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100 rev port estomatol med dent cir maxilofac. 2020;61(3):97-105

Table 3. World Dental Federation (FDI) Criteria Used for Clinical Evaluation.
Esthetic property Functional properties Biological properties
1. Marginal staining 2. Fractures 3. Marginal 4. Postoperative 5. Recurrence
and retention adaptation (hyper) sensitivity of caries
1. Clinically very 1.1. No marginal 2.1 Restoration 3.1 Harmonious 4.1 No 5.1 No secondary or
good staining retained, no outline, no gaps, no hypersensitivity primary caries
fractures/cracks. discoloration.
2. Clinically good 1.2 Minor marginal 2.2 Small hairline 3.2.1 Marginal gap 4.2 Low 5.2.2 Very small and
(after correction staining, easily crack (50 µm). hypersensitivity for localized
very good) removable by 3.2.2 Small marginal a limited period of demineralization.
polishing. fracture removable time. No operative
by polishing. treatment required.

3. Clinically 1.3 Moderate 2.3 Two or more or 3.1 Gap <150 µm not 4.3.1 Premature/ 5.3 Larger areas of
sufficient/ marginal staining, larger hairline removable. slightly more demineralization,
satisfactory (minor not esthetically cracks and/or 3.3.2 Several small intense. but only preventive
shortcomings with unacceptable. chipping (not enamel or dentin 4.3.2 Delayed/weak measures necessary
no adverse effects, affecting the fractures. sensitivity, no (dentin not
but not adjustable marginal integrity). subjective exposed).
without damage to complaints, no
the tooth) treatment needed.

4. Clinically 1.4 Pronounced 2.4 Chipping 3.4.1 Gap >250 µm 4.4.1 Premature/very 4 Caries with
unsatisfactory marginal staining; fractures that or dentin/base intense. cavitation (localized
(repair for major intervention damage marginal exposed. 4.4.2 Extremely and accessible and
prophylactic necessary for quality; bulk 3.4.2 Chip fracture delayed/weak with can be repaired).
reasons) improvement. fractures with or damaging margins. subjective
without partial loss 3.4.3 Notable complaints.
(less than half of the enamel or dentin 4.4.3 Negative
restoration) wall fracture. sensitivity /
intervention
necessary but not
replacement.

5. Clinically poor 1.5 Deep marginal 2.5 Partial or 3.5 Filling is loose 4.5 Very intense, 5.5 Deep secondary
(replacement staining not complete loss of but in situ. acute pulpitis or caries or exposed
necessary) accessible for restoration. nonvital. Endodontic dentin that is not
intervention. treatment is accessible for repair
necessary and of restoration
restoration has to be
replaced.
Acceptable or not Esthetic criteria Functional criteria Biological criteria
acceptable (N, %
and reasons)

The results were analyzed statistically by a paired chi -square of restorations between baseline and the 6 -month follow -up
test – McNemar test (SAS Institute Inc., SAS/STAT 9.3 User’s (marginal coloring: p=0.1366; fractures/retention: p=1.000;
Guide, Cary, NC: SAS Institute Inc., 2002 -2010) – with an α=0.05, marginal adaptation: p=1.000; hypersensitivity: p=0.4795; re-
to compare differences between baseline and 6 months. A gen- currence of caries: p=1.000). However, in the ADH -ER group, sig-
eralized estimating equation modeling analysis was also used nificant differences (p<0.01) were found regarding both frac-
to compare the two techniques while controlling potential clus- tures/retention (p=0.0028) and marginal adaptation (p=0.0016).
tering problems due to multiple teeth from the same patient. At baseline, significant differences were found between the
two techniques on hypersensitivity (p=0.0118) (proportion of
no hypersensitivity: 81% in the ADH -SE vs. 59% in the ADH -ER
Results group). However, at 6 months, no differences were observed in
postoperative sensitivity between these techniques (p=0.3852).
Results from the restorations’ evaluation are presented in Ta- At 6 months, significant differences were detected between
ble 4, summarized as frequencies and proportions. Strong groups regarding fractures/retention and marginal adaptation
agreement between the examiners was found, with a kappa (p<0.01). The ER technique had a lower proportion of FDI crite-
value of 0.87. Recall rates were at 100% for all follow -ups. In the ria’ level 1 than the SE technique (84.8% vs. 100% for fractures/
ADH -SE group, no differences were found in the performance retention and 78.4% vs. 98.3% for marginal adaptation). Nine