In a randomized clinical study 47 titanium and gold-alloy fixed partial dentures (FPDs) were placed during a 1-year period. In the titanium group (n = 22) all metal substructures were made of unalloyed titanium. The titanium substructures were fabricated by copy milling, spark erosion and laser welding (Procera, Nobelpharma). Ceramic veneering was carried out with Duceratin titanium ceramics (Ducera, Germany). In the control group (n = 25) the high-gold alloy Degudent U (Degussa, Germany) and Vita VMK 68 ceramics (Vita, Germany) were used. The longest observation time was 6 years. Only one FPD had to be removed due to metal-ceramic failure (titanium group). The clinical performance of all 125 porcelain-fused-to-metal (PFM) veneers with respect to the longevity of the metal-ceramic compound was described by Kaplan-Meyer survivor analyses. Relating survival to a completely intact ceramic veneer, the 5-year survivor rate was 84% for titanium and 98% for the high-gold alloy. PFM titanium restorations exhibited a significantly increased risk of metal-ceramic failure. However, concerning defects requiring removal, no significant differences in titanium versus high-gold alloy occurred. There were no significant differences in the survival distributions between crowns and pontics within the two groups.