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

Abstract

Objectives The FDI criteria for the evaluation of direct and indirect dental restorations were first published in 2007 and updated in 2010. Meanwhile, their scientific use increased steadily, but several questions from users justified some clarification and improvement of the living document. Materials and methods An expert panel (N = 10) initiated the revision and consensus process that included a kick-off workshop and multiple online meetings by using the Delphi method. During and after each round of discussion, all opinions were collected, and the aggregated summary was presented to the experts aiming to adjust the wording of the criteria as precisely as possible. Finally, the expert panel agreed on the revision. Results Some categories were redefined, ambiguities were cleared, and the descriptions of all scores were harmonized to cross-link different clinical situations with possible management strategies: reviewing/monitoring (score 1–4), refurbishment/reseal (score 3), repair (score 4), and replacement (score 5). Functional properties (domain F: fracture of material and retention, marginal adaptation, proximal contact, form and contour, occlusion and wear) were now placed at the beginning followed by biological (domain B: caries at restoration margin, hard tissue defects, postoperative hypersensitivity) and aesthetic characteristics (domain A: surface luster and texture, marginal staining, color match). Conclusion The most frequently used eleven categories of the FDI criteria set were revised for better understanding and handling. Clinical relevance The improved description and structuring of the criteria may help to standardize the evaluation of direct and indirect restorations and may enhance their acceptance by researchers, teachers, and dental practitioners.

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

“…This reliability study supported the recently initiated revision of the FDI criteria set for the evaluation of direct and indirect dental restorations [12]. The reliability tests were It was shown that (1) the intra-and inter-examiner reliability increased over the three evaluation rounds and ranged from a moderate to substantial order of magnitude and (2) Kappa estimates were found to be higher for the functional and biological categories compared to the aesthetic categories (Tables 1, 2, 3, and 4; Figs.…”

“…The expert group represented a broad spectrum of clinical and scientific experience in the field of restorative dentistry, and each of the expert contributed to the revised FDI criteria set. Details of the update process were reported elsewhere [12]. It is noteworthy that all participating experts were familiar with the concept of the FDI criteria and no specific theoretical or practical training was performed before each round of evaluation.…”

Development of clinical criteria for the evaluation of indirect restorations

“…Although the FDI criteria were titled “standard criteria” for the clinical evaluation of direct and indirect restoration materials, 11 these criteria were considered confusing by other authors 29 and difficult to obtain excellent intra and inter‐examiner agreement, probably due to the five scores it presents with very subtle differences between them 30 . In 2022, 13 a revision of the FDI criteria was published, seeking to resolve the ambiguities of evaluations. However, these changes have not yet been used in clinical studies.…”

“…The FDI criteria 11,12 classify the restoration into four aesthetic parameters separately: gloss; marginal and superficial staining; color and translucency; aesthetic anatomical form, and the restoration can be classified as failure in any of these four parameters. The revised FDI 13 criteria consider the anatomical form of the restoration as the domain of functional properties, rather than the domain of aesthetic properties.…”

“…The most used criteria are the United States Public Health Service (USPHS) or Ryge criteria 9 ; the CDA system, proposed by the California Dental Association; and the FDI, approved by the International Dental Federation 10–12 . Recently, a revision of FDI criteria was published but there is still no clinical research corroborating its application 13 . They consist of classification systems based on observations of parameters related to restorative materials.…”