Zirconia is generally utilized as a framework for the rest of all-ceramic crowns, typically needing feldspar ceramic veneering to achieve suitable esthetics as it offers high opacity. Monolithic zirconia restorations have been presented lately, and their manufacturing process needs attention. This systematic review aimed to determine the difference between monolithic and layered zirconia crowns regarding their clinical success and longevity. A thorough analysis of the literature covering the years 2012–2023 was done, using the ScienceDirect, Medline, and PubMed databases. The terms that were employed were "monolithic zirconia", "layered zirconia", "longevity", and "aesthetics". The procedure for choosing the articles that were searched was outlined using the PRISMA flowchart. From 112, we recruited 10 studies after a comprehensive screening process. Most of the included studies suggested that the clinical success rate and fracture resistance were superior among monolithic zirconia crowns compared to the multilayered ones. However, some studies revealed no significant difference between the two. Therefore, further studies are required to provide more evidence of whether monolithic zirconia possesses higher longevity and clinical success.
