The aim of this clinical study was to compare the internal gaps between abutment teeth and posterior fixed partial dentures (FPDs) fabricated utilizing milled zirconia and cast gold-alloy frameworks. As part of an ongoing randomized controlled clinical trial, 32 three-unit FPDs (16 zirconia and 16 metal-ceramic) in 25 patients were randomly selected for adaptation measurements. During the bisque-stage ceramic try-in, an A-silicone impression material was placed between the abutment teeth and the framework. The internal gap, corresponding to the thickness of the replica, was measured under magnification at the following locations: cervical, axial, and occlusal (cusp-tips and central). The internal gaps of FPDs with zirconia frameworks were significantly larger in cervical, axial, and centro-occlusal regions (cervical: 189.6 +/- 71.8 mum vs. 118.6 +/- 31.5 mum; axial: 140.5 +/- 38.3 mum vs. 95.7 +/- 18.1 mum; and centro-occlusal: 192.0 +/- 66.5 mum vs. 153.1 +/- 69.8 mum). The cervical gaps next to the pontics were significantly larger compared with those of the outer walls in both types of FPDs (zirconia: mean difference 67.7 +/- 114.7 mum; metal-ceramic: mean difference 30.0 +/- 71.2 mum). Posterior three-unit FPDs incorporating milled zirconia frameworks exhibited larger internal gaps than those constructed using conventional metal-ceramic techniques.