Evaluation of direct restorations using the revised FDI criteria: results from a reliability study

Abstract

Objectives The purpose of this in vitro reliability study was to determine the intra- and inter-examiner agreement of the revised FDI criteria including the categories “fracture of material and retention” (F1) and “caries at restoration margin” (B1). Materials and methods Forty-nine photographs of direct tooth-coloured posterior (n = 25) and anterior (n = 24) restorations with common deficiencies were included. Ten dental experts repeated the assessment in three blinded rounds. Later, the experts re-evaluated together all photographs and agreed on a reference standard. Statistical analysis included the calculation of Cohen’s (Cκ), Fleiss’ (Fκ), and weighted Kappa (wκ), the development of a logistic regression with a backward elimination model and Bland/Altman plots. Results Intra- and inter-examiner reliability exhibited mostly moderate to substantial Cκ, Fκ, and wκ values for posterior restorations (e.g. Intra: F1 Cκ = 0.57, wκ = 0.74; B1 Cκ = 0.57, wκ = 0.73/Inter F1 Fκ = 0.32, wκ = 0.53; B1 Fκ = 0.41, wκ = 0.64) and anterior restorations (e.g. Intra F1 Cκ = 0.63, wκ = 0.76; B1 Cκ = 0.48, wκ = 0.68/Inter F1 Fκ = 0.42, wκ = 0.57; B1 Fκ = 0.40, wκ = 0.51). Logistic regression analyses revealed significant differences between the evaluation rounds, examiners, categories, and tooth type. Both the intra- and inter-examiner reliability increased along with the evaluation rounds. The overall agreement was higher for anterior restorations compared to posterior restorations. Conclusions The overall reliability of the revised FDI criteria set was found to be moderate to substantial. Clinical relevance If properly trained, the revised FDI criteria set are a valid tool to evaluate direct and indirect restorations in a standardized way. However, training and calibration are needed to ensure reliable application.

Revised FDI criteria for evaluating direct and indirect dental restorations—recommendations for its clinical use, interpretation, and reporting

“…The final version of the revised FDI criteria was reviewed again by the whole expert panel and unanimously agreed on during another web meeting on November 9, 2020. The results of the reliability study were summarized in a separate report [12].…”

The Dentist’s Ability to Detect Different Restorative Procedures on Periapical Radiographs—Results from a Reliability Study

“…In contrast, little information is available about the dentist's ability to reliably detect different restorative procedures on dental radiographs. Here, only a few reliability studies have been published thus far that have considered the assessment of direct restorations [7], the marginal adaptation of indirect restorations [8] or the presence and quality of endodontic treatments [9,10]. With respect to the limited amount of available information, therefore, this study aimed to determine the inter-and intra-examiner reliability for the detection of direct fillings, indirect crown restorations, root canal fillings and dental implants on periapical radiographs.…”