Association between occlusal relationships during sleep bruxism and orofacial system diseases: a cross-sectional study of a self-established cohort in young and middle-aged adults

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OBJECTIVE: To investigate associations between occlusal relationships during sleep bruxism (SB) and orofacial system diseases. METHODS: In this cross-sectional study, 50 young/middle-aged SB participants (mean age 29.5 years; 51.5% female) underwent polysomnographic for SB confirmation. Occlusal relationships were quantified using BruxChecker® scoring. Logistic regression models were used to assess relationships between occlusal relationships and dental/periodontal/temporomandibular disorders. RESULTS: Group-grinding occlusion significantly predicted condylar displacement (Odds Ratio[OR] 10.70, 95% confidence intervals[95%CI]: 1.31-20.45) and abnormal morphology (OR 7.64, 95%CI: 4.72-10.38). Non-working side Occlusal interferences correlated with vertical alveolar bone loss (OR 6.56, 95%CI: 3.07-14.79) and periodontal probing depth >3mm (OR 6.42, 95%CI: 3.71-11.35). Discordance in cusp guidance slope increased risks of: Dental caries (OR 9.01, 95%CI: 5.30-15.56), Non-Carious Cervical Lesion (OR 4.66, 95%CI: 0.96-16.72), Tooth crack (OR 3.99, 95%CI: 2.38-6.68), Attrition (OR 9.36, 95%CI 6.69-13.24). Anxiety, low mandibular plane angle, and flat occlusal plane amplified orofacial disorder risks. CONCLUSION: Occlusal relationship during SB significantly impacts orofacial system diseases. Understanding the relationship between occlusal patterns during SB and orofacial damage may inform future preventive strategies. CLINICAL SIGNIFICANCE: Our findings reveal distinct biomechanical pathways linking specific occlusal relationship during SB to orofacial diseases, which may guide future research into mechanism-based management approaches.