Prompted by increased patient requests for esthetic treatment, restorative clinicians have evaluated a variety of new materials and procedures. This study reports on 5 years' experience with In-Ceram Spinell all-ceramic crowns. A total of 40 anterior crowns were positioned in 13 patients from October 1995 to December 1998. The clinical examination was made following modified California Dental Association/Ryge criteria. Final evaluation was carried out in October 2000, for an observation period of 22 to 60 months (mean 50 months). Only one failure was recorded, and the fractured crown needed to be replaced; according to Kaplan-Meier analysis, the estimated success rate was 97.5%. A thorough description of the clinical procedures through which anterior teeth can be successfully treated with all-ceramic Spinell crowns is described.