Choosing the Criteria for Clinical Evaluation of Composite Restorations: An Analysis of Impact on Reliabilty and Treatment Decision

Cleber Paradzinski Cavalheiro,Fausto Medeiros Mendes,Pablo Soares de Souza,Mariana Minatel Braga,Tathiane Larissa Lenzi,Daniela Prócida Raggio,Rachel de Oliveira Rocha

doi:10.1590/pboci.2020.055

Abstract

Objective: To assess the reproducibility of two clinical criteria for the evaluation of restorations in primary teeth and the impact on treatment decision. Material and Methods: A cross-sectional study was performed selecting 71 resin-based composite restorations placed in primary molars of children who had sought dental treatment at a dental school. Two trained examiners evaluated independently the restorations using modified FDI and USPHS criteria. All restorations were assessed separately with each system in random order to avoid memory bias. Kappa statistics were used to determine inter-examiner reliability considering each parameter of both criteria and score final about treatment decision. McNemar test was used to compare the treatment decision with two criteria. The significance level was set at 5%. Results: Kappa values ranged from 0.28 to 0.93 with USPHS and 0.28 to 0.88 with FDI, considering each parameter separately. Inter-examiner agreement for treatment decision was excellent for both criteria (Kappa: 0.85-0.90). For clinical decision-making, no difference between criteria was found, irrespective of examiner. Conclusion: Low inter-examiner agreement for evaluation of each parameter of USPHS and FDI criteria does not reflect on reproducibility for treatment decision. Both criteria may be suitable for evaluation of composite restorations in primary teeth.

Highlights

Resin-based dental composites are widely used in Pediatric Clinic for restoring anterior and posterior teeth
Both criteria may be suitable for evaluation of composite restorations in primary teeth
Seventy-one resin-based composite restorations placed in primary molars were selected from clinical records of patients attended at Pediatric Clinic of the School of Dentistry, Federal University of Santa Maria

Summary

Introduction

Resin-based dental composites are widely used in Pediatric Clinic for restoring anterior and posterior teeth. Parameters for assessing the restorations’ quality are often subjective, where small deviations from ideal concepts determine the replacement. In this sense, different criteria have been proposed aiming to standardize the evaluation of restorative materials or operative techniques in clinical trials. Different criteria have been proposed aiming to standardize the evaluation of restorative materials or operative techniques in clinical trials These criteria may be useful for quality assessment of restorations placed by clinicians in their own practices. Dental students should be trained to use them as part of a clinical evaluation to determine whether a restoration can be maintained or whether it needs repair or replacement [3]

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Conclusion