To evaluate the clinical suitability of a barium silicate-filled composite (TPH) for restoration of posterior teeth, 50 Class II restorations were restored in 36 patients. Restorations included 22 molars and 32 premolars. Cavity preparations were protected with calcium hydroxide or a resin-modified glass ionomer cement, or both. Enamel was etched for 30 seconds with 37 percent H3PO4. All dentin surfaces were treated with a dentin bonding system that was placed, cured, and restored in 2 microns increments. The restorations were finished using diamond burs, polishing points, and paste. Evaluation periods were at zero (50 restorations), 6 months (35 restorations), 1 year (31 restorations), and 2 years (29 restorations), using the USPHS System and M-L indirect scale. At zero time, 50 restorations were scored "a" in all categories by using two independent evaluators. After 6 months, 35 restorations were graded with one "a" in postoperative sensitivity. After 1 year, 31 restorations were evaluated with one additional "b" for marginal integrity. After 2 years, 2 additional "b" for marginal integrity and 1 "b" for surface staining were noted. No "c" was observed in any categories throughout this study. Wear analysis revealed, on average, 2 microns of wear after 6 months, 7.8 microns of wear after one year, and 10.3 microns of wear after 2 years.