The purpose of this prospective study was to evaluate the clinical outcome of three- to four-unit posterior all-ceramic fixed dental prostheses (FDPs) made of yttria-stabilized tetragonal zirconia-polycrystal ceramic frameworks (CerconBase; Degudent). Fifty-eight restorations were placed in 48 patients. Twenty-four FDPs had an end abutment design (EAD) replacing 3 premolars and 21 molars. Thirty-four FDPs had a cantilever design (CD) replacing 11 premolars and 23 molars. The frameworks had a minimum proximal connector dimension of 3 x 3 mm. The fixed dental prostheses were cemented with glass-ionomer cement after air-abrading the inner crown surfaces. Three FDPs were defined as drop-outs. The mean observation period was 48 +/- 7 months for the EAD (21 patients/24 FDPs) and 50 +/- 14 months for the CD (25 patients/31 FDPs). The 4-yr survival rate, according to the Kaplan-Meier analyses, was 96% for the EAD and 92% for the CD. The technical complication rate was 13% for the EAD and 12% for the CD, and the biological complication rate was 21% for the EAD and 15% for the CD. For none of the analyses were significant differences found between both groups. After 4 yr the clinical outcome of three- to four-unit posterior FDPs with EAD and CD was promising.