Objective: The objective of this prospective longitudinal 10-year follow-up study is to assess periodontal and prosthodontic parameters in zirconia restorations on teeth prepared with the biologically oriented preparation technique (BOPT). Materials and methods: A 10-year follow-up analysis was conducted on cases of fixed prosthesis retreatment using BOPT in the anterior sector. The selected sample was divided into two groups, comprising single-unit crowns and fixed partial dentures, respectively. Additionally, a control group consisting of antagonist teeth that had not undergone prosthodontic treatment was included. The following periodontal parameters were recorded on an annual basis: gingival margin stability, gingival index, plaque index, and probing depth. Furthermore, other parameters, including gingival thickness, biological and mechanical complications, and patient satisfaction were also examined. Results: A total of 33 patients with 91 abutment teeth were recalled after a 10-year follow-up period. Of these, 39 were single-unit crowns and 52 were fixed partial denture abutments (FPDs). An increase in gingival thickness was observed during the initial three-year period, followed by stabilization at the 10- year follow-up. A comparison of the BOPT abutments with their antagonists revealed a significantly greater gingival thickness (p<0.001). Additionally, the gingival margin and pocket depth exhibited stability. Conversely, there was an increase in the gingival index (p=0.022) and plaque index (p=0.013). No significant difference was identified in the parameters assessed between single-unit crowns and FPD abutments. Conclusions: The results of the long-term (10- year) follow-up investigation of fixed prosthetic restorations executed with the biologically oriented preparation technique (BOPT) demonstrate favorable periodontal and prosthodontic outcomes.