Use of Ultra-Translucent Monolithic Zirconia as Esthetic Dental Restorative Material: A Narrative Review

Abstract

It has been observed in recent years that zirconia (Zr) is being increasingly used for a wide range of clinical applications. There are several reasons for this, but the most significant one is its excellent mechanical properties, specifically its transformation toughening properties compared to other dental ceramics and its improved natural appearance when compared to ceramometal restorations. As a result of the advancement of chairside milling and developments in rapid-sintering technology, the fabrication of dental restorations has become more computerized, time-saving, and accurate over the past few decades. However, a main disadvantage of conventional Zr restorations is that they lack the translucency of glass–ceramics, although they are extremely strong. Recently, by increasing the yttrium %, changing the grain size, and reducing the impurities, the ultra-translucent monolithic zirconia “5-mol%-yttria-stabilized tetragonal zirconia polycrystals” has been introduced, with successful attempts to make translucent Zr an aesthetically attractive option for minimally invasive veneer restorations. It is important to note that veneer restorations do not possess the mechanical retentive features of the tooth preparations and rely primarily on bonding to resin cement. This presents a great challenge for the inert Zr since it does not bond chemically with resin cement, unlike glass–ceramic materials that establish chemical adhesion with resin cement, favoring their use for indirect veneer restorations. Taking this into account, this article aims to review the progressive development of ultra-translucent monolithic Zr materials as they are available today and, in the future, represents a concerted drive toward maximum translucency and strength, which renders them a viable treatment option for esthetic veneer restorations.