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 .
Direct and indirect evaluation of posterior composite restorations at three years.
The purpose of this study was to compare the use of direct ( USPHS ) and indirect ( M-L ) systems of evaluating the  occlusal wear of posterior composite restorations . Additionally , this study has utilized the USPHS method to compare the in vivo performance of  posterior resin composite restorations made from four different visible-light-cured material s. Of the 202 restorations placed for this r and omized clinical trial , only those restorations that were scored by both direct and indirect evaluation systems were included in these comparisons . Restorations were evaluated by two calibrated examiners from baseline to 36 months . While there were some differences noted among the four material s , the majority ( 99 % ) of the restorations evaluated in this study received " alpha " or " bravo " scores for all USPHS parameters , indicating acceptable in vivo performance . The results of this study also indicate that there was a consistent relationship between the direct ( USPHS ) and indirect ( M-L scale ) scoring systems . For those restorations that changed anatomic form scores , the mean wear at the alfa/bravo transition was 100 + /- 80 microns . By the 24-month recall examination , the use of the USPHS evaluation system category of anatomic form enabled examiners to differentiate restorations and material s that had experienced little occlusal wear from those that had experienced greater amounts of wear
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 .