Description:
<jats:title>Abstract
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<jats:title>Objectives
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<jats:p>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).</jats:p>
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<jats:title>Materials and methods</jats:title>
<jats:p>Forty-nine photographs of direct tooth-coloured posterior (<jats:italic>n</jats:italic> = 25) and anterior (<jats:italic>n</jats:italic> = 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.</jats:p>
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<jats:title>Results</jats:title>
<jats:p>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.</jats:p>
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<jats:title>Conclusions</jats:title>
<jats:p>The overall reliability of the revised FDI criteria set was found to be moderate to substantial.</jats:p>
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<jats:title>Clinical relevance</jats:title>
<jats:p>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.</jats:p>
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