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 .
A randomized clinical trial of cusp-replacing resin composite restorations: efficiency and short-term effectiveness.
PURPOSE This study aim ed to assess the efficacy and short-term effectiveness of the morphology and function of direct and indirect cusp-replacing resin composite restorations . MATERIAL S AND METHODS In 94 patients , 106 cusp-replacing restorations for maxillary premolars were fabricated to restore Class II caries lesions with 1 cusp missing . Fifty-four direct ( Clearfil AP-X ) and 52 indirect ( Estenia ) resin composite restorations were placed following a strict protocol . The treatment technique and operator were assigned r and omly . Treatment time was recorded for all restorations . One-month postoperative evaluation included assessment of postoperative sensitivity and presence of occlusal and proximal contacts . RESULTS Treatment time for the indirect technique ( 68 + /- 17 min ) was longer than for the direct technique ( 45 + /- 13 min ) . Regression analysis revealed that the restorative method , operator , and location of the preparation outline had a statistically significant effect on the total treatment time . Occlusal contacts were observed in 94 % of the direct restorations and in 98 % of the indirect restorations ( chi-square , P>.05 ) . Mesial proximal contacts were present in 98 % of the direct and in 97 % of the indirect restorations ( chi-square , P > .05 ) . Distal contacts were present in 100 % of the restorations for both techniques . Postoperative sensitivity within 1 week posttreatment was reported for 11 % of the direct restorations and for 13 % of the indirect restorations , but decreased to 4 % and 6 % , respectively , after 1 month ( chi-square , P > .05 ) . CONCLUSION The results of this study suggest that in the short term , both direct and indirect adhesive techniques are adequate to restore the morphology and function of premolars presenting with Class II caries lesions and a missing cusp
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 .