This retrospective study evaluated the incidence of complications to determine the long-term survival rate of teeth with severely compromised clinical crowns treated with minimally invasive crown lengthening (MICL) and restorative treatment. A sample of 112 teeth in 86 patients was treated with MICL and restorative dentistry. Endodontic and orthodontic therapies were applied when needed. Clinical outcomes were assessed at baseline, 1 year, and in the long term. The application of MICL resulted in very limited radiographic bone resection (RBR; 1 ± 0.1 mm on average). Limited local inflammation and shallow probing depths were detected at 1 year (2.6 ± 0.5 mm) and in the long term (2.9 ± 1.0 mm). Most of the teeth (76.8%) maintained good dental and periodontal health over time. The negative events observed in 26 teeth were caries (8.9%), fractures (7.1%), endodontic problems (1.8%), periodontal problems (4.5%), and restoration problems/complications (0.9%). The survival rate was 90.2%. The outcomes of this long-term retrospective analysis (mean: 8.9 ± 0.9 years; range: 8 to 10 years) show high tooth survival rates and low incidence of complications for teeth treated with MICL and restoration of the clinical crown.