Abstract
BACKGROUND: The interplay between tooth wear severity and dynamic occlusal patterns, such as canine protected occlusion (CPO) and group function occlusion (GFO), remains inadequately characterized, particularly in populations with distinct dietary and occlusal traits. This cross-sectional study aimed to investigate the correlation between dynamic occlusal conditions and tooth wear severity in Chinese adults, while evaluating age and gender as modulating factors. METHODS: A total of 300 participants (aged 18–76 years) without parafunctional habits or temporomandibular disorders (TMD) were enrolled. Dynamic occlusion patterns (CPO vs. GFO) were classified using articulating paper for preliminary screening and T-Scan III for dynamic validation. Tooth wear severity was quantified via the Smith & Knight Index across six dentition sextants. Statistical analyses included independent t-tests, ANOVA, chi-square tests, 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: GFO, advanced age, and male gender are critical risk factors for severe tooth wear in Chinese adults. The age-dependent transition from CPO to GFO represents a biomechanical adaptation to cumulative masticatory forces, while gender disparities highlight sex-specific biomechanical and behavioral influences. These findings underscore the necessity for population-specific prosthodontic guidelines addressing Chinese dietary habits and temporomandibular joint (TMJ) morphology to mitigate wear progression and optimize clinical outcomes. TRIAL REGISTRATION: Not applicable.