or the existing restoration.
- Adapt and cure the resin. Control excess material and use the prescribed curing exposure and light access.
- Verify contacts and clearance. Check the intended working surface, appliance protection and closure.
- Record and explain. Document the starting contact arrangement and tell the patient which changes require review.
At subsequent appointments, reassess the buildup and the treatment objective together:
| Review finding | Clinical response |
|---|---|
| Rough margin or tongue irritation | Locate the cause and consider local finishing |
| Unintended contact or closure shift | Reassess the mechanics before changing the resin |
| Fracture, loosening or wear | Decide whether repair, replacement or removal is appropriate |
| Intact turbo with intended clearance | Continue monitoring |
| Original objective achieved | Assess whether the turbo can be removed |
Adjusting a Turbo That Will Remain
A minor rough edge and a substantial change in height need different approaches. Select orthodontic burs according to the resin, access and intended contour change.
1. Reshape Gradually
A suitable diamond bur or composite-cutting carbide may be selected according to the resin and amount of adjustment. Alsheikho and Jomah describe diamond-bur shortening of resin turbos in their technique report.
For finer composite shaping, the 7006 round finishing carbide in the MR.BUR Orthodontic Kit FG is a finishing option where its instructions and the clinical access permit. A finishing instrument should not automatically be treated as the tool for substantial bulk reduction.
2. Refine the Working Contour
Choose a profile that follows the intended resin surface. The kit's CF198 and 7675 taper round-end finishing carbides provide alternative shapes for selected finishing tasks.
These are instrument choices, rather than a compulsory sequence. Preserve the tooth surface and the contact still needed for treatment.
3. Recheck and Polish
Pause to confirm appliance clearance and the planned contact relationship.
Where compatible with the resin and access, the 6002 composite diamond polisher may help smooth the adjusted composite. It is a low-speed RA/contra-angle instrument requiring a compatible handpiece. Exposed enamel requires a polishing system indicated for that substrate.
When and How Are Bite Turbos Removed?
Removal follows clinical progress, not a universal number of months. Confirm that appliance clearance and the planned bite relationship allow it.
- Identify the material and substrate. Establish what is bonded and whether the supporting surface is enamel or a restoration.
- Remove the main buildup using the material-specific method. Some resins permit mechanical release followed by cleanup. Opal Bond Flow's manufacturer instructions, for example, describe a fluted bur for the remainder. [3]
- Reassess residual resin. Improve lighting and visibility before approaching the resin-tooth boundary.
- Clean confirmed remnants. Where a debonding carbide is indicated, the kit's 9214 and 9406 finishing carbide burs are examples of orthodontic burs for adhesive cleanup. Confirm suitability and inspect frequently.
- Finish and verify. Use substrate-appropriate polishing, then check the surface and occlusion. Pause if the boundary becomes uncertain or unexpected symptoms occur.
Heat control matters throughout rotary cleanup. Migliorati and colleagues found that irrigation and bur type affected temperature changes during laboratory orthodontic composite removal; carbide burs also produced enamel damage under the tested conditions. This supports controlled instrumentation, rather than a claim that carbide cuts resin while leaving enamel untouched. The study concerned bracket cleanup, so it informs precautions without establishing a bite-turbo-specific protocol.
Patient Care and When to Contact the Clinic
Eating and speaking may initially feel unfamiliar. A prospective study of 60 patients by Fahim and colleagues found improving acceptance over the first month. Its short follow-up and lack of a control group mean that adaptation times should not be guaranteed.
- Eating: Choose manageable portions of soft, nutritious foods. Avoid hard or sticky foods that can damage appliances, and follow the orthodontist's advice as comfort changes.
- Cleaning: Brush gently around resin margins and gumlines with fluoride toothpaste and clean between the teeth. Rinsing with water can clear some debris when brushing is unavailable, but does not replace brushing.
- Breakage or persistent symptoms: Contact the orthodontic team if a turbo loosens, fractures or falls off, even if another remains. Report pain, an ulcer that is not settling, difficulty eating adequately or renewed bracket contact so the clinic can determine review timing. Do not file down, glue back or remove a turbo yourself.
