Factors Affecting the Color Change of Monolithic Zirconia Ceramics: A Narrative Review

Zirconia restorations are widely used in dentistry due to their high esthetic expectations and physical durability. However, zirconia's opaque white color can compromise esthetics. Therefore, zirconia is often veneered with porcelain, but fractures may occur in the veneer layer. Monolithic zirconia restorations, which do not require porcelain veneering and offer higher translucency, have been developed to address this issue. Zirconia exists in three main crystal phases: monoclinic, tetragonal, and cubic. Metal oxides such as yttrium are added to stabilize the tetragonal phase at room temperature. 3Y-TZP contains 3 mol% yttrium and provides high mechanical strength but has poor optical properties. Recently, 4Y-PSZ and 5Y-PSZ ceramics, which offer better optical properties but lower mechanical strength, have been introduced. This review examines the factors affecting the color change in monolithic zirconia ceramics. These factors are categorized into six main groups: cement type and color, restoration thickness, substrate color, sintering, aging, and zirconia type. Cement type and color are crucial in determining the final shade, especially in thin restorations. Increased restoration thickness reduces the influence of the substrate color while the sintering temperature and process improve optical properties. These findings emphasize the importance of material selection and application processes in ensuring esthetic harmony in zirconia restorations. This review aims to bridge gaps in the literature by providing valuable insights that guide clinicians in selecting and applying zirconia materials to meet both esthetic and functional requirements in restorative dentistry.