Sleep Bruxism and Occlusal Function: A Case–Control Study Based on Polysomnography in Young Colombians

<b>Objectives</b>: The objective of this study was to compare occlusal and articular characteristics between young adults with and without a confirmed diagnosis of sleep bruxism, through a case-control study based on polysomnography. <b>Methods</b>: We conducted a case-control study with probabilistic sampling, including 20 participants with a polysomnography-confirmed diagnosis of sleep bruxism and 20 age- and sex-matched controls. A clinical oral examination was conducted to identify wear facets, joint sounds, and soft tissue indentations. Occlusal relationships were analyzed using mounted models on a semi-adjustable articulator, evaluating interferences during working, balancing, and protrusive movements, premature contacts, attrition, and dental inclinations. <b>Results</b>: Sleep bruxism showed a higher frequency of temporomandibular joint sounds (35% vs. 5%; <i>p</i> = 0.017; w = 0.375) and left-side balancing interferences (<i>p</i> = 0.04; d = 0.723). Multivariate analysis revealed a moderate correlation between bruxism and the combination of joint sound and occlusal inclination (COR = 0.39; 95% CI: 0.19-0.57; I² = 0.0%). Joint sound showed a weak association with REM-related bruxism (COR = 0.29; 95% CI: 0.05-0.51; I² = 21.7%) and a moderate association with non-REM bruxism (COR = 0.41). The correlation with occlusal inclination was stronger during REM sleep (COR = 0.41) than during non-REM sleep (COR = 0.35; I² = 0.0%), indicating consistent and clinically relevant associations. <b>Conclusions</b>: Occlusal and functional characteristics associated with sleep bruxism were identified, particularly joint sounds and dental inclinations, although no direct causal relationship was established. These findings suggest the presence of specific morphofunctional patterns that may play a role in the clinical expression of sleep bruxism.