Purpose:This study performed a clinical evaluation of two ceramic systems retained with resin-bonded cement, observed clinical outcomes over time, and compared the two systems used (IPS Empress and Vitadur Alpha) and differences between inlays and onlays. Materials and Methods:Three general practitioners placed 317 restorations (215 IPS Empress and 102 Vitadur Alpha) in 153 patients. The first clinical registration was performed 6 to 36 months after placement of the restorations by calibrated investigators using the CDA criteria. A second follow-up was performed 36 months later. The mean time in function for all restorations at follow-up was 60 months. Results:At the first examination, five restorations were not clinically acceptable because of fractures and caries. At follow-up, another 16 restorations were judged as failures. The most significant changes over time were an increase in rough surfaces, evidence of increasing marginal discrepancy, and slight mismatch in color between restored tooth and ceramic restoration. When comparing IPS Empress to Vitadur Alpha, there was no difference in clinical performance. When comparing inlay and onlay restorations, there was a tendency toward a higher number of failures in the inlay group. The overall success rate was 92%. Conclusion:Ceramic restorations performed well after 5 years in function and provide a good treatment alternative that can be successfully managed in general dental practice. Int J Prosthodont 2004;17:302–306.