Abstract
Introduction: In the dental aesthetics scenario, there has been an increase in the indication of indirect restorations such as inlays, onlays, and overlays in ceramics and resins. Objective: This study aimed to examine the clinical outcomes of indirect onlay, overlay, and inlay restorations in dental aesthetic through a systematic review. Methods: The systematic review rules of the PRISMA Platform were followed. The search was carried out from March to April 2025 in the Scopus, Embase, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 125 articles were found. A total of 37 articles were evaluated in full and 28 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 18 studies with a high risk of bias and 20 studies that did not meet GRADE. It was concluded that there was an increase in the indication of indirect restorations inlays, onlays, and overlays in ceramics and resins. The restoration of posterior teeth, with loss of a large amount of tooth structure, using indirect restorations, aimed to overcome some problems associated with direct restorations, such as low mechanical and wear resistance, and difficulty in reestablishing proximal or occlusal morphology. Indirect Restorations are most indicated when there is loss of cusps, the need to reinforce the remaining teeth, and difficulty in reconstructing the anatomy directly in the mouth. Zirconia is a crystalline ceramic that has minimal or practically no glass phase and is available in powder (layered or sintered) or block (CAD/CAM). Another material option is laboratory composite resins, which have also been used to create indirect restorations, being an alternative to ceramics. Failures can be considered as events occurring after final cementation requiring some intervention or complete replacement of the restoration.