Objective This clinical study evaluated the clinical performance of composite resin inlays and onlays over 9 years. Materials and Methods Sixty composite resin inlays and onlays were placed in 32 patients, aged 20 to 60 years, by a single operator using the same clinical procedure. The restorations were examined for fracture rate; esthetics; and patient acceptance and marginal integrity, including caries, marginal discoloration, tooth integrity, and surface texture. All restorations were evaluated at the time of placement and 3, 6, and 9 years after placement by using the modified U.S. Public Health Service criteria. Results At the 3-year follow-up, an Alpha score was given to 88.4% of restorations, while a Bravo score was given to the remaining 11.6%. There was not any failure. At the 6-year follow-up, the success rate of the restorations was 100% without failure. None of the restorations was scored with Delta (D). An Alpha score was given to 60% of the restorations, a Bravo score was assigned to 35%, and a Charlie score was 5% of the restorations. Overall, the success rate of the restorations at 9-year follow-up was 85% and the failure rate was 15%. An Alpha score was given to 15% of the restorations, a Bravo score was given to 50%, a Charlie score was assigned to 20%, and a D score was given to 15% of the restorations. Conclusion Indirect resin composite inlays and onlays showed acceptable long-term clinical results. The success rate of the restorations at 9-year follow-up was 85% and the failure rate was 15%.

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