The current study will be intended to evaluate and compare three-year clinical performance of class II bulk-fill resin composite restorations placed with different techniques.

Fifty patients with proximal carious lesion in permanent molars were included in the study. A total eighty class II cavities were restored with one of the following bulk-fill resin composite with their adhesive systems (n=20) Filtek™ Bulk Fill, Heated Filtek™ Bulk Fill, G-aenial™ BULK Injectable or Sonicfill3. Double blinded randomized clinical trial with survival and clinical quality were evaluated at baseline, after 12 , 24 and 36months using modified FDI(Fédération dentaire internationale) World Dental Federation criteria

Inclusion Criteria:

• Good general health
• Good oral hygienic
• Patient aging 18-35 year
• Patient available for follow-up visits compound class II (mesio-occlusal or disto-occlusal)
• Carious lesion in the external and middle third of dentin thickness
• ICDAS (International caries detection and assessment system) 4 or 5 that diagnosed clinically and radiographically.
• Maxillary or mandibular first or second molars
• Tooth with antagonist and adjacent mesial and distal tooth contact,
• Normal response to a vitality test.

Exclusion Criteria:

• Poor oral hygiene
• Severe or chronic periodontitis
• Heavy bruxism
• Occlusion fewer than 20 teeth
• Sensitivity to resin-based material.
• Patients with orthodontic treatment
• Patients on pregnancy or lactation
• chronic use of anti-inflammatory drugs, analgesic, and/or psychotropic drugs
• Patient potentially unable to attend recall visits
• Teeth would need direct pulp capping or
• Teeth act as abutment for fixed or removable prosthesis.