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Additive Manufacturing of Zirconia and Its Clinical Applications in Dentistry

Mengzhe Cai, Bingjie Wang, Tingting Cao, Luyi Chai

Journal of Ceramic Science and Technology, Vol. 17, No. 2 (2026), pp. 121-138

DOI: 10.4416/JCST2025-00032

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Abstract

The emergence of additive manufacturing (AM) has catalyzed a paradigm shift in the fabrication of dental zirconia restorations, challenging the long-standing dominance of subtractive manufacturing (SM) methods. AM techniques – including vat photopolymerization, material extrusion, and binder jetting – offer unprecedented design freedom, near-net-shape fabrication, and reduced material waste, enabling the production of complex, patient-specific restorations. Unlike milling, which relies on standardized industrial blanks, AM defines material properties through a process-dependent workflow encompassing feedstock formulation, printing parameters, debinding, and sintering. Recent studies demonstrate that optimized AM zirconia can approach or match SM in flexural strength, hardness, and phase composition, though significant variability persists. Microstructural anisotropy, residual porosity, and interlayer defects remain critical factors limiting fatigue resistance and long-term reliability. Dimensional accuracy, while statistically inferior to SM, frequently meets clinical acceptability thresholds, and translucency improvements are rapidly closing the aesthetic gap. Biocompatibility assessments confirm the safety of fully sintered AM zirconia, though rigorous post-processing protocols are essential to eliminate residual cytotoxic agents. Clinical applications currently focus on single-unit crowns, with expanding potential for more complex prostheses as process standardization and quality control improve. Despite substantial progress, the lack of randomized clinical trials and standardized manufacturing pathways remains a central barrier to widespread adoption. This review critically synthesizes the evolving evidence on AM zirconia, providing a comprehensive framework for evaluating its performance, challenges, and translational potential in restorative dentistry.

Keywords

Microstructure, fatigue resistance, dimensional accuracy, translucency, biocompatibility

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