Background: The composite restoration of anterior is always a challenging job.

Aim: To compare the clinical outcome of class 2 direct composite restorations using total-etch and selective etch adhesives, according to USPHS criteria.

Methods: One hundred patients were included in this randomized controlled clinical trial study at Operative Dentistry department of LMDC, Lahore. They were divided in two groups. Group 1 for total etch technique, group 2 for selective etch technique enamel was etched with 37% phosphoric acid for 20 second and then washed thoroughly with water for 5-10 seconds and was dried with air for 5 seconds till frosty white and bond with self etch.

Results: The majority of patients were in the age range of 25-31 years, 25 (50%) patients used total etch technique and 22 (44%) patients used selected etch technique. When compare the overall rating for restorations, 38 patients (76%) have acceptable restoration in total etch technique and 46 patients (92%) in selected etch technique. Statistically the difference was significant (P<0.05).

Conclusion: Selected etch technique presented a successful clinical performance over total etch technique for Class II restorations.

Keywords: Class II direct composition restoration, Total etch technique, Selected etch technique.