Zirconium (Zirconia) in Dentistry

How the types differ

Zirconia is stabilised with a small amount of yttrium oxide (yttria). Types are now classified by how much yttria they contain², and you may see them written as 3Y, 4Y or 5Y. The traditional 3Y type is opaque. The 4Y and 5Y types contain more yttria and let more light through; they are often called "translucent" zirconia.

The extra yttria has a cost. Most translucent types no longer benefit from the mechanism that helps stop small cracks from spreading, so their strength is reduced². In a 2026 review of laboratory studies, the 4Y types were significantly stronger than the 5Y types. Even the more translucent types still let less light through than glass ceramics³ such as lithium disilicate. Some newer blocks are built in layers of different colour or composition (multilayer zirconia).

Monolithic and layered zirconia

• Monolithic (single-piece) zirconia is made entirely of zirconia, with no separate layer of porcelain on top. Its surface is polished or glazed.
• Layered (veneered) zirconia has porcelain built up on a zirconia framework. The porcelain allows colour and surface detail to be tailored to the person; small fractures of the porcelain layer (chipping) are more common.

How zirconia fits among the other dental ceramics, from feldspathic porcelain to glass ceramics, is set out on porcelain and dental ceramics.

• Crowns, most often on back teeth, where chewing forces are high. What a zirconia crown involves for the tooth, and how the treatment runs, is covered on zirconia crowns.
• Bridges that replace one or more missing teeth. Whether zirconia suits a bridge depends on the type, the length of the gap and the design; see "Assessment and material selection" below.
• Frameworks under porcelain. The opaque 3Y type is used as a framework for layered crowns and bridges, and for implant parts and abutments².
• Crowns on implants, and the connecting parts (abutments) between an implant and its crown.
• Veneers. Possible, but a 2025 review found no long-term data⁴ for zirconia veneers. Options with better-documented long-term results should be considered.

Zirconia implants and abutments

An abutment is the part that connects an implant to its crown, and it can be made of zirconia. In one small trial with 44 patients, most of the zirconia-based implant restorations lost for technical reasons were lost because the zirconia abutment broke⁵. One trial cannot show how often this happens in general.

Some implants are made entirely of zirconia (ceramic implants). A German clinical guideline regards titanium as the international standard⁶ for implants, and titanium has a much longer record. An international expert consensus states that ceramic implants can be an alternative to titanium in selected cases⁷. A European expert position paper finds the clinical evidence strongest for one-piece implants replacing one to three missing teeth⁸. How the two materials compare is covered on titanium.

The material is chosen for each tooth after an examination, with X-rays where needed. The main questions are:

• Where the tooth is, and how much of it shows when you smile.
• How much of the tooth remains, and how much room there is for the restoration. Thin sections of the more translucent types, which are weaker, need particular care where biting forces are high³.
• Your bite, and whether you clench or grind your teeth.
• Whether it is a single crown, a bridge or a crown on an implant, and how many teeth a bridge would span.
• The colour of the tooth underneath, and what you expect of the result.

An international standard for dental ceramics, ISO 6872, groups ceramics into classes by their minimum strength⁹. The class sets the uses a material is suitable for. For bridges, the authors of a 2026 review of laboratory studies drew a conclusion by type. In their view, 4Y types can be used for three-unit bridges, and 5Y types only for three-unit bridges at the front of the mouth². For bridges of four units or more, they strongly recommended the 3Y type, preferably with porcelain on the outer side for appearance. These are conclusions from laboratory tests. The same review found that manufacturers' strength figures did not always match independent laboratory results. It adds that the manufacturer's instructions for each product still apply.

A crown needs tissue removed from every surface of the tooth, and that cannot be undone. When a tooth needs a crown at all, and when a smaller restoration is enough, is covered on dental crowns.

Ask which zirconia type and product is proposed for each tooth. Ask too why it suits that tooth better than lithium disilicate or metal-ceramic.

The figures below come from published studies, not from our own records.

Benefits

• No metal. Zirconia has no metal alloy or metal framework, so no metal edge shows. The colour of the tooth underneath or a receding gum can still make the edge look darker. On an implant, a zirconia crown or abutment is still fixed to an implant that is usually titanium.
• Strength. Its strength allows use on back teeth and in bridges. Whether it suits a bridge depends on the type, the length of the gap and the design.
• Less chipping when monolithic. A 2026 review of single crowns found that fractures and chipping were significantly less common on single-piece crowns¹⁰ than on layered ones.

How long single crowns last

The same review estimated how many of every 100 single crowns on natural teeth would still be in place after five years. For monolithic zirconia, layered zirconia and metal-ceramic alike, it was about 97¹⁰. For monolithic lithium disilicate it was 98 to 99. A strong material does not mean the crown will stay in the mouth longer.

Limitations

• Appearance. Zirconia lets less light through than glass ceramics. On a front tooth, a layered crown or lithium disilicate may match the neighbouring teeth more closely.
• The translucent types are weaker, and less studied. A 2026 review notes that no long-term clinical studies are available² on translucent zirconia.
• Chipping and fracture. On layered zirconia, small fractures can occur in the porcelain layer on top¹⁰. Monolithic zirconia has no separate layer, so no layer can come away; but edge fractures or larger fractures can still occur in the zirconia itself.
• Wear of the opposing tooth. Ceramic crowns can wear down the natural tooth they bite against. In studies of monolithic zirconia lasting 6 to 24 months, the deepest wear measured on the opposing tooth averaged about 0.1 mm¹¹. The review could not reliably say how this compares with the wear natural teeth cause on each other. Surface roughness, polishing and the bite all affect wear.
• Bridges. Survival figures for single crowns cannot be applied directly to bridges or implant crowns¹⁰. A 2026 review of bridges on natural teeth found decay at the edges and loosening more common with all-ceramic bridges¹² than with metal-ceramic ones. Bridge designs and their trade-offs are covered on dental bridges.
• It cannot be undone. Like every full crown on a natural tooth, a zirconia crown needs tissue removed from all surfaces of the tooth.
• Effect on the tooth's nerve. In studies of living teeth that received crowns or other laboratory-made restorations, the nerve later died in some of them¹³. If it happens, root canal treatment is needed to keep the tooth.

For single crowns on natural teeth, five-year survival is close across zirconia, lithium disilicate and metal-ceramic (see "Benefits and limitations" above). The studies cited on this page do not show that zirconia lasts longer. The choice depends on where the tooth is, how much of it remains, your bite and what you expect of its appearance.

• Lithium disilicate glass ceramic lets more light through and is used for veneers, single crowns and partial restorations. Its properties are explained on lithium disilicate glass ceramic. e.max is the trade name most patients meet; what that name covers is explained on e.max.
• Feldspathic porcelain is used for thin veneers, and as the porcelain layer on layered zirconia and metal-ceramic crowns.
• Metal-ceramic (porcelain fused to metal) has been used for decades for long bridges and under heavy loads. A metal edge may show if the gum recedes.

Your dentist will explain the pros and cons of each option for your tooth.

Zirconia restorations are usually designed on a computer and milled by machine (CAD/CAM). A 2026 review of laboratory studies describes the process. The restoration is milled from a pre-sintered block or disc, about a fifth larger than its final size². It is then heated in a furnace over several hours (sintering), and shrinks to its final size and strength. The review also states that the success of a zirconia restoration depends on a surface free of flaws and defects².

The steps below are for a crown on a natural tooth, which usually needs two or three appointments. Bridges and work on several teeth can take longer. Ask the clinic where your restoration will be designed, milled and finished, and which zirconia product will be used.

A zirconia crown does not protect the tooth beneath it from decay. New decay can develop at its edge or underneath it, and the gum around it needs daily care.

• Brush twice a day with a fluoride toothpaste.
• Clean every day where the crown meets the gum, and under bridges; use interdental brushes or bridge floss.
• If you clench or grind your teeth, wear the night guard your dentist recommends.
• Avoid biting hard objects, such as ice¹⁴.
• Keep up regular check-ups, usually with your own dentist in the UK.

Whitening, adjustments and repairs

• Whitening will not work on crowns¹⁵. If you are thinking of whitening your natural teeth, tell your dentist before the shade is chosen.
• If a zirconia crown needs adjusting later, tell the dentist it is zirconia. In laboratory studies, a smooth polish increased the strength of zirconia, while coarse grinding reduced it³.
• Small chips in a porcelain layer can sometimes be smoothed or repaired. More extensive damage may mean the restoration has to be replaced.

When to see a dentist

• The crown feels loose or comes off (keep it, and do not glue it back yourself)
• The crown cracks or porcelain chips off
• Sensitivity that does not settle, or keeps getting worse
• Pain when you bite, or the crown feels high when you bite
• Swelling, bleeding or discharge from the gum around the crown

If pain keeps increasing, or you have facial swelling or a high temperature, see a dentist without waiting for the clinic's reply. In England, if you have no dentist or cannot get an emergency appointment, the NHS says to call 111 or use 111 online¹⁶. Elsewhere in the UK, check the urgent dental care route where you live.

Emergencies. With a suspected dental abscess, the NHS says the following need urgent medical help¹⁶. In the UK, call 999 or go to A&E.

• It is hard to breathe, speak, swallow or open your mouth
• A swollen or painful eye, or sudden problems with your eyesight
• A lot of swelling inside your mouth

Ask for these details in writing before treatment.

• Which material each restoration will be made of: monolithic or layered zirconia, and which type.
• The product name and its manufacturer.
• Where the restoration will be designed, milled and finished.
• What the clinic's written terms say if a restoration chips, breaks, comes loose or fails, including after you are back in the UK: whom you contact, and who would pay for the repair and any travel.

Bring home for your UK dentist. Ask for a written record of each restoration: the tooth, the material and type, the product and manufacturer, the shade and the laboratory. For a crown on an implant, add the implant system, what each part is made of, and the part and lot (batch) numbers. Turkey's health tourism regulation helps here. On request, it entitles international patients to free copies of the records of the materials used, the tests and the imaging¹⁷.

Aftercare. Problems that appear later are usually first seen by your own dentist in the UK. The NHS website for England states that the NHS is not liable for negligence or failure of treatment¹⁸ when you have treatment abroad. The same page says that most travel insurance policies will not cover you for planned treatment abroad¹⁸, so you may need specialist cover. That guidance is for England. Scotland, Wales and Northern Ireland run their own health services, with their own rules, which this page does not cover; if you live there, ask your dentist.

Zirconia crowns and bridges are also available from dentists in the UK, and a UK dentist can give you an independent opinion before you decide. The questions the GDC and the NHS suggest you ask before treatment abroad are answered on zirconia crowns.