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 evaluation of ceramic inlays compared to composite restorations.
This study compared the clinical performance of  indirectly manufactured ceramic Evopress inlays with those of directly placed , fine particle hybrid Filtek Z250 composite restorations in posterior teeth . From January 2000 to October 2003 , 109 patients received 264 Evopress ( Wegold ) ceramic inlays and 68 patients received 145 Filtek Z250 ( 3 M ESPE ) composite restorations in a dental office . Two-hundred and fifty ceramic inlays ( 95 % ) and 135 composite restorations ( 93 % ) were re-examined up to 57 months after placement . Modified USPHS criteria were used for the study . The worst finding of all the assessment s was the overall assessment of individual restorations . On the basis of these criteria , 220 ( 88 % ) Evopress ceramic inlays were assessed as Alpha at the time of clinical re-examination , 26 ( 10 % ) were judged Beta and four ceramic inlays ( 2 % ) were rated Delta in the re-examination interval and thus categorized as failures . At the time of re-examination , 91 of the 135 composite restorations ( 67 % ) were judged Alpha , 36 restorations ( 26 % ) were rated Beta and three restorations ( 2 % ) were judged Charlie . Five restorations ( 4 % ) were categorized as failures ( Delta ) . In two cases , there were marginal gap formations ; there were also two cases of secondary caries after 28 and 35 months , as well as a fracture after 13 months . According to Kaplan and Meier , the survival rate after 57 months was 94 % for ceramic inlays and 93 % for composite restorations . The log rank test showed no significant differences in the survival curves . The current study showed that indirectly manufactured Evopress ceramic inlays performed better than direct Filtek Z250 composite restorations in marginal adaptation , color match and anatomic form . However , with regard to survival probability , there was no significant difference
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 .