FDI Criteria: A Standardized Approach to Evaluating Dental Restorations

The FDI criteria, introduced in 2007 and updated in 2010, provide a systematic framework for evaluating the quality of direct and indirect dental restorations. The revised version, developed through expert consensus using the Delphi method, incorporates significant clarifications and improvements to enhance usability and clinical relevance. This article addresses the criteria to assess restorations based on functional (Domain F) properties.

The Prevalence of Dental Issues in Athletes

Dental caries, erosion, and periodontal disease are common among athletes, with 15–89% affected globally. Elite athletes, especially in endurance sports, report high DMFT scores. In the 2012 London Olympics, 55% of athletes had dental caries, and half of Dutch athletes in the 2016 Rio Olympics required dental treatment.

Evaluation of Dental Restorations

Evaluating restorations is a stepwise process involving:

Professional cleaning and air drying to enhance visibility.

Functionality tests using standardized tools like probes and articulation paper.

Occlusion testing to assess static and dynamic alignment.

Scoring system: A structured 5-point scale rates restorations as:
•	Scores 1–3: Clinically acceptable outcomes.
•	Scores 4–5: Clinically unacceptable outcomes requiring repair (score 4) or replacement (score 5).

Functional Properties (Domain F)

Functional properties, central to restoration performance, are prioritized in the revised FDI criteria. The five categories include:

Fracture of Material and Retention (F1):
Evaluates cracks, chipping, fractures, and retention.

Marginal Adaptation (F2):
Assesses the smoothness of transitions between the restoration material and tooth structure.

Proximal Contact Point (F3):
Examines the tightness of contact points to prevent food impact or inflammation.

Form and Contour (F4):
Ensures the restoration aligns with functional and anatomical needs, including protection of gingiva and periodontium.

Occlusion and Wear (F5):
Evaluates alignment and wear in static and dynamic occlusion.

Category	Score 1 (Excellent)	Score 2 (Good)	Score 3 (Satisfactory)	Score 4 (Unsatisfactory)	Score 5 (Poor)
Fracture of Material and Retention (F1)	Intact restoration with no cracks, chipping, or fractures.	Minor chipping or hairline cracks, requiring only monitoring.	Distinct material loss (e.g., chipping) that can be corrected by refurbishment if needed.	Severe deficiencies (e.g., partially loose restorations) that can be repaired.	Extensive fractures or fully lost restorations requiring replacement.
Marginal Adaptation (F2)	Perfect marginal adaptation with no detectable gaps.	Minor marginal deficiencies detected only after air drying.	Marginal gaps or ditching < 250 μm wide or < 2 mm deep.	Severe gaps ≥ 250 μm wide or ≥ 2 mm deep; repairable.	Generalized gaps requiring complete replacement.
Proximal Contact Point (F3)	Proper contact with resistance using a 25-μm metal blade; no gingival inflammation or food impaction.	Slightly weak contact using a 50-μm blade; no gingival inflammation.	Oversized, tight, or weak contact (100-μm blade) causing no inflammation but requiring refurbishment.	Severely weak or interlocked contact causing inflammation/ food impaction; repairable.	Severe deficiencies causing inflammation/ food impaction requiring replacement.
Form and Contour (F4)	Ideal outline, contour, and convexity, protecting gingiva and periodontium.	Minor deficiencies in contour that do not affect function or aesthetics.	Slight irregularities like minor overhangs that require correction.	Severe overhangs or under-contouring compromising function; repairable.	Extensive deficiencies affecting gingival/ periodontium requiring replacement.
Occlusion and Wear (F5)	Harmonized static and dynamic occlusion; no premature contacts, non-occlusion, or hyper-occlusion.	Minor occlusion/wear deficiencies with no functional impact.	Noticeable wear or occlusion issues causing mild discomfort but repairable.	Severe occlusion problems, premature contacts, or significant wear that is repairable.	Extensive wear or occlusion failure significantly affecting functionality, requiring replacement.

Conclusion
The structured evaluation of functional properties under Domain F ensures that restorations meet both clinical and patient expectations for functionality and longevity. These revised criteria offer a standardized approach for researchers, educators, and dental practitioners to assess the performance of direct and indirect restorations effectively.

GGI-CO-A1-AQS-300032384-AM-B25-0187
Reference:
Hickel R, Mesinger S, Opdam N, et al. Revised FDI criteria for evaluating direct and indirect dental restorations-recommendations for its clinical use, interpretation, and reporting [published correction appears in Clin Oral Investig. 2023 Jun;27(6):2593. doi: 10.1007/s00784-022-04851-w]. Clin Oral Investig. 2023;27(6):2573-2592. doi:10.1007/s00784-022-04814-1.

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FDI Criteria: A Standardized Approach to Evaluating Dental Restorations

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