Original Article

Clinical Oral Investigations

, Volume 14, Issue 4, pp 349-366

First online:

FDI World Dental Federation: clinical criteria for the evaluation of direct and indirect restorations—update and clinical examples

  • Reinhard HickelAffiliated withDepartment of Operative Dentistry and Periodontology, Ludwig-Maximilians-University Email author 
  • , Arnd PeschkeAffiliated withResearch & Development, Ivoclar Vivadent
  • , Martin TyasAffiliated withMelbourne Dental School, University of Melbourne
  • , Ivar MjörAffiliated withCollege of Dentistry, University of Florida
  • , Stephen BayneAffiliated withDepartment of Cariology, Restorative Sciences, and Endodontics, University of Michigan School of Dentistry
  • , Mathilde PetersAffiliated withDepartment of Cariology, Restorative Sciences, and Endodontics, University of Michigan School of Dentistry
  • , Karl-Anton HillerAffiliated withDepartment of Operative Dentistry and Periodontology, University of Regensburg
  • , Ross RandallAffiliated with3M ESPE Dental
  • , Guido VanherleAffiliated withK.U. Leuven
    • , Siegward D. HeintzeAffiliated withResearch & Development, Ivoclar Vivadent

Rent the article at a discount

Rent now

* Final gross prices may vary according to local VAT.

Get Access


In 2007, new clinical criteria were approved by the FDI World Dental Federation and simultaneously published in three dental journals. The criteria were categorized into three groups: esthetic parameters (four criteria), functional parameters (six criteria) and biological parameters (six criteria). Each criterion can be expressed with five scores, three for acceptable and two for non-acceptable (one for reparable and one for replacement). The criteria have been used in several clinical studies since 2007, and the resulting experience in their application has led to a requirement to modify some of the criteria and scores. The two major alterations involve staining and approximal contacts. As staining of the margins and the surface has different causes, both phenomena do not appear simultaneously. Thus, staining has been differentiated into marginal staining and surface staining. The approximal contact now appears under the name “approximal anatomic form” as the approximal contour is a specific, often non-esthetic issue that cannot be integrated into the criterion “esthetic anatomical form”. In 2008, a web-based training and calibration tool called e-calib (www.​e-calib.​info) was made available. Clinical investigators and other research workers can train and calibrate themselves interactively by assessing clinical cases of posterior restorations which are presented as high-quality pictures. Currently, about 300 clinical cases are included in the database which is regularly updated. Training for eight of the 16 clinical criteria is available in the program: “Surface lustre”; “Staining (surface, margins)”; “Color match and translucency”; Esthetic anatomical form”; “Fracture of material and retention”; “Marginal adaptation”; “Recurrence of caries, erosion, abfraction”; and “Tooth integrity (enamel cracks, tooth fractures)”. Typical clinical cases are presented for each of these eight criteria and their corresponding five scores.


Study e-calib Calibration Composite