Layer-Matched A2 Shade Compatibility Across 3Y/4Y/5Y Multilayer Zirconia: CIEDE2000 Color Differences Correlated with Y2O3 Content (EDS), Phase Constitution (XRD), and Grain Size (FE-SEM)

Abstract

Objective: This in vitro study aimed to compare the layer-matched color compatibility of three 3Y/4Y/5Y multilayer zirconia grades marketed in shade A2. Materials and Methods: Disc specimens (18 mm × 1.5 mm) were milled from pre-shaded multilayer zirconia blanks (Katana™ Multi-Layered Zirconia; Kuraray Noritake Dental Inc., Tokyo, Japan) in three grades: UTML (5Y), STML (4Y), and HTML (3Y). Twelve discs per grade were polished and measured on a neutral-gray background (Munsell N7) using a dental spectrophotometer (VITA Easyshade Advance 4.0; VITA Zahnfabrik, Bad Säckingen, Germany) at the incisal, middle, and cervical thirds. Color differences were calculated using CIEDE2000 (ΔE00). Yttria content (wt%) was determined using EDS (JSM-7800F; JEOL Ltd., Tokyo, Japan), and phases were assessed using XRD (X’Pert PRO; Malvern Panalytical, Almelo, The Netherlands); microstructure and grain size were examined using FE-SEM after thermal etching. Statistics: A two-way mixed-design ANOVA with Bonferroni adjustment (α = 0.05) was conducted. Results: A significant incisal-to-cervical gradient was observed within each grade (p < 0.001), whereas layer-matched inter-material differences were small (all ΔE00 < 1.0), i.e., below the commonly accepted perceptibility threshold. EDS confirmed the expected stepwise decrease in Y2O3 from UTML to HTML, accompanied by corresponding changes in phase constitution and grain size. Conclusions: Despite compositional and microstructural differences, the three multilayer zirconia grades showed no clinically perceptible layer-matched color differences, supporting their combined use in extended rehabilitations while maintaining the natural-like color gradient across the multilayer blank.