The present systematic review aims to compare the clinical effectiveness of direct and indirect composite restorations in the posterior teeth by taking into consideration several clinical factors including the marginal status, surface finish, color change and the overall patient opinion. This paper, based on the randomized controlled trials and clinical studies, was designed to introduce a comparison between the two techniques, shed light on the strength and weakness of the two, and contribute to dental practice. The risk of bias for the randomized controlled trials was evaluated by the Cochrane Risk of Bias tool and the quality of the observational studies by Newcastle–Ottawa Scale. These tools assess different parameters of study quality such as participant selection, reporting, performance, detection and attrition biases.The studies show that though, both techniques have their advantage and disadvantages, overall, indirect composite restorations provide better results in some or many ways, where marginal adaption, surface finish is considered but they take more time and cost.

Direct restorations, indirect restorations, case-control study, restorative dentistry.