Modern concepts on zirconia materials for dental restorations

OBJECTIVES The aim of this study is to provide a narrative review of the evolution, selection criteria and current clinical applications of the different types of zirconia materials currently available on the market. The goal is to provide upto-date concepts on new zirconia materials to simplify the decision-making and production process for tooth-supported and implant-supported zirconia restorations. MATERIALS AND METHODS The research was conducted using the PubMed/MEDLINE and Scopus databases, and the following keywords were used: "zirconia" AND "dental" AND "restoration" OR "prosthesis". The research examined the literature from the last 10 years (from 31 July 2015 to 31 July 2025) on the evolution of zirconia and its current clinical applications for tooth-supported and implant-supported fixed dental restorations, with particular reference to the selection criteria for the different types of zirconia materials currently available on the market. The results are presented in a narrative review of the literature. RESULTS The growing demand for metal-free restorations and advances in CAD-CAM technologies have driven progress in zirconia materials for tooth-supported and implant-supported fixed dental restorations. In recent years, zirconia has undergone changes in its microstructural composition to improve its translucency while maintaining adequate mechanical properties. The evolution of zirconia has led to the introduction of multilayer materials with superior aesthetic qualities, designed to mimic the characteristics of natural teeth according to the biomimetic principle. These allow for monolithic restorations with simplified designs that are less prone to the technical complications of zirconia-ceramic systems. Chemical composition and microstructural characteristics, production processes, and prosthetic design are the main factors that can affect the mechanical strength and optical properties of zirconia restorations. Monolithic zirconia is currently a promising alternative to metal-ceramic and glass-ceramic systems in both highly aesthetic clinical cases and clinical cases requiring high mechanical reliability, including implant-supported full-arch restorations. CONCLUSIONS The evolution of zirconia has expanded the range of materials available for fixed prosthetic restorations, filling the gaps in the applications of earlier generations. To fully exploit the potential of the latest zirconia materials, it is recommended to have indepth knowledge of both the chemical and physical aspects and the technical and manufacturing processes involved in these materials. Furthermore, in the absence of medium-and long-term clinical data, for the safe and satisfactory use of the latest generation of zirconia, it is crucial to understand the clinical and technical factors that are potentially capable of altering the mechanical strength and optical properties of monolithic restorations. This allows for the correct selection of the type of zirconia and the processing and sintering processes, the safe design of restorations, the achievement of aesthetic results in line with patient expectations, and a favorable clinical prognosis.