Clinical investigation of the correlation between tooth wear and dynamic functional occlusal condition in Chinese cohort

Background The relationship between tooth wear and dynamic occlusal patterns, such as canine protected occlusion (CPO) versus group function occlusion (GFO), are poorly understood. This study aimed to investigate the correlation between tooth wear severity and dynamic occlusal patterns in Chinese adults, while evaluating age and gender as risk factors. Methods A cross-sectional study enrolled 300 patients (aged 18–76 years) without parafunctional habits. Dynamic occlusion patterns were classified as canine protected occlusion or group function occlusion. Tooth wear severity was assessed via the Smith & Knight Index across six sextants. Statistical analyses included independent t-tests, ANOVA, chi-square, and binary logistic regression. Results Age ≥ 45 years ( OR  = 33.44, P  < 0.001), male gender ( OR  = 2.20, P  = 0.048), and group function occlusion ( OR  = 2.21, P  = 0.045) independently predicted severe wear. group function occlusion prevalence increased with age (60.9–85.5%), correlating with higher wear severity ( P  < 0.001). Males exhibited greater wear than females ( P  < 0.05). Posterior molars and mandibular incisors showed predominant dentin exposure. Conclusions Dynamic occlusion patterns, age, and gender significantly influence tooth wear in Chinese adults. The age-dependent shift from canine protected occlusion to group function occlusion reflects biomechanical adaptations to cumulative masticatory forces. An age-stratified strategy should be recommended for prosthodontic rehabilitation: canine protected occlusion preservation in younger patients and GFO-adapted digital restorations for elderly cohorts. Population-specific guidelines addressing Chinese dietary and temporomandibular joint (TMJ) traits are essential for optimizing outcomes. Trial registration Not applicable.