Restorative treatment of posterior teeth: direct or indirect technique?

Many different materials and techniques are available for restoring posterior teeth. As a result, the clinical decision-making is challenging as the influence of several factors related to the tooth, material, patient and operator must be taken into consideration. There are great variations among dentists’ clinical decisions, but the overall philosophy should be minimally invasive and biological and the focus ideally should move from longevity of the restoration to longevity of the tooth. The first choice should be the least invasive: direct composite. Neither literature nor the user manuals from the manufacturers place any restrictions on the extension of composite restorations. However, if there are technical difficulties in using proper matrix technique or achieving acceptable anatomic contour, or if parafunctional activities are present, indirect restorative techniques should be considered.