Clinical Readiness of Additively Manufactured Dental Ceramics for Crowns, Veneers, and Partial-Coverage Restorations: A Scoping Review and Evidence Map
Source abstract
Abstract
This scoping review mapped the clinical readiness of directly additively manufactured (AM) dental ceramics for single-unit definitive restorations (crowns, veneers, and partial-coverage restorations) using a predefined review-specific five-tier readiness framework (R1–R5) designed to organize evidence maturity from restoration-relevant foundational studies to comparative clinical evidence. MEDLINE (PubMed), Scopus, Web of Science Core Collection, EBSCO (Dentistry and Oral Sciences Sources), and ClinicalTrials.gov were searched from inception to February 2026, with citation tracking. Thirty-five sources were included: 31 in vitro studies and 4 clinical studies. Evidence clustered in preclinical tiers, with most studies classified as restoration-level in vitro investigations (R2, 22/35) or foundational specimen-level studies explicitly linked to restorative performance (R1, 9/35); only one feasibility study reached R3 (1/35), three studies provided comparative clinical evidence (R4, 3/35), and no R5-level evidence was identified. The additively manufactured definitive restorations evaluated were zirconia-based. Most restoration-level studies addressed zirconia crowns (18/35), with fewer studies focusing on veneers/laminates (5/35) and occlusal veneers/tabletops (2/35). Across AM routes (most commonly vat photopolymerization ceramic workflows and nanoparticle jetting) outcomes focused on fit/adaptation, manufacturing accuracy, mechanical performance, and aging simulations; clinical studies reported short- to mid-term performance using standardized evaluation criteria. Overall, the evidence suggests technical feasibility and increasing restoration-level evaluation under controlled conditions, but clinical applicability remains preliminary because higher-readiness clinical evidence is still limited. Future work should prioritize standardized reporting, clinically relevant aging/fatigue paradigms, and longer-term comparative clinical studies.
Source: crossref · Quality: baseline
Research context
OpenAlex topics: Dental materials and restorations · Additive Manufacturing and 3D Printing Technologies · Anatomy and Medical Technology
SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.
Affiliations
Doctoral School, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
Orthodontics and Dento-Facial Orthopedics Department, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
Department of Dental Technology, Faculty of Midwifery and Nursing, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania
Department of Dental Prosthesis Technology, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
Department of Implant-Prosthetic Therapy, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
Department of Operative Dentistry, Faculty of Dentistry, “Carol Davila” University of Medicine and Pharmacy, 010221 Bucharest, Romania
Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
References (66)
Show source-provided references
1. Ruggiero, M.M., Souza, L.V.S., Magno, M.B., Song, X., Maia, L.C., Cury, A., and Zhang, Y. (J. Esthet. Restor. Dent., 2025). Is Additive Manufacturing of Dental Zirconia Comparable to Subtractive Methods when Considering Printing Orientation and Layer Thickness? A Systematic Review and Meta-Analysis, J. Esthet. Restor. Dent., online ahead of print.10.1111/jerd.13514 ↗
2. Additive manufacturing of dental ceramics in prosthodontics: The status quo and the future10.2186/jpr.JPR_D_23_00119 ↗
3. Ethical and Medico-Legal Aspects Behind the Use of Digital Technologies in Dentistry10.4323/rjlm.2020.202 ↗
4. Effect of Milling Speed on the Properties of Zirconia Restorations10.4317/jced.61231 ↗
5. Accuracy of zirconia crowns manufactured by stereolithography with an occlusal full-supporting structure: An in vitro study10.1016/j.prosdent.2022.01.015 ↗
6. Additive Manufacturing of Dental Ceramics: A Systematic Review and Meta-Analysis
7. Vorovenci, A., Perieanu, V.Ș., Burlibașa, M., Gligor, M.R., Malița, M.A., David, M., Ionescu, C., Stănescu, R., Ionaș, M., and Costea, R.C. (2026). Head-to-Head: AI and Human Workflows for Single-Unit Crown Design—Systematic Review. Oral, 6.10.3390/oral6010016 ↗
8. Accuracy and adaptation of 3D printed zirconia crowns: A review of current methodologies10.1016/j.prosdent.2025.01.027 ↗
9. Flexural strength and Weibull analysis of Y-TZP fabricated by stereolithographic additive manufacturing and subtractive manufacturing10.1016/j.jeurceramsoc.2019.10.058 ↗
10. AlGhamdi, M.A. (2025). Additively Fabricated Permanent Crown Materials: An Overview of Literature and Update. Prosthesis, 7.10.3390/prosthesis7020035 ↗
11. Popescu, M., Perieanu, V.S., Burlibașa, M., Vorovenci, A., Malița, M.A., Petri, D.-C., Ștețiu, A.A., Costea, R.C., Costea, R.M., and Burlibașa, A. (2025). Comparative Cost-Effectiveness of Resin 3D Printing Protocols in Dental Prosthodontics: A Systematic Review. Prosthesis, 7.10.3390/prosthesis7040078 ↗
12. The enhanced ZrO2 produced by DLP via a reliable plasticizer and its dental application10.1016/j.jmbbm.2023.105751 ↗
13. Branco, A.C., Colaço, R., Figueiredo-Pina, C.G., and Serro, A.P. (2023). Recent Advances on 3D-Printed Zirconia-Based Dental Materials: A Review. Materials, 16.10.3390/ma16051860 ↗
14. DLP 3D printing of high strength semi-translucent zirconia ceramics with relatively low-loaded UV-curable formulations10.1016/j.ceramint.2023.03.236 ↗
15. Mechanical Properties Improvement of 3D-Printed Aesthetic Dental Artificial Crowns Using UV-Curable Ceramic-Urethane Acrylate Nano-Composite Resins with Varying Filler Ratios
16. Do 3D printed and milled tooth-supported complete monolithic zirconia crowns differ in accuracy and fit? A systematic review and meta-analysis of in vitro studies10.1016/j.prosdent.2024.04.010 ↗
17. Alrabiah, M. (2025). Comparative Evaluation of Mechanical Properties Between CAD/CAM-Milled and 3D-Printed Dental Zirconia: A Systematic Review and Meta-Analysis. Materials, 18.10.3390/ma18225112 ↗
18. Influence of surface finishing and printing layer orientation on surface roughness and flexural strength of stereolithography-manufactured dental zirconia10.1016/j.jmbbm.2023.105944 ↗
19. Comparison of the flexural strength and microstructure of 3D printed and milled mono- and multilayer zirconia10.1016/j.jmbbm.2026.107370 ↗
20. Zandinejad, A., Revilla-León, M., Methani, M.M., Khanlar, L.N., and Morton, D. (2021). The Fracture Resistance of Additively Manufactured Monolithic Zirconia vs. Bi-Layered Alumina Toughened Zirconia Crowns When Cemented to Zirconia Abutments. Evaluating the Potential of 3D Printing of Ceramic Crowns: An In Vitro Study. Dent. J., 9.10.3390/dj9100115 ↗
21. Khanlar, L.N., Rios, A.S., Tahmaseb, A., and Zandinejad, A. (2021). Additive Manufacturing of Zirconia Ceramic and Its Application in Clinical Dentistry: A Review. Dent. J., 9.10.3390/dj9090104 ↗
22. Finite element method analysis of the stress induced upon the dental implant by the mastication process
23. Costa, L.P.G.d., Zamalloa, S.I.D., Alves, F.A.M., Spigolon, R., Mano, L.Y., Costa, C., and Mazzo, A. (2021). 3D printers in dentistry: A review of additive manufacturing techniques and materials. Clin. Lab. Res. Dent., 1–10.10.11606/issn.2357-8041.clrd.2021.188502 ↗
24. JBI Critical appraisal checklist for systematic reviews and research syntheses10.29173/jchla29801 ↗
25. PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation10.7326/M18-0850 ↗
26. Clinical Efficacy Evaluation of a Novel 3D-Printed Zirconia Crown10.1016/j.identj.2025.105216 ↗
27. Esthetic appearances of anatomic contour zirconia crowns made by additive wet deposition and subtractive dry milling: A self-controlled clinical trial10.1016/j.prosdent.2019.02.016 ↗
28. Yu, F., Xiang, F., Zhao, J., Lin, N., Sun, Z., and Zheng, Y. (2024). Clinical outcomes of self-glazed zirconia veneers produced by 3D gel deposition: A retrospective study. BMC Oral Health, 24.10.1186/s12903-024-04253-2 ↗
29. Clinical evaluation of 3D-printed zirconia crowns fabricated by selective laser melting (SLM) for posterior teeth restorations: Short-term pilot study10.1016/j.jds.2022.11.017 ↗
30. The effect of cyclic loading on the fracture resistance of 3D-printed and CAD/CAM milled zirconia crowns—An in vitro study10.1007/s00784-023-05229-2 ↗
31. Hassan, R.M., Ibrahim, Y., AboElhassan, R.G., and Azer, A.S. (2025). Evaluation of fracture resistance and surface characteristics in monolithic zirconia: A comparative analysis of 3D printing and milling techniques. BMC Oral Health, 25.10.1186/s12903-025-06570-6 ↗
32. Refaie, A., Fouda, A., Bourauel, C., and Singer, L. (2023). Marginal gap and internal fit of 3D printed versus milled monolithic zirconia crowns. BMC Oral Health, 23.10.1186/s12903-023-03184-8 ↗
33. Accuracy and margin quality of advanced 3D printed monolithic zirconia crowns10.1016/j.prosdent.2023.07.004 ↗
34. An in vitro comparison of the marginal and internal adaptation of ultrathin occlusal veneers made of 3D-printed zirconia, milled zirconia, and heat-pressed lithium disilicate10.1016/j.prosdent.2020.09.053 ↗
35. 3D printing and milling accuracy influence full-contour zirconia crown adaptation10.1016/j.dental.2022.11.002 ↗
36. Abualsaud, R., and Alalawi, H. (2022). Fit, Precision, and Trueness of 3D-Printed Zirconia Crowns Compared to Milled Counterparts. Dent. J., 10.10.3390/dj10110215 ↗
37. Load-bearing capacity of CAD/CAM 3D-printed zirconia, CAD/CAM milled zirconia, and heat-pressed lithium disilicate ultra-thin occlusal veneers on molars10.1016/j.dental.2020.01.016 ↗
38. Load-bearing capacity of 3D-printed incisor partial-coverage crowns made from zirconia and composite10.2186/jpr.JPR_D_23_00028 ↗
39. Quality Assessment and Comparison of 3D-Printed and Milled Zirconia Anterior Crowns and Veneers: In Vitro Pilot Study10.1055/s-0044-1782183 ↗
40. Internal and marginal discrepancies associated with stereolithography (SLA) additively manufactured zirconia crowns10.1016/j.prosdent.2019.09.018 ↗
41. Comparison of properties and cost efficiency of zirconia processed by DIW printing, casting and CAD/CAM-milling10.1016/j.dental.2023.05.001 ↗
42. Suitability of 3D printed pieces of nanocrystalline zirconia for dental applications10.1016/j.dental.2020.01.006 ↗
43. Cho, S.-M., Park, J.-M., Ioannidis, A., Kim, R.J.Y., and Chung, H.-M. (2025). Comparative analysis of fit, mechanical properties, and surface characteristics in subtractive- and additive-manufactured zirconia crowns. BMC Oral Health, 25.10.1186/s12903-025-06561-7 ↗
44. Zenthöfer, A., Fien, D., Rossipal, J., Ilani, A., Schmitt, C., Hetzler, S., Rammelsberg, P., and Rues, S. (2024). Fracture Resistance of 3D-Printed Occlusal Veneers Made from 3Y-TZP Zirconia. Materials, 17.10.3390/ma17092122 ↗
45. Accuracy of zirconia crown manufactured using stereolithography and digital light processing10.1016/j.jdent.2024.104834 ↗
46. Hetzler, S., Hinzen, C., Rues, S., Schmitt, C., Rammelsberg, P., and Zenthöfer, A. (2025). Biaxial Flexural Strength and Vickers Hardness of 3D-Printed and Milled 5Y Partially Stabilized Zirconia. J. Funct. Biomater., 16.10.3390/jfb16010036 ↗
47. Elsayed, M.S., El-Kouedi, A.Y., and Shokry, T.E. (2025). Effect of aging on the marginal fit of milled and printed zirconia crowns: An in-vitro study. BMC Oral Health, 25.10.1186/s12903-025-05542-0 ↗
48. Moon, J.-M., Jeong, C.-S., Lee, H.-J., Bae, J.-M., Choi, E.-J., Kim, S.-T., Park, Y.-B., and Oh, S.-H. (2022). A Comparative Study of Additive and Subtractive Manufacturing Techniques for a Zirconia Dental Product: An Analysis of the Manufacturing Accuracy and the Bond Strength of Porcelain to Zirconia. Materials, 15.10.3390/ma15155398 ↗
49. Jung, J.-M., Kim, G.-N., Koh, Y.-H., and Kim, H.-E. (2023). Manufacturing and Characterization of Dental Crowns Made of 5-mol% Yttria Stabilized Zirconia by Digital Light Processing. Materials, 16.10.3390/ma16041447 ↗
50. Adaptation and uniformity of monolithic zirconia crowns fabricated by additive 3-dimensional gel deposition10.1016/j.prosdent.2021.11.023 ↗
51. Evaluation of zirconia ceramics fabricated through DLP 3d printing process for dental applications10.1016/j.heliyon.2024.e36725 ↗
52. Accuracy and retention of laminate veneers made from zirconia, resin composite, and lithium disilicate using additive and subtractive techniques: An in vitro study10.1016/j.jdent.2025.106153 ↗
53. High-strength DLP-printed zirconia for ultra-thin dental veneers10.1016/j.dental.2025.08.005 ↗
54. Fabrication of Zirconia Ceramic Dental Crowns by Digital Light Processing: Effects of the Process on Physical Properties and Microstructure10.1089/3dp.2022.0342 ↗
55. Noh, M., and Kim, J. (2024). A Comparison of Internal, Marginal, and Incisal Gaps in Zirconia Laminates Fabricated Using Subtractive Manufacturing and 3D Printing Methods. Biomimetics, 9.10.3390/biomimetics9120728 ↗
56. Hajjaj, M.S., Alamoudi, R.A.A., Babeer, W.A., Rizg, W.Y., Basalah, A.A., Alzahrani, S.J., and Yeslam, H.E. (2024). Flexural strength, flexural modulus and microhardness of milled vs. fused deposition modeling printed Zirconia; effect of conventional vs. speed sintering. BMC Oral Health, 24.10.1186/s12903-023-03829-8 ↗
57. Trueness of stereolithography ZrO2 crowns with different build directions10.4012/dmj.2022-041 ↗
58. Biaxial flexural strength of 3D-printed 3Y-TZP zirconia using a novel ceramic printer10.1007/s00784-024-05533-5 ↗
59. Bömicke, W., Schwindling, F.S., Rammelsberg, P., and Rues, S. (2024). Bond Strength of Milled and Printed Zirconia to 10-Methacryloyloxydecyl Dihydrogen Phosphate (10-MDP) Resin Cement as a Function of Ceramic Conditioning, Disinfection and Ageing. Materials, 17.10.3390/ma17092159 ↗
60. Manufacturing accuracy and volumetric changes of stereolithography additively manufactured zirconia with different porosities
61. Popescu, M., Malița, M., Vorovenci, A., Ștețiu, A.A., Perieanu, V.Ș., Costea, R.C., David, M., Costea, R.M., Ștețiu, M.A., and Drăguș, A.C. (2025). Wet vs. Dry Dentin Bonding: A Systematic Review and Meta-Analysis of Adhesive Performance and Hybrid Layer Integrity. Oral, 5.10.3390/oral5030063 ↗
62. Effect of the volume fraction of zirconia suspensions on the microstructure and physical properties of products produced by additive manufacturing10.1016/j.dental.2019.02.001 ↗
63. Pinelli, L.A.P., Ferreira, I., and Cândido dos Reis, A. (2025). Analysis of flexural strength and Weibull modulus of printed and milled zirconia: A systematic review. J. Prosthet. Dent., 134.10.1016/j.prosdent.2025.05.032 ↗
64. Optical properties of vat photopolymerization additively manufactured zirconia monoliths and substrates for porcelain veneering: A pilot study
65. Trueness and precision of 3D-printed versus milled monolithic zirconia crowns: An in vitro study10.1016/j.jdent.2021.103792 ↗
66. Lu, Y., van Steenoven, A., de Oliveira Dal Piva, A.M., Tribst, J.P.M., Wang, L., Kleverlaan, C.J., and Feilzer, A.J. (2025). Additive-manufactured ceramics for dental restorations: A systematic review on mechanical perspective. Front. Dent. Med., 6.10.3389/fdmed.2025.1512887 ↗