Monolithic Zirconia Is the Most Biocompatible Ceramic in Dentistry . . . NOT!

Biocompatibility has been defined by Williams as “the ability of a biomaterial to perform its desired function with respect to a medical therapy, without eliciting any undesirable local or systemic effects in the recipient … and optimizing the clinically relevant performance of that therapy.”1 Monolithic zirconia (MZ) is often described as the most biocompatible ceramic option for indirect dentistry.2 This assertion is typically presented with no attached citations, implying that it is a generally known fact. The purpose of this commentary is to explore the biocompatibility of MZ not only as it relates to localized cellular response, but also within the context of the broader stomatognathic system.