Objective: The objective of this study is to evaluate the safety, longevity, esthetic result and efficacy of Gradia Class II restorations placed under clinical conditions. Methods: 40 Class II OM or OD restorations were placed using Exp. Gradia direct material in combination with Unifill bonding system (GC). The performance of Class II restorations wassessed at baseline and at the 1 and 7 days and 1-month (for post-op sensitivity) 6-month, 12-month recalls. No bevel and macromichenical retention were placed. Cervical margins was located primarily in dentin. A rubber dam will be applied, and the restorations are placed following an incremental technique. The patients were recalled for evaluating post-operative sensitivity and other clinical parameters such as Marginal Integrity (MI), marginal discoloration (MD), Color stability (CS), Surface staining (SS) Retention (R) and Secondary caries (SC) according with Ryge criteria. Results: only one restorations showed moderate post-op sensitivity after 1 year. Another restorations showed slight but still acceptable discoloration (CS and SS) not requiring replacement, with a slight discoloration at the interface (MI, MD). All restorations showed proper retention and no secondary caries. Conclusions: The restorative materials used in this study showed acceptable clinical performances after 1 year of clinical service. Longer clinical trial will elucidate clinical behavior of Gradia direct resin composite in combination with Unifill bonding system. This study was partially supported by GC Europe.

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