Monolithic zirconia versus lithium disilicate: a review of the evidence on clinical and esthetic performance

Abstract

The evolution of ceramic materials has significantly expanded the therapeutic possibilities in contemporary restorative dentistry, particularly due to the growing demand for rehabilitative treatments that combine mechanical strength, clinical longevity, and esthetic excellence. In this context, monolithic zirconia and lithium disilicate have emerged as the most widely used ceramic materials in current clinical practice. This study aimed to analyze the available scientific evidence regarding the clinical and esthetic performance of these materials, comparing their mechanical properties, clinical survival rates, behavior in implant-supported prostheses, wear resistance, interaction with antagonist teeth, and esthetic outcomes. This narrative literature review was developed based on the analysis of studies published between 2017 and 2025 and selected from recognized scientific databases. The results demonstrated that monolithic zirconia exhibits superior mechanical properties, characterized by high fracture resistance, lower susceptibility to wear, and excellent performance under conditions of increased functional demand. In contrast, lithium disilicate showed superior optical properties, greater translucency, and an enhanced ability to reproduce the esthetic characteristics of natural teeth, particularly in anterior restorations. Both materials presented high clinical survival rates and satisfactory outcomes across different restorative modalities. It can be concluded that the choice between monolithic zirconia and lithium disilicate should be individualized according to the functional, biomechanical, and esthetic requirements of each clinical case, aiming to maximize treatment predictability and longevity.