Purpose: Evalute the leakage of Class II box composite restorations and compared with composite lined by flowable composite and combined amalgam-composite restoration. Method: Fifty-four Class II box shaped cavities were on the distal (1 mm below CEJ) surfaces, 18 cavities for each. Scotchbond Multi-Purpose adhesive system, Filtek Z250 composite, and a metal band system were used for all. After thermocycling test (1000 cycles, 5–55°C with 30 s) and dye immersion, the teeth were sectioned longitudinally in a mesio-distal direction and dye penetration was recorded. Results: Combine amalgam-composite restorations showed less gingival leakage than composite alone and composite lined by flowable composite restorations, significantly. Conclusion: For class II box composite restorations, the ginigival leakage, below CEJ with missing enamel, can be reduced by pacing amalgam ginigivally combined by composite occlusaly.
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