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Effect of coloring and sintering on the translucency and biaxial strength of

monolithic zirconia

Article  in  The Journal of prosthetic dentistry · November 2017

DOI: 10.1016/j.prosdent.2017.08.013

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 RESEARCH AND EDUCATION

Effect of coloring and sintering on the translucency and biaxial

strength of monolithic zirconia
Nazmiye Sen, DDS, PhD,a Ibrahim Bülent Sermet, DDS, PhD,b and Sevki Cinar, DDSc

The increase in esthetic ABSTRACT

expectations and technological Statement of problem. The influences of coloring and sintering procedures on the optical and
developments has led to the mechanical properties of monolithic zirconia have not been thoroughly investigated.
use of different materials with
Purpose. The purpose of this in vitro study was to investigate the effects of the coloring procedure
excellent mechanical properties
and of varying final sintering temperatures on the translucency parameter (TP) and biaxial flexural
that are biologically compatible strength (BFS) of monolithic zirconia.
and esthetically acceptable as
alternatives to metal-ceramic Material and methods. Disk-shaped specimens (N=210) of 2 different monolithic zirconia brands
(Vita YZ HTWhite [VYZa]; Vita YZ HTColor A2 [VYZb]; Prettau Zirkonzahn [PZ]; Prettau Anterior Zir-
restorations. Zirconia was first
konzahn [PZA]) with a diameter of 15 mm and a thickness of 1.0 ±0.05 mm were prepared. Half of
used as a substructure material the specimens prepared from noncolored blocks (VYZa, PZ, and PZA) received coloring liquid
for fixed prosthetic restorations application. Then, the specimens were divided into 3 subgroups (n=10) according to the final
because of its high mechanical sintering temperatures (1350
C, 1450
C, and 1600
C). The TP was determined by using a reflection
strength, biocompatibility, and spectrophotometer, and the BFS was tested with the piston-on-3-ball method in a universal testing
white color.1,2 High-strength machine. Data were statistically analyzed by multivariate multiple regression and Bonferroni tests
zirconia substructures pre- (a=.05).
pared with computer-assisted Results. Significant differences were obtained among the groups based on the results of the TP and
design and computer-assisted BFS (P<.05). The TP was affected by the changes in final sintering temperature. The varying final
manufacturing (CAD-CAM) sintering temperatures demonstrated no significant effect on the BFS, except in group PZ
(noncolored) that produced lower BFS when sintered at 1350
C than the subgroups sintered at
technology are veneered with
1450
C and 1600
C (P<.05). Coloring liquid application significantly decreased the TP of VYZa
feldspathic porcelain to mimic (sintered at 1350
C) but produced no significant effect on the groups PZ and PZA. Additionally, the
natural teeth. However, chip- coloring procedure had no significant effect on the BFS of tested materials (VYZa, PZ, and PZA)
ping of the veneering porcelain (P>.05).
has been the most frequent
Conclusions. Increased sintering temperature leads to increased translucency with minimal impact
disadvantage of veneered zir- on the BFS. The coloring procedure should be considered at the time of material selection to avoid
3-5
conia restorations. Mono- possible reduction in translucency. (J Prosthet Dent 2018;119:308.e1-e7)
lithic zirconia restorations have
been developed to eliminate the risk of porcelain veneer Zirconia is a polymorphic material that exists in 3
chipping or fracture, and advantages such as crystallographic forms: monoclinic (stable at room tem-
mechanical strength, reduced material thickness, accept- perature up to 1170
C), tetragonal (stable at 1170
C to
able esthetic results, and reduction in production time and 2370
C), and cubic (stable over 2370
C to melting point,
cost have made the restorations popular. 6-9
2716
C).1 While cooling zirconia to room temperature, a

a
Doctoral researcher, Department of Prosthodontics, School of Dentistry, University of Istanbul, Istanbul, Turkey.
b
Professor, Department of Prosthodontics, School of Dentistry, University of Istanbul, Istanbul, Turkey.
c
Doctoral student, Department of Prosthodontics, School of Dentistry, University of Istanbul, Istanbul, Turkey.

308.e1 THE JOURNAL OF PROSTHETIC DENTISTRY

February 2018 308.e2

Table 1. Tested materials

Clinical Implications Brand Composition* N Code Manufacturer
Vita YZ HTWhite 4-6% Y2O3, 1.5-2.5% HfO2, 60 VYZa Vita
The type of monolithic zirconia, the coloring (Ø 98.4x25 mm) 0-0.3% Al2O3, 0-0.5% Er2O3, Zahnfabrik
procedure, and the final sintering temperature 0-0.3% Fe2O3
Vita YZ HTColor 4-6% Y2O3, 1.5-2.5% HfO2, 30 VYZb Vita
changes affect the mechanical and optical (Ø 98.4x25 mm) 0-0.3% Al2O3, 0-0.5% Er2O3, Zahnfabrik
properties of monolithic zirconia. 0-0.3% Fe2O3
Prettau 4-6% Y2O3, 0-1% Al2O3, 60 PZ Zirkonzahn
Zirkonzahn 0.02% SiO2, 0.01% Fe2O3, GmbH
(Ø 98x25 mm) 0.04% Na2O
phase transformation from tetragonal to monoclinic phase Prettau Anterior 8-12% Y2O3, 0-1% Al2O3, 60 PZA Zirkonzahn
occurs with a volume expansion of between 3% and 5%, Zirkonzahn 0.02% SiO2, 0.01% Fe2O3, GmbH
(Ø 98x25 mm) 0.04% Na2O
causing expansion stresses that can lead to the failure of
*According to manufacturer information.
the material.2,3,5 The addition of oxides such as CaO, MgO,
and Y2O3 to the pure zirconia can stabilize the tetragonal
phase at room temperature. Y2O3 is the most frequently
YZ HTColor [VYZb], Zirkonzahn GmbH; Prettau Zirkon-
used stabilizing oxide in dental zirconias. Yttria-stabilized
zahn [PZ], Zirkonzahn GmbH; and Prettau Anterior
tetragonal zirconia polycrystals (Y-TZP) contain between
Zirkonzahn [PZA]; Zirkonzahn GmbH) were prepared
2 and 5 mol% Y2O3.1,3,10 Y-TZP is metastable, and the
by using CAD-CAM technology (InLab MC X5; Dentsply
tetragonal particles can spontaneously transform into the
Sirona) (Table 1). No power analysis was performed. A
larger monoclinic form.11 This phase transformation or
sample size of 10 in each subgroup was based on the
transformation toughening induces compressive stresses
results of previous studies with 80% power and 5% sig-
around the crack tips and prevents crack propagation by
nificance level.9,21,22
increasing localized fracture toughness.12 However,
Half the specimens (n=30) prepared from noncol-
excessive stresses from sintering, surface treatment, and
ored blocks (VYZa, PZ, and PZA) received coloring
coloring liquid application may exceed the compressive
liquid application. Specimens of VYZa were colored
strength under the surface and around the tip of the crack,
with Vita YZ HT A2 shade liquid (Zirkonzahn GmbH),
leading to eventual failure of the material.13-17 Therefore,
whereas the specimens of PZ and PZA were colored
although the phase transformation may initially increase
with Prettau Aquarell A2 coloring liquid (Zirkonzahn
the flexural and tensile fracture resistance of monolithic
GmbH). The immersion technique was used to color
zirconia, the material may deteriorate when exposed to
the specimens. The disks of VYZa were immersed in
different sintering temperatures, coloring liquid applica-
the coloring liquid with plastic tweezers for 15 seconds
tions, and fatiguing mechanical forces.2-5,18
and dried under an infrared drying lamp (Zirkonlamp
Producing tooth-colored monolithic zirconia has been a
250; Zirkonzahn GmbH) as recommended by the
challenge because of the semitranslucent and white opaque
manufacturer. The disks of PZ and PZA were colored
appearance of the material.19 Approaches to obtaining a
with the technique recommended by the manufacturer.
tooth-colored zirconia include adding coloring pigments
The disks were immersed in the coloring liquid for 1
such as metal oxides to the zirconia powder at the block
second and then immersed in the water for 1 to 2
formation stage and immersing the presintered, uncolored
seconds. Any remaining water was removed with
zirconia block in coloring liquids.16,17 Coloring may influ-
absorbent paper, and the disks were dried for 20 mi-
ence the optical and mechanical properties of zirconia by
nutes under an infrared lamp (Zirkonlamp 250; Zir-
producing crystallographic and microstructural changes in
konzahn GmbH).
the material.7,13,19,20 Zirconia is generally sintered between
Both the colored and the noncolored groups were
1350
C and 1600
C.1,5 The sintering temperature may affect
divided into 3 subgroups according to the final sintering
the mechanical and optical properties of zirconia.7,14,15
temperatures (1350
C, 1450
C, and 1600
C; n=10 each)
The purpose of this in vitro study was to investigate
(Fig. 1). The sintering temperatures and time were
the effects of coloring procedure and sintering tempera-
adjusted on the furnace’s control panel before sintering
ture on the translucency parameter (TP) and biaxial
each subgroup (Zirkonofen 600; Zirkonzahn GmbH).
flexural strength (BFS) of different monolithic zirconia
Test specimens were sintered at a heating and cooling
blocks. The null hypothesis was that the material type,
rate of 10
C/min to the sintering temperatures 1350
C,
coloring procedure, and sintering temperature would not
1450
C, and 1600
C with a 2-hour holding time. The
affect the TP and BFS of monolithic zirconia.
final dimensions of the specimens were measured by
using a micrometer (Digimatic Micrometer; Mitutoyo). In
MATERIAL AND METHODS
total, 210 disk-shaped specimens with a final specimen
Disk-shaped specimens of different monolithic zirconia size of 15 mm in diameter and 1.0 ±0.05 mm in thickness
blocks (Vita YZ HT White [VYZa], Zirkonzahn GmbH; Vita were prepared.

Sen et al THE JOURNAL OF PROSTHETIC DENTISTRY

308.e3 Volume 119 Issue 2

Colored
(n=30)
Vita YZ
Sintered at Sintered at Sintered at
HTwhite/VYZa
1350°C 1450°C 1600°C
(n=60)
Non-colored
(n=30)

Vita YZ
HTcolored/VYZb
(n=30) Sintered at Sintered at Sintered at
1350°C 1450°C 1600°C

Colored
(n=30)
Prettau
Sintered at Sintered at Sintered at
Zirkonzahn/PZ
1350°C 1450°C 1600°C
(n=60)
Non-colored
(n=30)

Colored
(n=30)
Prettau Anterior
Sintered at Sintered at Sintered at
Zirkonzahn/PZA
1350°C 1450°C 1600°C
(n=60)
Non-colored
(n=30)

Figure 1. Study design.

A reflection spectrophotometer (Color Eye 7000A
Xrite; GretagMacbeth) was used to measure the trans-
lucency of the specimens placed on white or black
backings in the wavelength range of 400 to 700 nm at 10-
nm data intervals. The standard Commission Inter-
nationale de L’éclairage (CIE) illuminant D65 and 2-
degree observer function were used to determine the
CIELab coordinates of the specimens. All measurements
were made on 5 different areas of each specimen, and the
mean value was recorded. The TP value was determined
by calculating the color differences of the specimen over a
white or black backing with the following equation:
h  2  2  2 1 i
TP= L B −L W + a B −a W + b B −b W 0 2 ;
=
3 steel balls with a diameter of 3.2 mm and positioned 120
degrees apart on a circle with a diameter of 10 mm. Speci-
mens were loaded by a piston with a diameter of 1.4 mm at a
crosshead speed of 0.5 mm/min until failure occurred. The
fracture load was recorded, and the biaxial flexural
strength was calculated according to equations 1 to 3, as
follows:
S=−0:2387PðX−YÞ=d2; (1)
X=ð1+nÞ Inðr2 =r3 Þ2 +ð½1−n=2Þðr2 =r3 Þ2 ; and (2)
 
Y=ð1+nÞ 1+In½r1 =r3 2 +ð1−nÞðr1 =r3 Þ2 ; (3)

where B is the color coordinates over a black backing and
W is the coordinate over a white backing. L* refers to
brightness, a* refers to red-green, and b* refers to yel-
low-blue.23 TP values can range from 0 to 100. Lower TP
values correspond to materials with lower translucency,
whereas higher TP values correspond to materials with
higher translucency.
After the translucency was measured, the specimens
were tested for BFS by using the piston-on-3-ball method in
a universal testing machine (Shimadzu AG-IS; Shimadzu
Comp.) at room temperature following International
Organization for Standardization (ISO) 2015 standard
6872.24 The disk-shaped specimens were positioned on
where S is biaxial flexural strength (MPa); P is fracture
load (N); d is disk thickness at fracture site (mm); n is
Poisson ratio (0.25); r1 is radius of support circle (5 mm);
r2 is radius of loaded area (0.7 mm); and r3 is radius of
specimen (7.5 mm).
Statistical analyses were performed with statistical
software (STATA Statistical Software v14; Stata Corp and
IBM SPSS Statistics v20; IBM Corp). The independent
variables were materials, coloring procedure, and sin-
tering temperatures. The dependent variables were TP
and BFS. Multivariate multiple regression analysis was
used to test the omnibus hypothesis and to identify the
relationship between independent and dependent

THE JOURNAL OF PROSTHETIC DENTISTRY Sen et al

February 2018 308.e4

Table 2. Multivariate tests* multiple regression analysis Table 3. Tests of between-subjects effects
Hypothesis Error Type III Sum Mean
Source Value F df df P Source/Dependent Variable of Squares df Square F P
Intercept Corrected model
Pillai Trace 0.319 14.27 5 1788.00 <.001a Translucency parameter 19791.065a 5 5250.095 131,039 <.001
Wilks Lambda 0.485 15.02 5 1696.00 <.001 a
Biaxial flexural strength 23219.568b 5 6139.617 123.116 <.001
Hotelling Trace 0.405 15.69 5 1788.00 <.001a Intercept
Roy Largest Root 0.337 5.14 5 596.00 <.001u Translucency parameter 2613.148 1 2613.148 57.430 .002
Material type Biaxial flexural strength 52.019 1 52.019 0.963 .418
Pillai Trace 0.186 10.74 1 594.00 .003a Material type
Wilks Lambda 0.870 10.74 1 594.00 <.001e Translucency parameter 1165.312 1 1165.312 24.072 <.001
Hotelling Trace 0.234 10.74 1 594.00 <.001e Biaxial flexural strength 614.039 1 614.039 14.159 <.001
Roy Largest Root 0.234 10.74 1 594.00 .001a Coloring procedure
Coloring procedure Translucency parameter 214.162 1 214.162 3.984 .162
Pillai Trace 0.064 3.33 1 594.00 .016e Biaxial flexural strength 46.433 1 46.433 0.876 .784
Wilks Lambda 0.974 3.33 1 594.00 .016e Sintering temperatures
Hotelling Trace 0.085 3.33 1 594.00 .016e Translucency parameter 2946.987 1 2946.987 63.154 <.001
Roy Largest Root 0.085 3.33 1 594.00 .016e Biaxial flexural strength 20.419 1 20.419 0.495 .984
Sintering Error
temperature Translucency parameter 17421.016 198 59.095
Pillai Trace 0.221 17.36 1 594.00 <.001e Biaxial flexural strength 18745.892 198 67.028
Wilks Lambda 0.834 17.36 1 594.00 <.001e Total
Hotelling Trace 0.283 17.36 1 594.00 <.001e Translucency parameter 894536,000 205
Roy Largest Root 0.283 17.36 1 594.00 <.001e Biaxial flexural strength 889973,000 205
a, approximate; u, upper bound on F; e, exact (a=.05). Design: intercept + material + Corrected total
coloring + sintering temperature.
Translucency parameter 43526.00 200
Biaxial flexural strength 44109.00 200
variables. Multiple pairwise comparisons were performed Type 3 Sum of Squares superscript letters. P values, a=.05. aR2, .369 (adjusted R2, .336).
b 2
by using Bonferroni post hoc tests and differences R , .294 (adjusted R2, .258).

(a=.05).
RESULTS
Multivariate multiple regression analysis was used to
identify the relationship between independent and
dependent variables and showed that material type and
sintering procedure significantly affected the dependent
variables (P<.05) (Table 2). However, the independent
variable of coloring procedure had no significant effect on
either TP or BFS (P>.05) (Table 2). Tests of between-
subjects effects were performed to further investigate the
effects of independent variables on TP and BFS (Table 3).
The mean ±SD TP values are summarized in Table 4.
The TP values of the groups ranged from 14.4 ±0.3 (PZ,
colored and sintered at 1350
C) to 22.8 ±0.6 (PZA, colored
and sintered at 1600
C). The mean TP value of the PZA
was significantly higher than the TP values of the VYZa,
VYZb, and PZ groups regardless of the coloring liquid
application and final sintering temperature (P<.05)
(Table 4). Coloring procedure significantly affected the TP
of VYZa (sintered at 1350
C; P<.05) but produced no sig-
nificant effect on the TP of PZ or PZA (P>.05). The mean TP
values of all groups (VYZa, VYZb, PZ, and PZA) signifi-
cantly increased as the final sintering temperature
increased from 1350
C to 1600
C (P<.05) (Table 4).
The mean ±SD BFS values are summarized in Table 5.
The maximum mean value (1328 ±25 MPa) of the BFS
was recorded in the VYZa (colored and sintered at
1600
C), whereas the lowest mean value (781 ±53 MPa)
was recorded in the PZA (colored and sintered at
1350
C). PZA showed significantly lower BFS than VYZa,
VYZb, or PZ, regardless of the coloring liquid application
and final sintering temperature (P<.05) (Table 5). Col-
oring produced no significant effect on the BFS of tested
materials (VYZa, PZ, and PZA). Final sintering temper-
ature changes significantly affected the BFS of PZ
(noncolored) that produced higher strength results when
sintered at 1450
C and 1600
C than the subgroup sin-
tered at 1350
C. Final sintering temperature changes
produced no significant effect on the BFS of VYZa, VYZb,
and PZ (P>.05) (Table 5).
DISCUSSION
The null hypothesis was rejected as significant differ-
ences were found among the groups based on the results
of TP and BFS.
Translucency is essential for achieving a natural looking
appearance and therefore plays an important role in ma-
terial selection.3 Translucency is determined by the relative
amount of light that is absorbed, transmitted, or reflected23
and is affected for dental ceramic materials by chemical
composition, crystalline content, microstructure, grain
size, pores, additives, and sintered density.7,19,20

Sen et al THE JOURNAL OF PROSTHETIC DENTISTRY

308.e5 Volume 119 Issue 2

Table 4. Mean ±SD translucency parameter values Table 5. Mean ±SD biaxial flexural strength values
Translucency Parameter, Biaxial Flexural Strength
Final Sintering Temperatures, (n=10) Mean ±SD Final Sintering Temperatures (n=10) (MPa), Mean ±SD
VYZa colored (n=30) VYZa colored (n=30)
1350
C 15.28 ±0.43a 1350
C 1157 ±29b,c

c

1450 C 17.14 ±0.71 1450 C 1254 ±41c
1600
C 18.26 ±0.36d 1600
C 1328 ±25c,d
VYZa noncolored (n=30) VYZa noncolored (n=30)
1350
C 16.42 ±0.62b 1350
C 1282 ±56c,d

c

1450 C 17.49 ±0.38 1450 C 1170 ±63c

c,d

1600 C 18.05 ±0.44 1600 C 1202 ±123c
VYZb precolored (n=30) VYZb precolored (n=30)
1350
C 17.28 ±0.56c 1350
C 1256 ±94c
1450
C 18.03 ±0.87c,d 1450
C 1310 ±36c,d
1600
C 18.40 ±0.27d 1600
C 1285 ±44c,d
PZ colored (n=30) PZ colored (n=30)
1350
C 14.37 ±0.27a 1350
C 1102 ±62b
1450
C 15.73 ±0.74b 1450
C 1128 ±117b,c
1600
C 16.74 ±0.46b.c 1600
C 1090 ±75b
PZ noncolored (n=30) PZ noncolored (n=30)
1350
C 14.86 ±0.21a 1350
C 1057 ±96b

b

1450 C 16.05 ±0.36 1450 C 1245 ±64c
1600
C 16.32 ±0.28b 1600
C 1174 ±82c
PZA colored (n=30) PZA colored (n=30)
1350
C 18.96 ±0.65e 1350
C 781 ±53a

f

1450 C 21.34 ±1.04 1450 C 908 ±83a,b

g

1600 C 22.76 ±0.62 1600 C 819 ±71a
PZA noncolored (n=30) PZA noncolored (n=30)
1350
C 19.23 ±0.4e 1350
C 834 ±46a

f

1450 C 20.80 ±0.89 1450 C 803 ±38a

f,g

1600 C 22.03 ±1.55 1600 C 890 ±92a

PZ, Prettau Zirkonzahn; PZA, Prettau Anterior Zirkonzahn; VYZa, Vita YZ HTWhite; VYZb, PZ, Prettau Zirkonzahn; PZA, Prettau Anterior Zirkonzahn; VYZa, Vita YZ HTWhite; VYZb,
Vita YZ HTColor A2. Different superscripted letters indicate statistically significant Vita YZ HTColor A2. Same superscripted letters represent groups with no statistically
differences of materials according to Bonferroni post hoc comparisons (P<.05). significant (P>.05) differences according to Bonferroni post hoc comparisons.

Coloring is essential if monolithic zirconia is to be
used for a tooth-colored restoration with an appropriate
shade and translucency. This can be achieved by adding
metal oxides to the zirconia powder at the block forma-
tion stage or by applying a coloring liquid to the pre-
sintered and noncolored zirconia after the milling
process.13 Different types of monolithic zirconia blocks
were used in the present study according to the coloring
procedure: precolored (VYZb), noncolored (VYZa, PZ,
and PZA), and colored with immersion technique (VYZa,
PZ, and PZA). The TP of VYZa (colored and sintered at
1350
C) was significantly lower than the TP values of the
groups VYZb (precolored) and VYZa (noncolored). The
effects of coloring procedure on the translucency of
dental zirconia have been investigated in previous
studies.19,20 Spyropoulou et al20 evaluated the trans-
lucency of shaded zirconia and reported significant dif-
ferences among the specific shades. However, other
studies reported no significant effect of coloring on
translucency.25,26 In the present study, the highest mean
TP value was obtained in the PZA group, followed by
groups VYZb, VYZa, and PZ. PZA is a fully stabilized
monolithic zirconia (FSZ) which has an yttria content of
more than 8 mol% to achieve full stabilization.7 Different
methods have been used to enhance the translucency of
zirconia, including increasing the yttria content to in-
crease the cubic phase and zirconia grain size and
decrease the number of grain boundaries.6,7,13 In a recent
study, Suleiman et al7 investigated the effects of staining
on the TP values of FSZ versus PSZ and reported a sig-
nificant decrease in the translucency of FSZ after stain-
ing; staining produced no significant effect on the
translucency of PSZ. They attributed this finding to the
larger grains and grain boundaries of FSZ that may have
led to an increase in coloring liquid intake. Thus, more
light photons can be absorbed because of the chemical
nature of the solution, resulting in reduced translucency.
The varying responses to coloring procedures could be
related to the test conditions, specimen dimensions,
different zirconia brands, coloring liquid type, and time or
to the methodology of the studies.
The sintering procedure plays an important role in the
translucency of monolithic zirconia and has a direct impact
on the amount of cubic phase, yttria distribution, and grain

THE JOURNAL OF PROSTHETIC DENTISTRY Sen et al

February 2018
size.6,14,27 In the present study, test specimens were sin-
tered according to 3 different final sintering temperatures.
The TP values of all the groups (VYZa, VYZb, PZ, and PZA)
significantly increased as the final sintering temperature
increased from 1350
C to 1600
C. Several studies have
investigated the effects of sintering temperatures on the
translucency of zirconia. They all reached the conclusion
that increasing the sintering temperature leads to
increased translucency by increasing grain size, sintered
density, and reducing porosity, ultimately providing a
more compact crystalline structure of zirconia.6,14,27 Larger
grains increase the translucency of zirconia by producing
fewer grain boundaries14 but make the material more
susceptible to transformation,27 which may reduce its
mechanical properties.
BFS is a mechanical property used to determine the
long-term clinical performance of dental materials.22 In
the present study, statistically significant differences were
found among the groups based on the results of BFS.
Group PZA which has a higher yttria content than the
other zirconia blocks tested, produced the lowest mean
BFS, regardless of the coloring liquid application and final
sintering temperature (P<.05) (Table 5). Increasing yttria
content increases the cubic phase, which is less stable
than the tetragonal phase, leading to a decrease in
BFS.6,14,27 The results of the present study are in agree-
ment with those of Suleiman et al,7 who investigated the
mechanical properties of FSZ versus PSZ and reported a
significantly lower flexural strength for FSZ.
The coloring procedure had no significant effect on
the BFS of the tested materials (VYZa, PZ, and PZA).
Other studies have investigated the effects of coloring
procedure on the mechanical properties of zirco-
nia.8,13,16,17 Recently, Sedda et al16 reported no signifi-
cant effects of the coloring procedure on the flexural
resistance of zirconia blocks. However, other studies have
reported a significant influence of coloring on the me-
chanical properties of zirconia, depending on the con-
centration of coloring liquid and dipping time.8,13,17
No significant differences were found for the BFSs of
the tested groups, except the group PZ (noncolored) that
had higher BFS as the final sintering temperature
increased from 1350
C to 1600
C (P<.05) (Table 5). These
results are in agreement with those of previous studies
that found no significant difference for the BFS of zir-
conia as the final sintering temperature increased.7,8,14
However, higher sintering temperatures affect the grain
size and yttria.14,23,28 The uneven distribution of yttria
could increase the cubic phases, which is undesirable
because of the negative effect on flexural strength.6,29
Stawarczyk et al14 reported a significant negative corre-
lation between the sintering temperature and flexural
strength of zirconia and recommended a sintering tem-
perature below 1550
C. Chevalier et al11 recommended a
narrower range of sintering temperature between 1400
C
Sen et al
308.e6
and 1450
C to obtain optimum mechanical strength. The
differences between the study results could be explained
by different brands of zirconia, specimen dimensions, test
conditions, and range of temperature used.
Clinical conditions such as thermal and mechanical
aging were not simulated in the present study, which
may have affected the results. Further investigations of
the optical and mechanical properties of monolithic zir-
conia by combining the variables of the intraoral envi-
ronment are needed. Additionally, the influence of
coloring technique, chemical composition of the liquid,
and dipping time should be further investigated to clarify
the effects of coloring procedure on the TP values of
monolithic zirconia. Long-term clinical studies assessing
color stability and the survival rates of the materials are
also essential before definitive clinical recommendations
can be made.
CONCLUSIONS
Within the limitations of the present in vitro study, the
following conclusions were drawn:
1. Increased sintering temperatures led to increased
translucency with minimal impact on the biaxial
flexural strength.
2. Coloring procedure of monolithic zirconia should be
taken into consideration at the time of material se-
lection to avoid possible reduction in translucency.
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Corresponding author:
Dr Nazmiye Sen
School of Dentistry
Department of Prosthodontics
University of Istanbul, Capa/Fatih
Istanbul 34093
TURKEY
Email: nazmiye.sonmez@istanbul.edu.tr
Acknowledgments
The authors thank Creadent for preparation of test specimens and Emre Karaca
(from SPSS Turkey) for support with statistical analysis.
Copyright © 2017 by the Editorial Council for The Journal of Prosthetic Dentistry.

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