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Cesar PF, Miranda RBDP, Santos KF, Scherrer SS, Zhang Y. Recent advances in dental zirconia: 15 years of material and processing evolution. Dent Mater 2024; 40:824-836. [PMID: 38521694 PMCID: PMC11098698 DOI: 10.1016/j.dental.2024.02.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 02/26/2024] [Accepted: 02/27/2024] [Indexed: 03/25/2024]
Abstract
OBJECTIVES The objective was to discuss the research on zirconia published in the past 15 years to help the dental materials community understand the key properties of the types of zirconia and their clinical applications. METHODS A literature search was performed in May/2023 using Web of Science Core Collection with the term "dental zirconia". The search returned 5102 articles, which were categorized into 31 groups according to the research topic. RESULTS The current approach to improving the translucency of zirconia is to decrease the alumina content while increasing the yttria content. The resulting materials (4Y-, 5Y-, and above 5 mol% PSZs) may contain more than 50% of cubic phase, with a decrease in mechanical properties. The market trend for zirconia is the production of CAD/CAM disks containing more fracture resistant 3Y-TZP at the bottom layers and more translucent 5Y-PSZ at the top. Although flaws located between layers in multilayered blocks might represent a problem, newer generations of zirconia layered blocks appear to have solved this problem with novel powder compaction technology. Significant advancements in zirconia processing technologies have been made, but there is still plenty of room for improvement, especially in the fields of high-speed sintering and additive manufacturing. SIGNIFICANCE The wide range of zirconia materials currently available in the market may cause confusion in materials selection. It is therefore imperative for dental clinicians and laboratory technicians to get the needed knowledge on zirconia material science, to follow manufacturers' instructions, and to optimize the design of the prosthetic restoration with a good understanding where to reinforce the structure with a tough and strong zirconia.
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Affiliation(s)
- Paulo Francisco Cesar
- Department of Biomaterials and Oral Biology, School of Dentistry, University of São Paulo, São Paulo, Brazil.
| | | | - Karina Felix Santos
- Department of Biomaterials and Oral Biology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Susanne S Scherrer
- Division of Fixed Prosthodontics and Biomaterials, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Yu Zhang
- Department of Preventive and Restorative Sciences, School of Dental Medicine, University of Pennsylvania, Philadelphia, USA
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Alshahrani AM, Lim CH, Wolff MS, Janal MN, Zhang Y. Current speed sintering and high-speed sintering protocols compromise the translucency but not strength of yttria-stabilized zirconia. Dent Mater 2024; 40:664-673. [PMID: 38378371 PMCID: PMC11015968 DOI: 10.1016/j.dental.2024.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 01/05/2024] [Accepted: 02/12/2024] [Indexed: 02/22/2024]
Abstract
OBJECTIVES To investigate the impacts of speed and high-speed sintering on the densification, microstructure, phase composition, translucency, and flexural strength of yttria-stabilized zirconia (YSZ). METHODS A total of 162 disc-shaped specimens (n = 18) were cold-isostatically pressed from 3YSZ (Zpex), 4YSZ (Zpex 4), and 5YSZ (Zpex Smile) powders (Tosoh Corporation) and sintered according to the following protocols: conventional (control, ∼12 h), speed (∼28 min for 3YSZ; ∼60 min for 4YSZ and 5YSZ), and high-speed (∼18 min) sintering. Dimensions of zirconia specimens after sintering and polishing (1-μm diamond grit finish) were Ø13.75 × 1 mm. Density, microstructure, phase content, translucency parameter, and biaxial flexural strength were evaluated using Archimedes', SEM, XRD, spectrophotometric, and piston-on-3-ball methods, respectively. Data were analyzed with either one-way ANOVA and Tukey's test or Kruskal-Wallis with Dunn's test (α = 0.05). RESULTS For all YSZ compositions, conventional sintering yielded the highest density followed by speed then high-speed sintering. All sintering protocols resulted in similar strength values; however, speed and high-speed sintering protocols afforded significantly lower translucency relative to conventional sintering. XRD analysis revealed similar spectra for YSZs sintered by various protocols. The speed sintered specimens had the smallest grain size whereas the high-speed sintered 5YSZ possessed the largest grain size among all groups. SEM examination of all YSZ compositions revealed that the average pore size was an order of magnitude smaller than the average grain size. SIGNIFICANCE Speed and high-speed sintering of YSZs yield similar strength but diminished density and translucency relative to their conventionally sintered counterparts.
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Affiliation(s)
- Abdulaziz M Alshahrani
- Laboratories for Microstructure Physics & Mechanics of Materials, Department of Preventive and Restorative Sciences, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; Department of Restorative Dental Sciences, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Chek Hai Lim
- Laboratories for Microstructure Physics & Mechanics of Materials, Department of Preventive and Restorative Sciences, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Mark S Wolff
- Morton Amsterdam Dean, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Malvin N Janal
- Department of Epidemiology & Health Promotion, New York University College of Dentistry, New York, NY 10010, USA
| | - Yu Zhang
- Laboratories for Microstructure Physics & Mechanics of Materials, Department of Preventive and Restorative Sciences, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
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Yousry M, Hammad I, Halawani ME, Aboushelib M. Translucency of recent zirconia materials and material-related variables affecting their translucency: a systematic review and meta-analysis. BMC Oral Health 2024; 24:309. [PMID: 38443872 PMCID: PMC10913643 DOI: 10.1186/s12903-024-04070-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 02/25/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND Recent forms of translucent zirconia material have been developed, offering a wide range of options and varieties for enhancing aesthetics, making it a preferred choice in the field of prosthetic dentistry. However, there is insufficient understanding regarding the recent types of zirconia materials and their optical behavior. Understanding the variables that influence the translucency of zirconia and identifying strategies to enhance its esthetics are crucial. PURPOSE The current systemic review highlights a comprehensive understanding of different zirconia generations in relation to their optical characteristics and evaluates material-related variables affecting their translucency. METHODS The present review studied in-vitro studies that evaluated the optical characteristics of different yttria content of yttria stabilized materials. The topics explored were: (1) the different zirconia material generations and their optical behavior; (2) material-related factors that affect their translucency. The research was restricted to online publication in the English language from July 1, 2010, to July 31, 2023, using PubMed, Scopus, and Science Direct resources. The search key terms and their combinations were "zirconia," "translucent zirconia," "cubic zirconia," "highly translucent zirconia," "yttria partially stabilized zirconia," "monolithic zirconia," "translucency," "optical properties," and "light transmission." RESULTS The data obtained from fifty-three studies addressed the optical characteristics of various zirconia generations. They reported that changing yttria content had a significant impact on translucency. Different kinds of zirconia ceramics of the same generation have varying translucencies. Achieving optimum aesthetics with monolithic zirconia is challenging due to factors related to material aspects such as the presence of additives, point defects, microstructure, thickness, phase distribution, and sintering conditions. CONCLUSIONS Newly developed monolithic dental zirconia ceramics have improved aesthetics and translucency. However, additional research is necessary to evaluate their performance and long-term durability. TRIAL REGISTRATION This systematic review was registered in PROSPERO, under number CRD42023474482.
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Affiliation(s)
- Mahinour Yousry
- Department of Conservative Dentistry, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
| | - Ihab Hammad
- Department of Conservative Dentistry, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Mohamed El Halawani
- Department of Conservative Dentistry, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Moustafa Aboushelib
- Department of Dental Materials Science, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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Liu H, Inokoshi M, Xu K, Tonprasong W, Minakuchi S, Van Meerbeek B, Vleugels J, Zhang F. Does speed-sintering affect the optical and mechanical properties of yttria-stabilized zirconia? A systematic review and meta-analysis of in-vitro studies. JAPANESE DENTAL SCIENCE REVIEW 2023; 59:312-328. [PMID: 37705876 PMCID: PMC10495607 DOI: 10.1016/j.jdsr.2023.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 08/02/2023] [Accepted: 08/22/2023] [Indexed: 09/15/2023] Open
Abstract
Zirconia restorations are increasingly popular in dental treatment. Yttria-stabilized zirconia (YSZ) needs to be sintered for clinical applications and novel speed-sintering protocols are being developed for chairside treatments. Whether the properties of speed-sintered YSZ meet clinical requirements, however, remains unclear. Therefore, we conducted a systematic review and meta-analysis on the influence of speed-sintering on the optical and mechanical properties of dental YSZ according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. A literature search was conducted using PubMed, Embase, and Web of Science databases for relevant articles published between January 1, 2010 and February 28, 2022 in English, Chinese, or Japanese. After full-text evaluation and quality assessment, 26 articles were selected. Meta-analysis revealed that speed-sintering does not significantly affect the CIEDE2000-based translucency parameter, contrast ratio, three-point flexural strength, biaxial flexural strength, or fracture toughness of YSZ (p < 0.01) compared to conventional sintering. However, the CIELab-based translucency parameter of conventionally sintered YSZ is higher than that of speed-sintered YSZ. The descriptive analysis indicated that speed-sintering does not affect the hardness of YSZ compared to that of conventionally sintered YSZ. The results indicate that speed-sintering is suitable for preparing YSZ for dental restorations.
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Affiliation(s)
- Hengyi Liu
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo, Tokyo 113-8549, Japan
| | - Masanao Inokoshi
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo, Tokyo 113-8549, Japan
| | - Kaiqi Xu
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo, Tokyo 113-8549, Japan
| | - Watcharapong Tonprasong
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo, Tokyo 113-8549, Japan
| | - Shunsuke Minakuchi
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo, Tokyo 113-8549, Japan
| | - Bart Van Meerbeek
- KU Leuven (University of Leuven), Department of Oral Health Sciences, BIOMAT & UZ Leuven (University Hospitals Leuven), Dentistry, Kapucijnenvoer 7 blok a, B-3000 Leuven, Belgium
| | - Jef Vleugels
- KU Leuven (University of Leuven), Department of Materials Engineering, Kasteelpark Arenberg 44, BE-3001 Leuven, Belgium
| | - Fei Zhang
- KU Leuven (University of Leuven), Department of Oral Health Sciences, BIOMAT & UZ Leuven (University Hospitals Leuven), Dentistry, Kapucijnenvoer 7 blok a, B-3000 Leuven, Belgium
- KU Leuven (University of Leuven), Department of Materials Engineering, Kasteelpark Arenberg 44, BE-3001 Leuven, Belgium
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Lee S, Choi G, Choi J, Kim Y, Kim HK. Effect of high-speed sintering on the marginal and internal fit of CAD/CAM-fabricated monolithic zirconia crowns. Sci Rep 2023; 13:17215. [PMID: 37821643 PMCID: PMC10567905 DOI: 10.1038/s41598-023-44587-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 10/10/2023] [Indexed: 10/13/2023] Open
Abstract
This study compared the marginal and internal fit of zirconia crowns fabricated using conventional and high-speed induction sintering. A typodont mandibular right first molar was prepared and 60 zirconia crowns were fabricated: 30 crowns using conventional sintering and 30 crowns using high-speed sintering. We presented a new evaluation methodology to measure the marginal and internal fit of restorations through digital scanning, aligning the two datasets, and measuring the distance between two arbitrary point sets of the datasets. For the marginal fit, we calculated the maximum values of the shortest distances between the marginal line of the prepared tooth and that of the crown. The calculated values ranged from 359 to 444 μm, with smaller values for the high-speed sintered crowns (P < 0.05). For the internal fit, we employed mesh sampling and computed the geodesic distances between the prepared tooth surface and the crown intaglio surface. The measured values ranged from 177 to 229 μm with smaller values for the high-speed sintered crowns, but no significant difference was found (P > 0.05). Based on our results, the high-speed sintering method can be considered a promising option for single-visit zirconia treatment in dental practice.
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Affiliation(s)
- Seulgi Lee
- Department of Dental Public Health, Graduate School of Clinical Dentistry, Ajou University, Suwon, Republic of Korea
| | | | | | | | - Hee-Kyung Kim
- Department of Prosthodontics, Institute of Oral Health Science, Ajou University School of Medicine, Suwon, Republic of Korea.
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He Q, Zhang W, Zhan X, Qin Y, Ye J. Enhanced bioactivity and hydrothermal aging resistance of Y-TZP ceramics for dental implant. J Biomed Mater Res B Appl Biomater 2023; 111:1824-1839. [PMID: 37255008 DOI: 10.1002/jbm.b.35288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 05/08/2023] [Accepted: 05/18/2023] [Indexed: 06/01/2023]
Abstract
Although yttria-stabilized tetragonal zirconia polycrystals (Y-TZP) ceramics have been widely used as restorative materials due to their high mechanical strength, unique esthetic effect, and good biocompatibility, their general application to implant materials is still limited by their biological inertness and hydrothermal aging phenomenon. Existing studies have attempted to investigate how to enhance the bioactivity or hydrothermal aging resistance of Y-TZP. Still, more studies need to be done on the modification that combines these two aspects. In this study, Y-TZP was prepared by 77S bioactive glass (BG) sol and akermanite (AKT) sol infiltration and microwave sintering, which provided Y-TZP with high bioactivity while maintaining resistance to hydrothermal aging. Results of phase composition evaluation, microstructural characteristics, and mechanical property tests showed that modified Y-TZP specimens exhibited little or no tetragonal-to-monoclinic (t → m) transformation and maintained relatively high mechanical properties after accelerated hydrothermal aging treatment. The in vitro biological behaviors showed that the introduction of 77S BG and AKT significantly promoted cell adhesion, spreading, viability, and proliferation on the surface of modified Y-TZP ceramics. Therefore, this modification could effectively enhance the bioactivity and hydrothermal aging resistance of Y-TZP ceramics for its application in dental implant materials.
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Affiliation(s)
- Qixuan He
- School of Material Science and Engineering, South China University of Technology, Guangzhou, China
- National Engineering Research Center for Tissue Restoration and Reconstruction, Guangzhou, China
| | - Wenmin Zhang
- School of Material Science and Engineering, South China University of Technology, Guangzhou, China
- National Engineering Research Center for Tissue Restoration and Reconstruction, Guangzhou, China
| | - Xiaozhen Zhan
- Hospital of Stomatology, the First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Yanping Qin
- School of Material Science and Engineering, South China University of Technology, Guangzhou, China
- National Engineering Research Center for Tissue Restoration and Reconstruction, Guangzhou, China
| | - Jiandong Ye
- School of Material Science and Engineering, South China University of Technology, Guangzhou, China
- National Engineering Research Center for Tissue Restoration and Reconstruction, Guangzhou, China
- Key Laboratory of Biomedical Materials of Ministry of Education, South China University of Technology, Guangzhou, China
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Giugliano TS, Zhang Y, Janal MN, Lim CH, Smith RM, Choi M. In vitro comparison of physical characteristics of milled versus printed zirconia discs. J Prosthodont 2023:10.1111/jopr.13778. [PMID: 37776103 PMCID: PMC10980599 DOI: 10.1111/jopr.13778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 09/25/2023] [Accepted: 09/27/2023] [Indexed: 10/01/2023] Open
Abstract
PURPOSE The purpose of this study was to compare the dimensional accuracy, translucency, and biaxial flexural strength of milled zirconia (MZ) versus 3D-printed zirconia (PZ) discs. MATERIALS & METHODS A circular disc measuring 14.0 mm in diameter and 1.20 mm in thickness was designed using computer-aided design (CAD) software. The resulting standard tessellation language (STL) file was used both as a control and to fabricate 36 zirconia (3Y-TZP) disc specimens (n = 36): 18 were milled (group MZ) and 18 were 3D-printed (group PZ). The diameter and thickness of each disc were measured using a digital caliper. Translucency was evaluated using a calibrated dental colorimeter. The flexural strength was determined using the piston-on-three-ball biaxial flexure test. All measurements were done by one blinded examiner. The statistical significance level was set to α = 0.05. RESULTS The MZ discs had significantly more accurate dimensions than the PZ discs in both diameter and thickness when compared to the control CAD software-designed disc. The MZ discs exhibited significantly higher translucency (translucency parameter (TP) = 16.95 ±0.36 vs. 9.24 ±1.98) and biaxial flexural strength (996.16 ±137.37 MPa vs. 845.75 ±266.16 MPa) than the PZ discs. Finally, MZ possessed a significantly higher Weibull modulus relative to PZ. CONCLUSIONS The results showed that the milled specimens achieved better dimensional accuracy and were more translucent, stronger, and less prone to failure than printed specimens.
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Affiliation(s)
- Thomas S. Giugliano
- Department of Prosthodontics, New York University College of Dentistry, New York, NY
| | - Yu Zhang
- Laboratories for Microstructure Physics & Mechanics of Materials, Department of Preventive and Restorative Sciences, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA
| | - Malvin N. Janal
- Department of Epidemiology & Health Promotion, New York University College of Dentistry, New York, NY
| | - Chek Hai Lim
- Laboratories for Microstructure Physics & Mechanics of Materials, Department of Preventive and Restorative Sciences, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA
| | - Ruby M. Smith
- Post-Graduate Student, Department of Prosthodontics, New York University College of Dentistry, New York, NY
| | - Mijin Choi
- Department of Prosthodontics, New York University College of Dentistry, New York, NY
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Dyakonenko EE, Sakhabieva DA, Axelrod IB, Lebedenko IY. [Comparative evaluation of traditional and speed sintering of dental ceramics based on zirconium dioxide]. STOMATOLOGIIA 2022; 101:106-113. [PMID: 35362712 DOI: 10.17116/stomat2022101021106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
This study analyzed the traditional and high-speed firing of dental ceramics based on zirconia. The types of furnaces for sintering zirconia, the basic principles of traditional, high-speed and super-speed firing, as well as the effect of the sintering protocol on the structure, physical, mechanical, optical properties, wear and marginal fit of zirconia were evaluated. The analysis showed that it`s necessary to develop a special optimal sintering technique using particular protocols in specific types of furnaces for each dental ceramic material based on zirconia, taking into account the composition and structure of the ceramics. To write this review, articles from the electronic databases of Medline, PubMed and the websites of dental journals were used.
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Affiliation(s)
- E E Dyakonenko
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | - D A Sakhabieva
- Peoples' Friendship University of Russia, Moscow, Russia
| | - I B Axelrod
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | - I Yu Lebedenko
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
- Peoples' Friendship University of Russia, Moscow, Russia
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Influence of high-speed sintering protocols on translucency, mechanical properties, microstructure, crystallography, and low-temperature degradation of highly translucent zirconia. Dent Mater 2021; 38:451-468. [PMID: 34961644 DOI: 10.1016/j.dental.2021.12.028] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 12/15/2021] [Accepted: 12/15/2021] [Indexed: 01/24/2023]
Abstract
OBJECTIVES Impacts of high-speed sintering on the optical and mechanical properties, microstructure, crystallography, and low-temperature degradation of commercial yttria-partially stabilized zirconia (Y-PSZ) were investigated. METHODS Five commercial Y-PSZ products (KATANA HT, KATANA STML, KATANA UTML, Zpex 4, and Zpex Smile) were investigated. Specimens were sintered following speed-sintering (~90 min) and conventional-sintering protocols (~7 h), and a group of KATANA STML was super-speed-sintered (18 min). Dimensions of the zirconia specimens after sintering were 14.5 mm (diameter) and 1.2 mm (thickness). Translucency was assessed using a colorimeter. Biaxial flexural strength was measured using a universal testing machine, followed by Weibull analysis. Scanning electron microscopy was used for microstructure assessments. X-ray diffraction was used to analyze the crystallography before and after hydrothermal aging. Low-temperature degradation (LTD) tests were performed at 134 °C under 2-3 bar water vapor in an autoclave. RESULTS The translucency and flexural strength were not affected significantly by the sintering programs (p > 0.05). The conventionally sintered KATANA STML and speed-sintered Zpex 4 presented the highest and lowest Weibull modulus, respectively. The conventionally-sintered Y-PSZ had a larger average grain size and smaller fraction of fine grains than those of the speed-sintered specimens. The fractographic analysis of the speed- and conventionally sintered Y-PSZ yielded comparable results. The speed-sintered Y-PSZ exhibited a lower c-ZrO2 content than that of conventionally-sintered Y-PSZ, except for KATANA HT and KATANA STML. LTD tests indicated that some of the speed and conventionally-sintered Y-PSZ exhibited similar monoclinic volume fractions. SIGNIFICANCE Speed-sintering programs are acceptable for Y-PSZ zirconia.
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