Dentistry is evolving fast, and so are the expectations of patients and dentists. Nowadays, most dental practitioners know that different zirconia variants are available and that there are certain quality standards the selected material should meet to provide for aesthetic, functional and durable outcomes. Consequently, they often demand the use of a specific zirconia variant for their planned restorations.

Due to the widespread use of Tosoh zirconia in the market, however, many of these dentists are only familiar with the Tosoh 3Y / 4Y / 5Y zirconia terminology. This means that when prescribing a specific type of zirconia, they mention the desired yttria concentration. Unfortunately, this can create confusion in communication between dentists and dental laboratories: Not every zirconia brand and variant on the market fits into this Tosoh classification system.

KATANA™ Zirconia discs of Kuraray Noritake Dental Inc. are made of proprietary powders and advanced multi-layered technology developed in-house. The unique performance these blanks deliver cannot be simply described with the aid of the Tosoh system. Instead, we rely on the internationally recognized ISO 6872 classification — a standard that reflects clinical indications and material performance with precision.

WHY THE ISO 6872 CLASSIFICATION MATTERS

Unlike brand-specific powder classifications, ISO 6872 provides a clear, scientific, and globally accepted framework. It ensures that when a dentist prescribes a solution, or a technician selects a material, everyone speaks the same language – based on strength, translucency, and indication range. 

CONCLUSION

KATANA Zirconia is an advanced dental zirconia family that does not fit into standard boxes like 3Y, 4Y, or 5Y. It redefines what zirconia can do – blending beauty and strength with a scientifically validated ISO classification system. By embracing globally defined and accepted ISO 6872, we can contribute to peace of mind and eliminate confusion in the market.

Always follow Information for Use provided with the product and any other relevant local regulations.

Our recent webinar “Chasing the Halo: Aesthetic Layering Secrets for Anterior Composites” with Algimantė Lošytė-Jančė is now available on-demand in the Events section of our website.

In this session, participants explored the optical and anatomical principles behind the halo effect and learned step-by-step composite layering techniques to achieve lifelike anterior restorations.

Algimantė, an experienced aesthetic dentist specialized in minimally invasive dentistry and natural smile design, shared her clinical insights through practical examples and artistic approaches.

If you missed the live webinar or would like to revisit the content, you can now watch it anytime at your convenience.

Case by Dr. Michał Jaczewski

FLOWABLE INJECTION TECHNIQUE

What are the most important properties of a flowable composite used for the flowable injection technique? Personal experience shows that balanced optical properties are essential, with an appropriate translucency, blend-in ability and surface gloss leading the way. However, the mechanical properties are also important, not least because the restorative material will be in direct contact with the antagonist teeth. And finally, handling properties are essential: The right level of flowability is needed for proper injection, while a void-free application is required for an intact, stain-resistant surface.

For the last seven years, CLEARFIL MAJESTY™ ES Flow Low (Kuraray Noritake Dental Inc.) has been my go-to flowable composite for the flowable injection technique. Its level of flowability is ideal for the technique in the anterior and posterior region. Whenever a lower flowability is needed, it is possible to switch to the Super Low variant. Moreover, I like the shade offering, which – together with the superior polishability of the material – leads to natural aesthetics. Finally, its mechanical properties are so good that the product is approved for a wide indication range without load limitations.

When the company announced the introduction of CLEARFIL MAJESTY™ ES Flow Universal, which comes in just two universal shades and two different levels of flowability (Low and Super Low), I immediately decided to give it a try: The prospect of balanced properties I am already familiar with, combined with a simplified shade selection sounded very promising. So far, the new product comes up to my expectations: The following case example reveals the simplicity of the procedure and the beauty of the results. The patient presented during orthodontic (aligner) treatment for a shape correction in the anterior region due to wear of the incisal edge.

Fig. 1. Initial clinical situation: Patient in need of a shape correction in the maxillary incisor region.

Fig. 2. Application of CLEARFIL™ Universal Bond Quick 2 (Kuraray Noritake Dental Inc.) to the enamel of a central incisor, which has been merely roughened by air abrasion with aluminium oxide (50 μm at low pressure) followed by etching with a phosphoric acid etchant.

Fig. 3. Transparent silicon index placed in the mouth and CLEARFIL MAJESTY ES Flow Universal Low (U shade) already injected in the position of the maxillary right central incisor.

Fig. 4. Shape correction on the maxillary right central incisor completed.

Fig. 5. Situation after finishing and polishing of the incisor restorations.

Fig. 6. Nice shade match leading to a smooth blend-in with the surrounding natural tooth structure.

Fig. 7. Immediate treatment outcome supporting an improvement of the smile aesthetics and hence, the patient‘s quality of life during aligner therapy.

RESULTS THAT SPEAK FOR THEMSELVES

Like its related product CLEARFIL MAJESTY ES Flow, the universal-shade version CLEARFIL MAJESTY ES Flow Universal offers properties which are – from a personal perspective – ideal for the flowable injection technique. The shade-matching properties are astonishing; the translucency is quite high when placed in thin layers (so that enamel is very well imitated), and the polishability is as good as that of CLEARFIL MAJESTY ES Flow. For virtually effortless, bubble-free injection, the product comes in a nicely designed syringe. And last but not least, the product’s mechanical properties provide peace of mind even in the posterior region.

Dentist:

MICHAŁ JACZEWSKI

Michał Jaczewski graduated from Wroclaw Medical University in 2006 and today runs his private practice in the city of Legnica, Poland. He specializes in minimally invasive dentistry and digital dentistry and is the founder of the Biofunctional School of Occlusion. Here he lectures and runs workshops with focus on full comprehensive patient treatments.

A SMARTER GUIDE TO SELECTIVE DENTIN EXCAVATION

The modern approach to restorative dentistry emphasizes tissue preservation and clinical precision. Instead of extensive removal, today’s clinicians aim to conserve as much sound and remineralizable dentin as possible.

Caries Detector provides a simple yet effective way to achieve this precision by visually differentiating infected from affected dentin during caries excavation.

UNDERSTANDING THE DENTIN LAYERS

Dentin carious lesion is not homogeneous. It can be divided into two distinct zones:

• Infected dentin — irreversibly demineralized and heavily contaminated with bacteria; must be completely removed.
• Affected dentin — partially demineralized but capable of remineralization; should be preserved to maintain tooth vitality and strength.

The difficulty lies in identifying the exact transition between these two layers. Caries Detector facilitates this decision by providing a visual endpoint for excavation.

MECHANISM OF ACTION

Caries Detector selectively stains the infected outer dentin a vivid scarlet red while leaving the affected and sound dentin unstained.

This clear chromatic differentiation allows clinicians to identify residual infected tissue and avoid unnecessary removal of reparative dentin.

Depending on the clinical situation, the material can be used:

• In shallow cavities, prior to cavity opening for assessment.
• In deep lesions, following initial excavation to guide further selective removal while preventing pulpal exposure.

CLINICAL PROTOCOL

1. Preparation – After rubber dam placement, wash and dry the carious tooth.
2. Application – Place one drop of Caries Detector on a disposable brush and apply to the cavity.
3. Reaction time – Allow ten seconds for staining to occur.
4. Rinsing – Rinse thoroughly with water to remove excess dye and reveal the stained areas.
5. Selective removal – Excavate the red-stained infected dentin with a low-speed rotary instrument, avoiding the unstained tissue.
6. Verification – Repeat application if necessary to ensure complete removal of infected dentin.

The procedure yields a clean, sound dentin surface ready for adhesive bonding and restoration.

INTEGRATING WITH MINIMALLY INVASIVE RESTORATIVE WORKFLOWS

Caries Detector represents the first step in a conservative restorative protocol, aligning with the philosophy of minimum intervention dentistry (MID).

When combined with Kuraray Noritake Dental’s range of adhesive and restorative materials, clinicians can achieve:

• Controlled removal of infected dentin 
• Enhanced bonding to sound, remineralizable dentin
• Optimized aesthetic and long-term restorative outcomes

CONCLUSION

By translating histological principles into a practical chairside tool, Caries Detector allows clinicians to perform caries excavation with greater accuracy and confidence.

It supports minimally invasive principles, preserves tooth vitality, and lays the groundwork for durable, esthetic restorations.

Caries Detector — precision you can see.

Restorative dentistry continues to evolve — driven by smarter materials, refined techniques and a growing demand for streamlined solutions that do not compromise the outcomes.

In BOND 12 Magazine, we explore how modern ceramics, composites and adhesive technologies are shaping more efficient, predictable and aesthetic restorative workflows.

This latest issue brings together clinical expertise and material science, featuring inspiring case reports, expert insights and innovative techniques for both dental practitioners and dental technicians. Highlights include a tribute to Kiyoko Ban, a pioneer in dental technology, in-depth perspectives on the evolution of zirconia, and practical approaches to anterior and posterior restorations — from simplified composite layering to flowable injection and hybrid techniques.

Check out BOND Magazine Vol. 12 to discover the stories, techniques, clinical cases and ideas shaping contemporary restorative dentistry.

Start Reading: BOND | VOLUME 12 | 12/2025

Previous versions:

BOND | SPECIAL LAB SIDE EDITION | 07/2025

BOND | VOLUME 11 | 07/2024

BOND | VOLUME 10 | 10/2023

BOND | VOLUME 9 | 08/2022

BOND | VOLUME 8 | 12/2021

Case by DT Andreas Chatzimpatzakis

AESTHETIC AND EFFICIENT SMILE MAKEOVER

Most patients asking for a smile makeover desire custom solutions rather than an off-the-peg smile: Individual tooth shapes that fit their face and their character, an internal play of colours that matches their age and natural dentition. Modern dental materials allow us to deliver what they demand in many situations – usually at a reasonable price.

For a long time, however, we have been facing challenges when combining cosmetic and medically indicated treatment – e.g. a smile makeover including the rehabilitation of a missing lateral incisor. A straightforward solution – using lithium disilicate veneers alongside a zirconia cantilever bridge, both finished with their respective porcelain systems – would have been complicated by potential differences in the final appearance. With CERABIEN™ MiLai (Kuraray Noritake Dental Inc.), a set of internal stains and porcelains designed for micro-layering, the situation is different: Suitable for micro-layering on zirconia and lithium disilicate, it supports its user ideally in creating a harmonious smile even when the two framework materials are combined.

A NEW CUSTOM SMILE

The following patient case is a perfect example: A female patient with a missing lateral incisor, multiple visible composite restorations in the anterior region and an enamel fracture at her incisal edge desired a smile makeover. The selected materials were Amber Press LT (HASS), shade A1, for four veneers on the central incisors and the left lateral incisor and canine (teeth # 11, 21, 22 and 23 according to the FDI notation) and KATANA™ Zirconia YML (Kuraray Noritake Dental Inc.), shade A2, for the planned cantilever bridge on the maxillary right canine, replacing the missing lateral incisor (teeth # 12 and 13).

Fig. 1. Female patient with a missing maxillary lateral incisor and multiple composite restorations in the anterior area – a smile makeover is desired.

Fig. 2. Patient with mock-up.

Fig. 3. Minimally invasive preparation through the mock-up, which takes into account the minimum space required for the planned materials and restorations.

Fig. 4. Teeth prepared for the all-ceramic restorations.

Fig. 5. Occlusal view of the maxillary teeth after tooth preparation.

Fig. 6. Full-contour veneers and cantilever bridge on the model.

Fig. 7. Restorations after a cutback limited to the vestibular and incisal area.

Fig. 8. CERABIEN™ MiLai LT₁ is applied to the middle and cervical area of the zirconia cantilever bridge.

Fig. 9. CERABIEN™ MiLai Value Liner 2...

Fig. 10. … and Value Liner 1 applied to the incisal area of the central and lateral incisor restorations.

Fig. 11. CERABIEN™ MiLai porcelain Creamy Enamel mixed with Value Liner 2 (70/30) added to the middle and cervical areas of the four lithium disilicate restorations to increase and control the value.

Fig. 12. ... while E2 is added to the incisal area of both canines.

Fig. 13. Restorations covered by a layer of Tx ...

Fig. 14. ... and LTx.

Fig. 15. Appearance of the restorations after the first bake.

Fig. 16. Adding translucency and opalescence to the cervical area with LT₁ and brightness to the ridges with Creamy Enamel.

Fig. 17. Completion of the enamel surface with a cover layer of LTx, which is responsible for a high translucency and opalescence.

Fig. 18. Result of the second bake.

Fig. 19. Final restorations with a natural self-glaze effect on the model.

Fig. 20. Final restorations with a natural self-glaze effect in the patient’s mouth.

Fig. 21. Smooth optical integration of the restorations.

Fig. 22. Beautiful treatment outcome.

CONCLUSION

With the described approach and selected materials, it was possible to create restorations with a natural shade, shape and texture. They matched not only the appearance of the remaining natural teeth, but also showed internal consistency across the selected framework materials. The technical procedure was quite straightforward and efficient, while the result speaks for itself.

Special thanks to Dr. Kanellos Ioannis for the collaboration on this case and for kindly providing the pre- and post-treatment photographs that complemented it.

Dental technician:

ANDREAS CHATZIMPATZAKIS

Based in Athens, Greece, Andreas Chatzimpatzakis is the founder and director of ACH Dental Laboratory (since 2000), specializing in refractory veneers, lithium disilicate, zirconia, and implant prostheses. He graduated in Dental Technology from the University of West Attica and received advanced training in all-ceramic restorations in Helsinki and Japan under renowned masters including Shigeo Kataoka.

Since 2017, he has served as an international trainer for Kuraray–Noritake Dental Inc., delivering lectures and hands-on courses worldwide on advanced ceramic techniques. He has also held roles as Key Opinion Leader for MPF Brush Co., Ambassador for Hass Co., and Editor-in-Chief of Laborama. An active member of the Hellenic Academy of Aesthetic Dentistry, his work and articles have been published in both Greek and international journals.

Case by Dt. Koray Kendir, DDS, Turkey (İzmir)

ABSTRACT

This clinical case report presents a posterior direct composite restoration performed using Kuraray Noritake Dental Inc.’s “Universal Excellence” product concept. A universal adhesive (CLEARFIL™ Universal Bond Quick 2) and a highly filled, universal-shade flowable composite (CLEARFIL MAJESTY™ ES Flow Universal) were utilized to achieve both simplicity and predictability. Step-by-step documentation demonstrates isolation, cavity preparation, deep margin elevation, adhesive protocol, and final restoration.

CASE DESCRIPTION

A 38-year-old female patient presented with complaints of interdental bleeding and cold sensitivity between her maxillary left canine and first premolar (teeth #23 and #24, FDI notation). Clinical examination revealed an open margin and secondary caries at the gingival floor of the existing restoration on tooth #23. After rubber dam isolation, the stepwise treatment procedure was initiated.

CLINICAL PROCEDURE

Step 1. Tooth #23 exhibited an open gingival margin and caries (Fig. 1).

Step 2. After enamel removal, caries was excavated down to the gingival level. The lesion on tooth #24 was observed to extend subgingivally (Fig. 2).

Step 3. After complete caries excavation and cavity refinement, the need for deep margin elevation (DME) on tooth #24 became evident (Fig. 3).

Step 4. Deep margin elevation (DME) was performed on tooth #24 using a custom sectional wedge. First, selective etching and CLEARFIL™ Universal Bond Quick 2 were applied, followed by the placement of CLEARFIL MAJESTY™ ES Flow Universal (Super Low) (Figs. 4 to 6).

Step 5. After completion of the DME (deep margin elevation), appropriate matrix bands were placed, followed by a direct restoration of teeth #23 and #24 with CLEARFIL MAJESTY™ ES Flow Universal (Super Low) (Figs. 7 to 9). Thanks to the material’s easy handling, shade adaptation, and excellent polishability, this challenging DME case was successfully and efficiently managed.

The treatment outcome is shown in Figures 10 and 11.

Fig. 1. Preoperative view under rubber dam isolation.

Fig. 2. Clinical situation after caries excavation.

Fig. 3. Refined cavities with a deep margin on the premolar.

Fig. 4. Custom wedge placed to elevate the margin.

Fig. 5. Buccal view of the teeth after deep margin elevation with universal products.

Fig. 6. Occlusal view of the teeth after deep margin elevation with universal products.

Fig. 7. Placement of a sectional matrix.

Fig. 8. Buccal view of the teeth restored with a universal-shade flowable composite with super low flowability.

Fig. 9. Occlusal view of the teeth restored with a universal-shade flowable composite.

Fig. 10. Occlusal view of the final restorations of teeth #23 and #24, showing colour blending, anatomical form, and surface gloss.

Fig. 11. Buccal view of the final restorations of teeth #23 and #24, showing colour blending, anatomical form, and surface gloss.

DISCUSSION

Universal adhesives and modern flowable composites simplify posterior direct restorations by reducing technique sensitivity while providing for durable outcomes. In this case, CLEARFIL™ Universal Bond Quick 2 provided strong adhesion with minimal application time. The universal flowable composite demonstrated excellent adaptability, polishability, and durability. Even with a subgingival margin requiring DME, a streamlined approach was achieved without compromising quality.

CONCLUSION

The combination of CLEARFIL™ Universal Bond Quick 2 and CLEARFIL MAJESTY™ ES Flow Universal allows clinicians to perform predictable, efficient posterior restorations. Their universal applicability and handling properties align with the “Universal Excellence” concept, supporting simplified, yet reliable daily practice.

Ethics & Disclosure

All procedures were performed in accordance with standard dental practice. The patient provided informed consent for treatment and publication of anonymized clinical images. Author collaborates with Kuraray Noritake Dental Inc. as an advisor; content reflects clinical experience.

Dentist:

KORAY KENDIR

Dt. Koray Kendir is a graduate of Hacettepe University Faculty of Dentistry and the co-founder of a private dental clinic in İzmir. He specializes in digital dentistry, smile design, and computer-aided restorative treatments. Known for his innovative approach, Dr. Kendir is a frequent speaker at national dental congresses and serves as an advisor to several dental companies.

HOW TO OPTIMIZE ALL-CERAMIC RESTORATION BOTH AESTHETIC AND MECHANICAL?

A homogeneous porcelain structure, a strong bond between framework and veneering layer and a natural play of colours: All those characteristics of a high-quality all-ceramic restoration are not only strongly dependent on manual skills of the dental technician, but also on ideal firing conditions.

Only with a well maintained and properly functioning furnace and the right protocols, it is possible to obtain consistently great results in terms of aesthetics and function.

This is true for all kinds of all-ceramic restorations consisting of a framework and a veneering layer: It applies to full layering with a classical anatomical framework design and a relatively thick layer of porcelain, as well as to various cut-back designs finished using the modern micro-layering technique. A material that belongs to the latter category of porcelains and is becoming increasingly popular among dental technicians worldwide is CERABIEN™ MiLai (Kuraray Noritake Dental Inc.). The set of low-fusing porcelains and internal stains has been specifically developed for micro-layering, and works well with different variants of lithium disilicate and zirconia.

While the firing parameters provided by manufacturers like Kuraray Noritake Dental serve as reliable and thoroughly tested guidelines, experienced technicians often explore beyond these standards to achieve the highest possible aesthetic and functional outcomes.

This is precisely what MDT Nondas Vlachopoulos has done with CERABIEN MiLai.

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High-quality treatment is probably the most important element on the road to patient satisfaction. During every single appointment, the patient wants to feel well cared for by a skilled professional, while chair time and the number of appointments should be reduced to the necessary minimum. This implies that, in the context of prosthodontic treatment, a restoration needs to fit perfectly straight away and be stable over time to avoid remakes and extra appointments.

As explained in the first part of this series of articles, the quality of the selected prosthetic material – e.g. zirconia – has a decisive impact on the design, overall quality and long-term performance of definitive restoration. That is why you as a dental practitioner should

• order restorations that are produced domestically or in a region with the same standards as your own,
• know about the source of the zirconia your laboratory partner uses, and
• avoid deals that are too good to be true.

WHY ASK YOUR LABORATORY TO USE KATANA™ Zirconia

When quality matters, and you want to be sure that the zirconia restorations from your dental laboratory partner offer the desired mechanical and optical properties, requesting KATANA™ Zirconia can be a wise choice. This family of high-quality dental materials provides laboratories with everything they need to deliver restorations that you and your patients will appreciate, regardless of indication and no matter how unique the requirement. This is largely thanks to two factors: sophisticated multi-layered technology and a meticulous blank production process.

THE KEYS TO BRILLIANT AESTHETICS

Early zirconia materials often had a whitish, opaque appearance and were used mainly as framework materials. On the other hand, the dental zirconia used by dental laboratories today is typically pre-shaded and available in various levels of translucency. Some blanks even offer multi-layered technology: Recognising the importance of varying chroma and translucency in different areas of a natural tooth, Kuraray Noritake Dental Inc. has pioneered this trend. In 2013, the company became the first to introduce a blank with a polychromatic structure (KATANA™ Zirconia ML), featuring a natural gradient in chroma and a seamless transition between layers for a tooth-like appearance.

Initially developed for monolithic restorations, which are just polished or characterized with external stains and glazed, this new type of zirconia also inspired the micro-layering technique. Here, restorations are designed in full contour with only a slight cutback in the vestibular area, allowing for subtle porcelain effects that replicate the optical properties of enamel.

Continuous improvements of this first multi-layered zirconia generation ultimately resulted in the current zirconia portfolio offered by Kuraray Noritake Dental Inc. It consists of a multi-layered block for chairside milling machines, a classical framework material, and the KATANA™ Zirconia Multi-Layered discs series – even including a blank with flexural strength gradation:

Fig. 1. Four-layer colour structure of the KATANA™ Zirconia Multi-Layered series

KATANA™ Zirconia Block – Multi-layered block for chairside milling (available for CEREC and other chairside milling machines), with an 18-minute speed-sintering option* for natural tooth-coloured single restorations and short-span bridges.

^{*Speed-sintering option available only with compatible furnaces.}

KATANA™ Zirconia HT – High-strength zirconia for single-unit copings and long-span bridge frameworks, available in five different disc thicknesses.

KATANA™ Zirconia UTML – Ultra-translucent zirconia with a multilayered colour structure, ideal for monolithic anterior restorations including veneers.

KATANA™ Zirconia STML – Balanced translucency and strength for beautiful monolithic restorations, with natural colour gradation. This variant is ideal for crowns and up to three-unit bridges.

KATANA™ Zirconia HTML PLUS – High-translucency option with the strength needed for long-span bridges, offering vivid, natural colour.

KATANA™ Zirconia YML – Advanced zirconia with colour, translucency and strength gradation, featuring a strong body and highly translucent enamel layer for a virtually unlimited indication range.

THE KEYS TO HIGH-QUALITY RESTORATIONS

Zirconia quality depends on factors such as raw material purity, chemical composition, grain size and particle distribution. Every stage of production – from powder preparation to pressing and pre-sintering – affects the final mechanical and optical properties. Kuraray Noritake Dental Inc. optimises each of these steps to achieve consistently high quality.

1. RAW MATERIALS

Unlike most manufacturers who purchase pre-fabricated powders (from partners like Tosoh Corporation), Kuraray Noritake Dental Inc. produces all components in-house, including zirconium oxide, yttrium oxide, aluminium oxide, and those elements forming the company’s proprietary multilayer technology. This innovative technology is used to form a polychromatic blank structure and – in the case of KATANA™ Zirconia YML – additional translucency and flexural strength gradation.

Fig. 2. Powder for KATANA™ Zirconia

BENEFITS

• Natural translucency
• Shades matching VITA classical A1-D4™ shade guide concept
• Well-balanced flexural strength
• Precise millability for outstanding fit
• High ageing resistance
• Predictable sintering performance

2. PRESSING

A uniform density distribution throughout the blank and homogeneous material structure are essential for predictable processing outcomes and accurate fit. Kuraray Noritake Dental Inc. uses a unique pressing process that is designed to create even pressure distribution, minimise airborne particle contamination and reduce gravitation forces. This results in the desired purity and density of the zirconia blanks.

BENEFITS

• Uniform mechanical and optical properties
• Outstanding edge stability
• High surface quality
• Controlled sintering deformation

3. PRE-SINTERING

Pre-sintering gives pressed blanks the stability needed for milling. The selected temperature profile and duration of the pre-sintering cycle determine the material’s strength and hardness and processing properties, and have an impact on the final sintering process. The procedure used by Kuraray Noritake Dental Inc. results in blanks that are stable yet easily machinable with standard diamond-coated tools, without increased breakage risk or excessive tool wear.

Fig. 3. Restoration margins have been milled to a very thin profile, and yet they still show smooth margins without any chipping

BENEFITS

• High surface quality after milling
• Shorter sintering times possible (54 minutes for single tooth restorations and bridges with up to three units made of KATANA™ Zirconia UTML, STML, HTML PLUS or YML; 18 minutes in the case of KATANA™ Zirconia Block)

EVERYTHING YOUR LABORATORY PARTNERS NEED

Whether your partners in the laboratory prefer to work with different zirconia variants tailored to specific needs or a single material for all indications, whether they prefer full porcelain layering or simplified finishing techniques: KATANA™ Zirconia delivers the versatility needed – with a consistently high quality aimed at exceeding expectations.

Knowing this – and knowing how to distinguish high from poor quality zirconia materials – allows you to contribute significantly to the high quality of the prosthetic work produced in the dental laboratory. If you then also establish a well-structured, standardized and bidirectional flow of information maintaining records between practice and laboratory (e.g. by using checklists or a digital platform), all members of the restorative team are able to perform at their best for predictable treatment outcomes and long-term success.

COMPLEMENTARY PRODUCTS FOR THE DENTAL PRACTICE

Regarding the remaining clinical steps like the successful cementation of the delivered zirconia restorations, Kuraray Noritake Dental Inc. is a trustworthy partner, too: As well as offering complementary products for polishing, staining, glazing and veneering of zirconia restorations, the company is also a leading provider of clinical products such as resin cements, adhesives and cleaning agents. KATANA™ Cleaner, for example, can be applied both intra-orally and extra-orally, removing contamination from the bonding surfaces (tooth and restoration) after try-in. Applied to the pre-treated surface directly after cleaning, high-performance resin cement systems like PANAVIA™ V5 establish a strong bond to tooth structure and zirconia (as well as other restorative materials), so that high success rates are achieved even with partial restorations that offer minimal macro-mechanical retention1,2. Finally, if modifications are needed, TWIST™ DIA for Zirconia is a great option. It is suitable for polishing intra-orally and delivers a natural surface gloss. The products are well aligned and designed to complement each other for smooth workflows and outstanding results.

Literature

1. Blatz MB, Alvarez M, Sawyer K, Brindis M. How to Bond Zirconia: The APC Concept. Compend Contin Educ Dent. 2016 Oct;37(9):611-617; quiz 618. PMID: 27700128.
2. Alqutaibi AY, Alghauli MA, Almuzaini SA, Alharbi AF, Alsani AA, Mubarak AM, Alhajj MN. Failure and complication rates of different materials, designs, and bonding techniques of ceramic cantilever resin-bonded fixed dental prostheses for restoring missing anterior teeth: A systematic review and meta-analysis. J Esthet Restor Dent. 2024 Oct;36(10):1396-1411.

Case by Andreas Chatzimpatzakis

For zirconia-based screw-retained implant-supported prostheses, diverse finishing concepts are available. Most of them are quite complex and time-consuming. A streamlined approach that brings efficiency into the finishing procedure without compromising aesthetics and function is micro-layering with CERABIEN™ MiLai (Kuraray Noritake Dental Inc.) on a zirconia superstructure with just a slight vestibular cutback. A possible technical procedure is demonstrated using the following case example. The patient was treated by prosthodontist Dr. Georgios Siavikis from Ioannina, Greece.

Fig. 1. Occlusal view of an implant-supported overdenture made of KATANA™ Zirconia HTML PLUS (Kuraray Noritake Dental Inc.) for a male patient with an edentulous maxilla and a removable partial denture in the mandible.

Fig. 2. Frontal view of the milled and sintered screw-retained implant-supported prosthesis.

Fig. 3. Appearance after the application of CERABIEN™ MiLai SS Fluoro and internal stains to enhance the natural shading of the restoration in the tooth and gum areas.

Fig. 4. Result of micro-layering with CERABIEN™ MiLai porcelains LT1 for the cervical as well as E2 and TX for the middle and incisal sections for a seamless gradient in translucency. For an optimal gingival harmony and match with the surrounding tissue, the tissue shades 1, 5 and 6 were applied.

Fig. 5. The restoration after finishing.

Fig. 6. The gingiva and tooth areas have a natural appearance …

Fig. 7. … due to a natural colour, translucency and surface texture.

Fig. 8. Intraoral harmony.

PREDICTABLE OUTCOMES

In this case, the use of an aesthetic, high-strength multi-layered zirconia was a true enabler of a streamlined finishing technique. As a convinced and frequent user of CERABIEN™ ZR, micro-layering with CERABIEN™ MiLai appeared to work flawlessly right from the start. The systems are perfectly aligned to each other, and as they are both based on synthetic feldspathic technology, they offer consistent material properties. These provide precise control over the layering and shading, thus supporting a highly aesthetic and well-integrated implant restoration.

Dental technician:

ANDREAS CHATZIMPATZAKIS

Andreas graduated from the Dental Technology Institute (TEI) of Athens in 1999. During his studies he followed a program at the Helsinki Polytechnic Department of Dental Technique, where he trained on implant superstructures and all ceramic prosthetic restorations. As of 2000, he is running the ACH Dental Laboratory in Athens, Greece, specialized on refractory veneers, zirconia and long span implant prosthesis. In 2017 Andreas visited Japan where he trained under the guidance of Hitoshi Aoshima, Naoto Yuasa and Kazunabu Yamanda and become International Trainer for Kuraray Noritake Dental Inc..