Objective <p>The study aimed to evaluate the complexity of fixed dental prostheses using the Restorative Index of Treatment Need (RIOTN) system.</p> Materials and methods <p>This descriptive cross-sectional study included patients who received fixed dental prostheses. The complexity of their treatments was assessed using the RIOTN system’s fixed prosthodontics treatment assessment component, which evaluates the complexity of fixed prosthodontic treatments, including intra coronal restorations, veneer restorations, and extra coronal restorations (including pontic units).</p> Results <p>A total of 60 patients received 74 fixed prostheses. After applying modifying factors, 58.1% of cases were graded as complexity grade 1, 25.7% as grade 2, and 16.2% as grade 3. Modifying factors were present in 10.8% of patients, with a retching tendency being the most common (37.5%).</p> Conclusion <p>The study found that most patients (58.1%) required fixed dental prostheses with a complexity grade of 1, indicating a relatively straightforward treatment. The presence of a retching tendency (37.5%) was the most common modifying factor, which can increase treatment complexity. This assessment highlights the importance of evaluating the complexity of fixed dental prosthesis treatments to ensure optimal patient care and outcomes.</p> Clinical relevance <p>Fixed dental prostheses are a common dental procedure that requires accurate diagnosis, radiographic examination, clinical assessment, and technical expertise for successful outcomes. The complexity of these treatments varies widely, and assessing it is essential to ensure optimal patient care and outcomes.</p>