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Oxide breakdown has become an increasingly pressing reliability issue in modern very large scale integration design with ultrathin oxides. The conventional guard-band methodology assumes uniformly thin oxide thickness, resulting in overly pessimistic reliability estimation that severely degrades system performance. In this paper, we present the use of limited post-fabrication measurements of oxide thicknesses from on-chip sensors to aid in the chip-level oxide breakdown reliability management. A key challenge, which is the focus of this paper, is precisely predicting and managing the reliability condition of each chip with a limited number of measurements and quantifying the tradeoff between reliability margin and system performance. Given the post-fabrication measurements, chip oxide breakdown reliability can be formulated as a conditional distribution that allows one to achieve a significantly more accurate chip lifetime estimation. The estimation is then used to individually tune the supply voltage of each chip for performance maximization while maintaining or improving the reliability. Experimental results show that, by using 25 measurements, the proposed method can achieve an average of 19% performance improvement, and a 27% maximum for a design with up to 50 million devices, with an average operation time of approximately 0.4 s per chip.