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Zirconia, Making the Right Choices

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Full contour zirconia is taking over the dental market by storm. As a result, the choices of different materials have become somewhat overwhelming. To follow, we will examine what is available and how to make a decision for the best material for any laboratory. Before doing so, I think it’s important to take a look at the evolution of the material to better understand how we got to where are at today.

In 2001, 3M introduced Lava zirconia, which very quickly became widely accepted in both dental practices and labs. With a flexural strength of 1200 MPa, the product was so successful, many more entrepreneurs and existing companies developed new competitive products. At inception, Lava and competitive products were white discs that used dipping or paint-on colorants to shade the materials before sintering. These materials were very opaque in nature and were used as framework material for layered porcelain application.

Next, in 2009 Glidewell Laboratories introduced BruxZir. Still considerably more opaque than desired, initially marketed by Glidewell as “More Brawn than Beauty” for use as a full gold crown replacement. The timing of this introduction was coincidentally in unison with the rapidly escalating cost of gold. As a result, full contour zirconia started to become widely prescribed.

Having so many companies follow Glidewell, investing in this super strong, virtually unbreakable, all ceramic material, brought competition and many new full contour zirconia brands to our market. These include pre-shaded systems using 4 to 17 different pre-shaded discs. This eliminated the need to color the green state zirconia before sintering.

Next, was multi-layered, where multiple shades of zirconia are blended into a single disc to mimic a gingival, mid body and enamel shading. Keep in mind, all the described materials were super strong at 1100-1200 MPa flexural strength. Today, we are going through the next evolution in dental zirconia materials. Available from many companies, this new gen material has lower strength (600-720 MPa) but much more translucent and potentially viable for anterior restorations. Currently available in white and pre-shaded discs with multi-layered on the way.

Today there are more than 50 brands and types of zirconia available. How does one know what’s best for their lab? Let’s put some logic around the decision process. To start, I would suggest the continued use of all three categories of materials; 1200, 1100 and 600 MPa materials. The original 1200 MPa framework material for frames. This provides the highest strength zirconia framework and will generally block out dark stumps and metal posts and cores.

The 1100 MPa materials should be used for all full contour bridgework with some layering of powders as desired. I believe the new 600 MPa materials to be one of the biggest advancements in dental materials in decades. This material is 50% stronger than lithium disilicate with similar esthetics and lower manufacturing costs. The translucency falls between e.max LT and HT.

Let’s go through a needs analysis. To do so, place the following in order by priority, most important at the top of your list:

  • Esthetics
  • Cost
  • Ease of use
  • Simplicity in obtaining shade
  • Chip resistant
  • Well known name

By looking at your priorities we can narrow down the selection process. For example, if you have selected Esthetics and Ease of use as your first two priorities it is likely that a multi-layered material is best for you. Simplicity in obtaining shade, would result in a pre-shaded disc system.

If it’s best Esthetics, use a white disc and learn how to multi-shade in the green state using a complete disc and complete colorant system manufactured by one company. It is amazing how great you can make a monolithic restoration look. If Chip resistant is one of your top three, you need to change materials or get some help as many companies now produce very chip resistant discs. Well known name brand, easy, BruxZir.

Please note, the goal of this blog is to help you determine which zirconia is best for your business. At CAP we now distribute about 15 different zirconia discs (none from China) with more on the way. By having such a broad selection we can almost customize best in class material for any lab’s given needs.

The reason we support so many different materials, we know there is no one correct zirconia for all labs. We have invested in this comprehensive product knowledge and inventory for the laboratory community, as we are most interested in helping labs thrive. To do so, using the product that best suits your specific needs is critical.

For more help in determining what materials best meets your needs, contact a CAP Customer Success Manager at 800-496-9500 (option 9).

As always, thanks for reading,

Bob Cohen, CDT

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