BACKGROUND: Despite recent advances in restorative dentistry adhesive restorations may cause postoperative sensitivity which leads to restoration failure. AIM: This study aimed to compare and evaluate the incremental and bulk fill resin Composite postoperative sensitivity in class II posterior restorations bonded with two adhesive systems (self-etch and etch-and-rinse). METHODS: Sixty patients were randomly selected, their age range from twenty-five to forty years old, divided into two groups according to the packing technique of resin composite material; incremental Tetric Evoceram and Tetric Evoceram bulk-fill resin composite. Thirty patients (n = 30) for incremental Tetric Evoceram resin composite restorations and according to the adhesive systems used they were equally divided (n = 15 teeth).Thirty patients (n = 30) for Tetric Evoceram bulk-fill resin composite restorations and according to the adhesive systems used (etch and rinse or self-etch), they were equally divided (n = 15 teeth). Post-operative pain assessed at 24 hours, 1 week and 1 month using the Visual Analog Scale Score (VAS). Each patient was instructed to put a mark on the VAS line at home to point out the intensity of pain at each assessment period. The problem of measuring the pain that pain tolerance of individuals may be different from the others. This may be due to different reasons, and it is not always because of a problem in the restoration RESULTS: After 1 day, 1 week as well as 1 month, no statistically significant disagreement between the two resin composite types using self-etch adhesive strategy and total-etch adhesive strategy. Also, when the two adhesive systems were compared using Bulk Fill resin composite and incremental Nano resin composite no statistically significant disagreement between the two adhesive systems after 1 day, 1 week as well as 1 month. CONCLUSION: The post-operative hypersensitivity is related to many factors as the procedure of cavity preparation, adhesive approach, and type of resin composite used and placement technique of the resin composite.
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