Background <p>The poor marginal adaptation, sub-gingival margin placement and over-contoured crowns can contribute to localized periodontal inflammation. Besides, lack of proper clinical expertise of the restorative dentist can result in the excessively deep subgingival margin placement and inconsistencies in the margins preparation. This can lead to loss of marginal integrity, poor adaptation of the crowns and eventually periodontal breakdown. The aim of the study was to compare the periodontal condition of abutment and non-abutment teeth in a group of Nepali adult patients with fixed dental prosthesis who visited the tertiary care hospital of Nepal.</p> Methods <p>This analytical cross-sectional study was conducted among 95 patients with fixed dental prosthesis visiting Department of Periodontics, T.U. Dental Teaching Hospital. Gingival index, plaque index, probing pocket depth and clinical attachment loss were recorded as clinical parameters in both abutment and contralateral matched non-abutment teeth. In descriptive statistical analyses, mean, median, standard deviation (SD), interquartile range (IQR), frequency and percentage were calculated depending upon the nature of data. The differences in the clinical parameters between the abutment and non-abutment teeth were analyzed using the Mann-Whitney U test. </p> Results <p>The abutment teeth had significantly higher plaque index (PI) scores (<i>p</i> &lt; 0.001), gingival index (GI) scores (<i>p</i> &lt; 0.001), increased probing depth (PD) (<i>p</i> &lt; 0.001) and clinical attachment loss (CAL) (<i>p</i> &lt; 0.001) than contralateral matched non-abutment teeth. The duration of prosthesis showed statistically significant difference in plaque index score (<i>p</i> = 0.026) and clinical attachment loss (<i>p</i> = 0.037) but no significant difference in gingival index score and probing pocket depth . Similarly, prosthetic materials used had significant difference in PI score (<i> p</i>=0.004) and GI score (<i>p</i> = 0.036) but no significant difference in PD and CAL. However, the location of prosthetic margin had no significant effect on GI score, PI score, PD and CAL of abutment teeth.</p> Conclusions <p>Fixed dental prostheses may negatively influence periodontal status of abutment teeth, highlighting the need for periodic periodontal monitoring, patient education regarding oral hygiene and prosthetic quality control.</p>