There are still no replacement materials on the market that are equal to amalgam. However, alternatives of differing qualities are available and, for the most part, clinically proven. This article attempts to make a scientific and clinical comparison of these alternatives with respect to esthetics, biocompatibility, chemical durability, and treatment cost. The evaluation suggests that cementable restorations, in particular electroformed inlays and onlays, are superior to bonded ceramic inlays.