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Aim: The aim of the study was to evaluate and compare the postoperative pain and clinical efficacy of winged clamps and wingless metallic clamps in rubber dam isolation of permanent molars in class I restoration. Materials and Methods: After obtaining ethical approval and CTRI registration, a total of 60 patients with mild-to-moderate deep class I caries were included after obtaining informed consent and randomly allocated into two assigned groups: Group A – winged clamp and Group B – wingless clamp, with n = 30 per group. Local anesthesia was administered and the tooth was isolated using a rubber dam as per the standardized protocol. The postoperative evaluation was done for pain using the Verbal Rating Scale (VRS) at 6 and 12 h; trauma to the gingival tissues, sealing ability of the clamp, and slippage of the clamp were evaluated using criteria for clinical evaluation of rubber dam isolation. Statistical Analysis Used: Independent t-test and Chi-square test were used to compare VRS and clinical parameters, respectively, with P < 0.05. Results: Gingival trauma (P = 0.006) and postoperative pain were statistically significantly more in the wingless group at 6 h (P = 0.016) and 12 h (0.01). Statistically significant lower seepage of fluid (P = 0.017) was observed in the wingless group. Slippage was observed more with the winged group but was statistically insignificant. Conclusion: Both clamps showed acceptable clinical performance. Their use should be planned as per the requisite of the case and the position of the tooth. [ABSTRACT FROM AUTHOR]