Research results will be presented showing that not all zirconia ceramics are alike. Variation in the processing (blank pressing, firing) resulted in differences in the mechanical properties as well as fatigue limits. Transillumination and microscope failure analysis are necessary for identification of detrimental machining, grinding or firing defects (quality control). Errors in the 3D design may lead to premature failure of the structure as illustrated by clinical cases. A good understanding of the material science of zirconia ceramics as well as correct processing, designing and handling are essential for their best use in restorative dentistry.