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Aim: Intentional Root canal treatment of abutments is preferred by many prosthodontists to satisfy the principles of parallelism and line of draw before construction of fixed partial dentures. However, intact non-supra-erupted and non-tilted teeth need not be devitalized as this weakens the abutment. Hence this systematic review was undertaken to understand if the success of fixed partial denture improves with devitalized abutments.

Materials and Methods: The systematic review was done according to the PRISMA guidelines 2020. The databases searched were PubMed, Cochrane and Google Scholar. New castle Ottava scale of risk of bias tool was used for assessing the bias. Certainty of evidence was assessed using GRADEpro. Studies eligible for Meta-analysis was evaluated using Forest plot.

Results: Eleven studies were selected for the systematic review. None of the studies found non vital abutments to be superior to vital abutments in the survival or longevity of FPDs. All the studies included in the review either concluded that vital abutments improved the longevity/survival of FPDs and decrease the risk of complications or that there was no significant difference between vital and non-vital abutments for the success of FPDs. Meta-analysis was done for 8 eligible studies using Forest plot.

Conclusion: Endodontically treated abutments are not favorable for the longevity/survival of FPDs and they present with more risk of hazards/complications. Therefore, vitality of the abutment should not be sacrificed unless there is a questionable pulpal and/or periapical diagnosis preoperatively.