ObjectivesThis 120-month follow-up study aimed to investigate the complication rate of abutment teeth after endodontic pretreatment with base metal alloy double crowns with friction pins.Materials and methodsA total of 158 participants (n = 71, 44.9% women) aged 62.5 ยฑ 12.7 years with 182 prostheses on 520 abutment teeth (n = 459, 88.3% vital) were retrospectively analyzed between 2006 and 2022. Of the endodontically treated abutment teeth, 6.9% (n = 36) were additionally treated with post and core reconstructions. Cumulative complication rates were calculated using the KaplanโMeier estimator and log-rank test. In addition, Cox regression analysis was performed.ResultsThe cumulative complication rate at 120 months for the entire set of abutment teeth was 39.6% (confidence interval [CI]: 33.0โ46.2). Endodontically treated abutment teeth (33.8%; CI: 19.6โ48.0) were found to have a significantly higher cumulative fracture rate than vital teeth (19.9%; CI: 13.9โ25.9, p < 0.001). Endodontically treated teeth restored with post and core reconstructions (30.4%; CI: 13.2โ47.6) showed a nonsignificant lower cumulative fracture rate than that of teeth with root fillings only (41.6%; CI: 16.4โ66.8, p = 0.463).ConclusionsHigher 120-month cumulative fracture rates were observed in endodontically treated teeth. Comparable performance was observed in teeth with post and core reconstructions compared to teeth with root fillings only.Clinical relevanceIf endodontically treated teeth are used as abutments for double crowns, the risk of complications from these teeth should be considered when planning treatment and communicating with the patient.