Objectives: To investigate the long-term clinical survival of ceramic inlay restorations. Methods: As a part of a study about blood mercury levels after removal of dental amalgam restorations, 106 copy-milled ceramic Celay® inlays were prepared for 19 healthy men. Seventeen of the inlays were in premolars and the rest in molars. The restorations were evaluated after 1 week, 1 year, 2 years and 7 years with USPHS criteria. Twelve patients (63%) with 81 restorations (76%) were traced at 7-year-follow-up. Results: The overall mean follow-up time was 6,3 years (1 yr - 8 yrs). At initial evaluation post-op sensitivity was registered in 15 inlays; at 1 year these symptoms had disappeared. During the first year, in 3 inlays minor cracks at enamel-ceramic interface were either polished or repaired with composite resin. At 7 years, no inlays were lost and evaluation showed an overall excellent performance with > 98% Alpha recordings in anatomic form, interproximal contacts, secondary caries and post-op sensitivity. Color match was initially Alpha in 93% of inlays, whereas after 7 years, color match was Alpha in 55% and Bravo in 44% of them. Marginal integrity was initially Alpha in 95% and Bravo in 5% of the cases, whereas the figures were Alpha in 76%, Bravo in 22% and Charlie in 2% of the cases after 7 years. Conclusions: Celay® ceramic inlays are a good clinical alternative for amalgam restorations.

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