Clinical Oral Investigations

, Volume 22, Issue 6, pp 2319–2324 | Cite as

The Functional Implant Prosthodontic Score (FIPS): assessment of reproducibility and observer variability

  • Tim Joda
  • Fernando Zarone
  • Nicola U. Zitzmann
  • Marco Ferrari
Original Article



The aim of this study was to validate the reproducibility and observer variability of the Functional Implant Prosthodontic Score (FIPS), while considering the level of dental experience for intra- and inter-examiner analysis.

Materials and methods

A total of 44 examiners (n = 31 undergraduate dental students and n = 13 postgraduate prosthodontic students) applied FIPS to ten sample cases each showing one implant-supported single crown for premolar or molar replacements. Examiners’ assessments were carried out twice at an interval of 2 weeks (round A and round B). Pearson’s correlations including 95% confidence intervals (CI95) were calculated for intra- and inter-examiner reproducibility testing. Cohen’s Kappa score was additionally used to analyze the homogeneity of each FIPS variable.


The mean values of the total FIPS scores for round A (7.21 ± 0.91) and round B (7.27 ± 0.86) showed a strong correlation of 0.9374 (CI95 0.9250; 0.9478). No significant difference was identified between undergraduates and postgraduates representing different levels of dental experience. Homogeneity analysis of the defined FIPS variables was not significantly different.


Both intra- and inter-examiner analysis revealed very congruent results for reproducibility testing of FIPS. The findings validated the potential of FIPS as an objective and reliable evaluation instrument in assessing fixed implant restorations in posterior sites independent of the level of dental experience.

Clinical relevance

FIPS can be considered as an additional diagnostic tool to classify fixed implant restorations in routine dental practice, to compare follow-up observations, and to identify potential risks of failure.


Diagnostic test study Dental implant Fixed prosthodontics Reproducibility Validity Functional implant prosthodontic score (FIPS) 



The authors are grateful to all voluntary participants for intra- and inter-examiner analyses, and acknowledge Mr. Gabriel Fischer for the statistical support of the correlation analyses.


The work was supported by the Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Switzerland.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

For this type of study, formal consent is not required.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Reconstructive Dentistry and Gerodontology, School of Dental MedicineUniversity of BernBernSwitzerland
  2. 2.Department of Reconstructive Dentistry, University Center for Dental Medicine BaselUniversity of BaselBaselSwitzerland
  3. 3.Department of Prosthodontics, School of Dental MedicineUniversity of NaplesNaplesItaly
  4. 4.Department of Prosthodontics and Dental Materials, School of Dental MedicineUniversity of SienaSienaItaly
  5. 5.Department of Restorative Dentistry, School of Dental MedicineUniversity of LeedsLeedsUK

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