Objectives: To evaluate the clinical quality of three different ceramic inlay systems, 20 patients were treated with one Cerec, one Mirage and one Empress inlay respectively, inserted in a randomly selected order in the lower jaw. All patients were also treated with one gold inlay. In total, 35 premolars and 45 molars were treated with inlays. Methods: The inlays were examined independently by two calibrated examinors immediately after luting (Ex 1), 1 year (Ex 2), 3 years (Ex 3), 5 years (Ex 4) and 8 years (Ex 5) after luting. The inlays were rated using the California Dental Association (CDA) quality evaluation system. Results: One gold inlay was replaced after 8 years due to caries. Altogether five Empress inlays, two Cerec inlays and two Mirage inlays had to be replaced due to fracture during the 8 years follow-up period. The examination showed that the mismatch of colour increased from 15% to 50% between Ex 1 and Ex 5 for all ceramic systems. The gold inlays and the ceramic inlays were registered slightly roughened in 30% and 23-53% respectively at Ex 5. For the ceramic inlays a visible evidence of ditching along the margin increased from 5% (Ex 1) to 80% (Ex 5), and an apparent discoloration of the margin between the tooth increased from 0% (Ex 1) compared to 55% (Ex 5). Conclusions: To conclude, 9 (15%) ceramic inlays were fractured during the follow-up period of 8 years. Based on the criteria of the CDA quality evaluation system 85% of the 60 ceramic inlays were rated "satisfactory" 8 years after luting.

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