Purpose: The aim of this long-term follow-up study was to collect up to 17 years of survival data of endodontically treated single teeth with or without a prefabricated metal post. Materials and Methods: Single teeth were provided with direct composite resin core-crown reconstructions with or without posts by 15 operators. Restorations consisted of either a prefabricated metal post and a composite core-crown reconstruction or a post-free direct composite reconstruction. Allocation of either restoration was performed by balanced drawing. These restorations were not covered by an artificial crown. The study sample consisted of 87 patients who received 98 core-crown reconstructions. The performance of the restorations was evaluated based on data collected from the files of the clinicians currently monitoring the oral health of the patients. The survival probability was analyzed at different levels: on the restoration level and on the level of the tooth carrying the restoration. Kaplan-Meier analysis was used to compare survival probabilities. Results: Post placement showed no influence on the survival probability at either level (P > .05). The estimated overall survival rate at 17 years was 53% ± 14% at the restoration level and 79% ± 11% at the tooth level. Conclusion: The results of this long-term follow-up study showed no difference in survival probabilities between different direct composite resin core-crown reconstructions of endodontically treated single teeth (with or without a post).