Thirty-two consecutively treated patients were included in this study of 49 root-resected molars that were under regular recall of 3 to 6 months for a mean of 11.5 years (2 to 23 years). Treatment modalities for all patients were very similar. Endodontic treatment was conservatively performed prior to resection with maximum preservation of tooth structure. No threaded posts were used. Provisional restorations were in place prior to periodontal therapy (pocket reduction with or without osseous surgery). Most patients were treated with complete-mouth reconstructions. Ninety-two percent of all resected molars survived an average of 12 years. Teeth failed because of recurrent caries or for endodontic and strategic reasons. If proper treatment is rendered, periodontically involved molars can be maintained for a long period of time and serve successfully as abutments in complete-mouth restorations. Great care must be taken throughout the whole process of case selection, reevaluation, and endodontic, periodontal, restorative, and maintenance therapies.