The usage of monolithic zirconia has been increasing in daily practice in dentistry for the last 20 years. Monolithic zirconia is mainly used for posterior sector rehabilitation, as it lacks optical properties and has good technical properties; it does not chip and reduces antagonist wear compared to metal–ceramic prostheses. However, monolithic zirconia may present some issues, mainly low-temperature degradation (LTD), also known as “aging”, which must be considered and investigated in clinical studies with prolonged follow-up periods. The aim of this study was the aesthetic and functional evaluation of single monolithic zirconia crowns that were screwed onto implants for posterior dental rehabilitation using USPHS parameters and a long follow-up period of 7 years. The results showed that the USPHS scoring reduces year by year, passing from 100% excellence between the first and fourth years of observation, to 88% excellence and 12% success in the seventh year. Screw abutment loosening was the only technical adversity reported; no implant failure, crown fracture, or irreparable damage were additionally registered. Considering the emerging results and comparing them with the data available in the literature, the authors suggest that monolithic zirconia crowns could be considered as a valid alternative to classic metal–ceramic rehabilitations for the rehabilitation of posterior sectors.
