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To investigate the outcomes of root filled posterior teeth restored with indirect composite resin onlays using tooth and restoration survival as well as the quality of restoration as outcome measures. All patients were treated by the same clinician with indirect composite onlays for the restoration of root filled posterior teeth between January 2008 and February 2010 in a single clinic setting. Primary root canal treatment was performed and onlays fabricated with the indirect method using indirect composite resin. Patients were seen every 4-6 months for maintenance visits according to standard clinic protocols and each patient’s individualized maintenance schedule. Tooth and restoration survival were calculated, and the onlays were evaluated in accordance with the modified US Public Health Service (USPHS) criteria. Thirty-one premolars and one hundred and fifty-eight molars (n = 189) of 153 patients were included. The observation period ranged from 24 to 52 months with a median follow-up time of 37 months. Tooth survival was found to be 100%, whilst the restoration survival was 96.8% and the functional restoration survival 98.9% at the end of the follow-up period. According to modified USPHS criteria, the A rating had a range of 83.1-100% for all evaluation criteria. Onlay restorations fabricated with indirect resin can be a viable option for the restoration of root filled teeth.

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