The difference of the two techniques did not reach statistical significance in order to recommend one technique over the other .
CLINICAL SIGNIFICANCE Resin composite material s , placed directly or indirectly , exhibit a promising long-term clinical performance when rehabilitation of posterior teeth is needed .
OBJECTIVE To evaluate the long-term clinical performance of direct versus indirect composite inlays/onlays  in posterior teeth .
Although many years in clinical practice , the selection of the best treatment protocol still remains subjective .
Clinical performance and marginal adaptation of class II direct and semidirect composite restorations over 3.5 years in vivo.
OBJECTIVE The study evaluated the clinical performance and marginal adaptation of  direct and semi-direct class II composite restorations  in a split-mouth design over 3.5 years . DESIGN 44 upper posterior teeth in 11 adults with primary carious lesions were treated with 22  direct and 22  semi-direct restorations . Conventional cavities were prepared for both types of restorations . A fine fine hybrid composite ( APH ) and a multifunctional adhesive system ( Prisma universal bond 3 ) were used for all restorations . The incremental " 3-sited light curing " technique was applied to direct restorations . Semi-direct inlays were prefabricated on silicone casts and post-cured using light and heat .  Clinical performance was evaluated using modified USPHS parameters , while marginal adaptation was judged on replicas , using SEM and a st and ardized evaluation technique . RESULTS Clinical results after 3.5 years revealed a 100 % retention rate with no fractures , sensitivity or recurrent caries for both types of restorations . SEM-evaluation of the occlusal margins showed at the tooth-restoration interface relatively low rates of marginal openings over the observation period ( 4 - 8 % ) . Marginal restoration fractures ranged between 1 and 2 % , marginal tooth fractures between 3 and 9 % . Differences between the restorative techniques and after the different time observation periods were not statistically significant . Proportions of marginal fractures and openings at the restoration-luting composite interface were less than 10 % after 3.5 years . CONCLUSION The results indicated no significant differences for direct and semi-direct fine hybrid composite restorations  in medium size cavities in posterior teeth with respect to clinical performance and marginal adaptation over 3.5 years
The difference of the two techniques did not reach statistical significance in order to recommend one technique over the other .
CLINICAL SIGNIFICANCE Resin composite material s , placed directly or indirectly , exhibit a promising long-term clinical performance when rehabilitation of posterior teeth is needed .
OBJECTIVE To evaluate the long-term clinical performance of direct versus indirect composite inlays/onlays  in posterior teeth .
Although many years in clinical practice , the selection of the best treatment protocol still remains subjective .