Abstract
Introduction: Zirconia (Y-TZP) has come to the forefront in dental restorations as a metal-free, long-lasting, and biocompatible restoration due to the demand for the same mineral. It possesses excellent mechanical properties, such as flexural strength of 900–1200 MPa and fracture toughness of 9–10 MPa.m1/2. This scoping review aimed to systematically chart and document the existing evidence on the clinical performance, benefits, and limitations of monolithic zirconia crowns.
Methods: Systematic searching was conducted on PubMed, Scopus, and Web of Science using MeSH terms and combined free-text words. Overall, 23 articles were included, and data were narratively and thematically synthesized for reviewing performance.
Results: It was revealed that monolithic zirconia has various advantages, including veneer chipping removal due to its density and veneerlessness. It further supports conservative tooth reduction and offers straightforward conventional cementation. Clinical trials documented a high clinical survival rate (98%) for posterior crowns at 5 years. However, there were aesthetic issues, especially in the anterior area, since only 6.1% of the crowns had an acceptable color match in one study. Overall, unless proper finishing is performed, the risk of extensive antagonist tooth wear is present.
Conclusion: Monolithic zirconia crowns are considered a highly reliable and mechanically sound restorative solution, primarily to posterior teeth and stress-bearing cases. The ease of cementation and high strength are prime benefits. Nonetheless, clinician-friendly stringent finishing and polishing procedures should be followed to avoid the risk of wear on opposing teeth. It is noteworthy that cosmetic constraints will limit its placement in the esthetic zone. Accordingly, more long-term clinical trials of 5–7 years and more are warranted to better evaluate their performance.