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Fifty-three posterior glass fibre-reinforced composite inlay-fixed partial dentures (IFPDs) in 36 patients were followed for 5 yr. For statistical analysis, one IFPD per patient was randomly selected. The survival rate and influence of discrete predictors (gender, location) and continuous variables (age, abutment surfaces) were determined. Clinical observations were recorded by using modified United States Public Health System (USPHS) criteria. Replicas of 17 randomly selected abutments were analysed by scanning electron microscopy (SEM) for marginal adaptation and the results were compared by using a repeated-measures analysis of variance (ANOVA). The main reason for failure was veneering material delamination from the framework. The cumulative survival rate after 5 yr was 73% (95% confidence interval: 57–89%) for not delaminating and 96% (95% confidence interval: 88–100%) for not debonding. No significant influence of the tested predictors was found. Significant changes between baseline USPHS criteria and counterparts recorded at recall were fractures of the veneering material (chipping), wear, surface texture, and staining. Significant margin changes were only found between baseline and 1 yr. Thereafter, marginal adaptation remained stable. After 5 yr, 90% of the margins were termed as perfect. It was concluded that hard-tissue saving IFPDs with the current design maintained acceptable retention and marginal integrity. Future studies should aim at reducing delaminations by searching for improved framework designs and materials.