To compare the clinical effect of the zirconia inlay and gold alloy inlay in the restoration of the second class defect of molar with vital pulp.

60 teeth were randomly divided into zirconia inlay group and gold alloy inlay group, with 30 teeth in each group. Evaluate the restoration effect in 2 group at 1-year follow-up.

At 1-year follow-up, according to US Public Health Service Criteria, the success rate in anatomy zirconia group was 93. 53%, which was statistically higher than that of the gold alloy group (P ＜ 0. 05). In the comparison of aesthetics, the anatomy zirconia group was superior to that of the gold alloy group.

The aesthetic and overall success rate of the anatomy zirconia inlay is superior to that of the gold alloy inlay in the restoration of the second class defect of molar with vital pulp.