The evolution, clinical applications, and performance of zirconia in dentistry: A systematic review

Abstract

Background: Zirconia is the most used material as a metal free restoration. Due to its superior mechanical properties, excellent biocompatibility, and aestheitcs, zirconia is a much sought-after material in dentistry. Originally developed for industrial purposes, with the advances in digital fabrication, material science, and other fields of dentistry like prosthodontics, it has become highly commercialised. Objective: This systematic review has been attempted to assess the initiation, clinical efficacy, and usages of zirconia in dentistry with particular emphasis on the advantages, disadvantages, and possible future developments. Methods: A thorough search was carried out of the literature in an attempt to capture studies published between 1 Jan 2011 to 31 Dec 2024 that investigated zirconia usage in dental applications, in databases like pubmed, Scopus, and Web of Science. The selected studies were randomized controlled trials, observational studies, and relevant in vitro. Data extraction and quality assessment were conducted independently by two reviewers according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Results: The 13 studies reviewed included a range of clinical applications of zirconia from orthodontic, implantology, fixed prosthodontics. Zirconia has continuously exhibited excellent biocompatibility, resistance to fracture, and aesthetics. Zirconia limitations were: chipping of the veneering porcelain, ageing behaviour, and technical sensitivity in production. Improvements in CAD/CAM technology and monolithic zirconia have significantly increased its clinical viability. Conclusion: In contemporary dentistry, zirconia is a revolutionary material that provides a dependable and aesthetically pleasing substitute for conventional ceramics and metal-based restorations. It is anticipated that ongoing advancements in digital workflows and material composition would resolve existing issues and increase its clinical utility.