The purpose of this study was to compare the longevity of crowns versus large multisurface restorations in posterior teeth. The investigation used the treatment database at Virginia Commonwealth University School of Dentistry. The inclusion criteria for the final data set used for analysis were: only one restored tooth per patient, premolars with three or more restored surfaces, molars with four or more restored surfaces, molars and premolars restored with complete veneer metal crowns, or crowns veneered with metal and porcelain. The Kaplan-Meier approach was used to visualize the survival curves, and the Cox proportional hazards model was used for analysis of predictor variables. The investigation indicates crowns survive longer than large restorations and premolar restorations survive longer than molar restorations. The median survival for crowns exceeded 16.6 years, with the median survival of premolar restorations being 4.4 years and molar restorations 1.3 years. An interaction between age and treatment was discovered, with overall survival decreasing as patient age increases. The doctor supervising the treatment also affected survival with treatment supervised by specialists lasting longer than treatment supervised by nonspecialists.