AWARD WINNING PRODUCT

For the 9^th year in a row, CLEARFIL MAJESTY™ ES Flow (Low) has been named a Top Product by Dental Advisor, which announced in its JAN/FEB 2024 issue its choices for dental materials and equipment found to deliver the best practice-based performance based on the publication’s annual review of such products.

ABOUT THE PRODUCT

CLEARFIL MAJESTY™ ES Flow, which is available in three different levels of flowability, was the Top Product honoree in the Direct Restorative Category and was also given Editor’s Choice award for its medium viscosity version - Low.

Rather than limit practitioners to a single viscosity that might not be ideal for all flowable composite indications, CLEARFIL MAJESTY™ ES Flow comes in one version firm enough to stay in place when applied, another malleable enough to fashion a specific shape, and a third runny enough to flow into every corner or undercut. The practitioner would thus be able to select the best version for the job at hand—choosing the high flowability variant for cavity linings and as a resin coat in immediate dentin sealing (IDS) procedures, but instead, the super low flowability option for direct veneer procedures and for the build-up of cusps, etc.

Beyond its handling advantages, this universal flowable composite, which incorporates Kuraray Noritake Dental Inc.’s Light Diffusion Technology, is highly esthetic, with optical properties that enable the practitioner to fashion lifelike restorations that integrate seamlessly with the surrounding tooth structure.

EVALUATION

The flowable composite tested by the 29 DENTAL ADVISOR consultants in 909 uses in their dental practices was the medium flowability variant CLEARFIL MAJESTY™ ES Flow (Low). Their evaluations focused on properties including placement/handling, esthetics, viscosity, and polishability, and they rated all these key features to be “excellent”. This led to a recommendation rate of 100% and a 98% overall clinical rating.

REMARKS FROM EVALUATORS

Among their comments were: “The material blended so well with the tooth structure that you had to really look to find the interface.”. “Readily apparent on radiographs.” and “One of the best flowable composites I have used.”.

ABOUT DENTAL ADVISOR

The Top Product and Preferred Product Awards conferred by US-based DENTAL ADVISOR were initially introduced to help busy practitioners make sense of the numerous new solutions indicated for less invasive techniques and standardised or simplified procedures, ultimately, to achieve better outcomes regularly.

DENTAL ADVISOR conducts its practice-based clinical evaluations and product performance tests shortly after product launch. It publishes results annually online in its January/February issue to help potential users identify high-quality new dental materials and determine which among them are best suited to fulfil their individual requirements.

We are proud and delighted to announce that Kuraray Noritake Dental has been honored as the INNOVATIVE COMPANY OF THE YEAR by DENTAL ADVISOR.

DENTAL ADVISOR conducts annual practice-based clinical evaluations and product performance tests. The results are published online in the January/February issue, aiding potential users in identifying high-quality new dental materials and selecting those best suited to their individual requirements.

Quoting DENTAL ADVISOR: “Kuraray Noritake was chosen as innovative company of the year because of their constant ability to adapt to market needs and change. Their products are universally accepted by dental professionals as market leaders due to their ease of use and consistently high laboratory performance, making them ideal choices for long-term clinical results.”

In addition to being recognized as an innovative company, our products underwent testing and received prestigious DENTAL ADVISOR medals:

• CLEARFIL MAJESTY™ ES Flow (Low) received the Top Product Award for the 9th consecutive year in the Highly-Filled Flowable Composites category.
• CLEARFIL™ SE Protect, a Top Product Award winner in the Self Etch Bonding Agent category, has held this honor for the 10th consecutive year.
• Our very own PANAVIA™ SA Cement Universal secured the Self-Adhesive Cement category win.
• CLEARFIL™ Universal Bond Quick was honored with the Preferred Product Award in the Universal Bonding Agents category.
• Lastly, our most recent cement, PANAVIA™ Veneer LC, received the Research Award.

We extend our heartfelt gratitude to the dedicated practitioners worldwide who have placed their trust in Kuraray Noritake Dental products. Your unwavering commitment to excellence fuels our ongoing pursuit of innovation and quality. We are honored to stand alongside you in advancing dental care, and we look forward to continuing this journey together.

Thank you for choosing Kuraray Noritake Dental – where innovation meets trust, and quality meets precision.

By Dr. Aleksandra Łyżwińska, Warsaw, Poland.

Every dentist aims to polish to a high gloss without damaging the freshly modeled occlusal surface. Firstly, use high-quality polishing rubbers. The plural form is not accidental (Fig. 1). In my opinion, a single rubber systems are not capable of achieving an impeccable gloss in a safe manner. Be patient and gentle. Polishing requires time and a delicate touch.

Fig. 1.

Immediately after polymerization the composite is covered with an oxygen inhibition layer (Fig. 2). It is imperative to remove it by a brush and any polishing paste or a prophylactic sandblaster. The next step is to remove excess composite using abrasive discs, burs and firm polishing rubber points.

Fig. 2.

During polishing without water cooling, the rubber leaves crumbling on the composite surface (Fig. 3). These fragments can be spread across the restoration surface using a fine nylon brush. This allows for the polishing of each fissure and pit (Fig. 4).

Fig. 3.

Fig. 4.

The key to long lasting shine is polishing with gradation. Time to change a rubber point to the dark blue TWIST DIA for Composite rubber, which is more abrasive than light blue one (Fig. 5). Remember to apply gentle pressure and maintain a maximum speed of 8000 revolutions per minute. This way, you will achieve fine particles without the risk of overheating the pulp. The particles were once again spread over the entire surface. The thinner the bristle, the better the polishing effect in the grooves (Fig. 6).

Fig. 5.

Fig. 6.

Third round: use the light blue TWIST DIA for Composite rubber for a mirror-like gloss (Fig. 7). A beautiful gloss emerges beneath the particles. An alternative to thin nylon brushes is brushes made from natural goat hair (Fig. 8).

Fig. 7.

Fig. 8.

Polishing is not only a matter of aesthetics but, above all, function. The adherence of bacterial biofilm to a polished composite is significantly lower than to a rough surface (Fig. 9). My recipe for achieving a mirror-like gloss polish: high-quality diamond rubber points with gradation, used with sensitivity over an extended period (Fig. 10).

Fig. 9.

Fig. 10.

Dentist:

DR. ALEKSANDRA ŁYŻWIŃSKA
Warsaw, Poland

Dr. Aleksandra Łyżwińska is a restorative dentist. She graduated from the Warsaw Medical University in 2017, where she was an assistant professor at the Department of Conservative Dentistry and Endodontics. Her focus lies in modern adhesive techniques, resin composites and biomaterials.

We are proud and delighted to announce that Kuraray Noritake Dental has been honored as the INNOVATIVE COMPANY OF THE YEAR by DENTAL ADVISOR.

DENTAL ADVISOR conducts annual practice-based clinical evaluations and product performance tests. The results are published online in the January/February issue, aiding potential users in identifying high-quality new dental materials and selecting those best suited to their individual requirements.

Quoting DENTAL ADVISOR: “Kuraray Noritake was chosen as innovative company of the year because of their constant ability to adapt to market needs and change. Their products are universally accepted by dental professionals as market leaders due to their ease of use and consistently high laboratory performance, making them ideal choices for long-term clinical results.”

In addition to being recognized as an innovative company, our products underwent testing and received prestigious DENTAL ADVISOR medals:

• CLEARFIL MAJESTY™ ES Flow (Low) received the Top Product Award for the 9th consecutive year in the Highly-Filled Flowable Composites category.
• CLEARFIL™ SE Protect, a Top Product Award winner in the Self Etch Bonding Agent category, has held this honor for the 10th consecutive year.
• Our very own PANAVIA™ SA Cement Universal secured the Self-Adhesive Cement category win.
• CLEARFIL™ Universal Bond Quick was honored with the Preferred Product Award in the Universal Bonding Agents category.
• Lastly, our most recent cement, PANAVIA™ Veneer LC, received the Research Award.

We extend our heartfelt gratitude to the dedicated practitioners worldwide who have placed their trust in Kuraray Noritake Dental products. Your unwavering commitment to excellence fuels our ongoing pursuit of innovation and quality. We are honored to stand alongside you in advancing dental care, and we look forward to continuing this journey together.

Thank you for choosing Kuraray Noritake Dental – where innovation meets trust, and quality meets precision.

2024 MARKS THE YEAR OF THE DRAGON

• Dragons, those mythical beings, embody innate courage, unyielding tenacity, and boundless intelligence. They fearlessly embrace challenges and eagerly venture into uncharted territories.
• The Year of the Dragon is hailed as a time of great power, auspicious beginnings, and transformative possibilities.
• This image, inspired by the traditional Japanese art of kirigami, combines age-old craftsmanship with cutting-edge AI technology. Just like the dragon, it represents a harmonious blend of ancient wisdom and modern innovation.

EMBRACE 2024 WITH OPEN ARMS –
IT BRINGS FORTH A YEAR OF NEW POSSIBILITIES

It is probably the best-known component of a dental product Kuraray Noritake Dental Inc. (Kuraray Noritake Dental) has ever developed: 10-Methacryloyloxydecyl Dihydrogen Phosphate, in short, the MDP monomer. Invented more than 40 years ago – the first product containing it was introduced in 1983 – MDP is still the leading functional monomer used to establish a long-term, durable and stable bond to hydroxyapatite in tooth structure and to metal oxides in restorative materials (oxide ceramics and metal alloys).

Nowadays, it is found in every dental adhesive and every component of a resin cement system with adhesive properties from Kuraray Noritake Dental. These include:

In addition, MDP has become an integral part of most universal adhesives and many adhesive cementation systems of other manufacturers as well. However, not all MDP is alike …

MDP: Chemical structure and mechanism of adhesion

The MDP monomer consists of three essential parts: A polymerizable group, a hydrophobic group and a hydrophilic group. The co-polymerizable methacrylate group has a terminal double bond enabling polymerisation. The large hydrophobic alkylene group – also referred to as the spacer – has the task to maintain a delicate balance between hydrophobic and hydrophilic properties of the monomer and offers great resistance to degradation. Finally, the hydrophilic phosphate group is responsible for acidic demineralisation, for chemical bonding with calcium in hydroxyapatite and for bonding with zirconia¹ (as well as with metal).

Bonding performance

Lots of in-vitro studies have been carried out to investigate the bonding behaviour of 10-MDP in the context of direct and indirect restorative procedures. No matter whether a cavity is to be filled with resin composite or an indirect restoration is to be placed, a strong and long-lasting bond to tooth structure needs to be established.Chemical structure of adhesive monomer 10-Methacryloyloxydecyl Dihydrogen Phosphate (MDP).

The critical substrate in this context is dentin, while bonding to enamel is found to be less challenging. That is why it is so important that (self-etch) adhesives containing 10-MDP show an extraordinarily high bond strength to tooth structure, particularly to dentin². In fact, 10-MDP also provides for a high bond stability over time by establishing an acid-base resistant zone on the adhesive interface³. This means that a great long-term performance may be expected. Fortunately, a great clinical long-term performance of products containing the MDP monomer has already been confirmed: A group from the University of Leuven (Belgium) has presented excellent results of a thirteen-year clinical trial involving the use of CLEARFIL™ SE Bond in 2015⁴.

When bonding to indirect restorations made of zirconia, the surface area of the ceramic should be increased by sandblasting⁵. Pre-treated in the recommended way, the bond strength to zirconia tends to be particularly high when MDP-based resin cement systems are used⁶. It is thus widely recommended by experts in the field of adhesive dentistry to employ MDP-containing primers or resin cements for the placement of zirconia-based restorations, especially those with a non- or less retentive preparation. The fact that products containing 10-MDP work well in this context has been confirmed in different clinical studies with observation periods of up to 10 years^7,8. The products used in these studies were PANAVIA™ 21, PANAVIA™ F2.0 and the latest version of the multi-component cementation system from Kuraray Noritake Dental, PANAVIA™ V5, which performed best.

Not all MDP is alike

Ever since the basic patent for MDP has expired, other manufacturers of dental adhesives and adhesive resin cements have started integrating the functional monomers in their own products. However, it has been revealed that there are differences in the purity of the MDP monomers synthesized and used, and that these differences have an impact on the long-term bonding performance of the products containing the MDP⁹. According to in-vitro test results, the Original MDP Monomer synthesized by Kuraray Noritake Dental stands out due to an unmatched level of purity. This purity has a positive effect on the microstructure and thickness of the hybrid layer formed on dentin, the intensity of nano-layering and the bond strength measured immediately as well as after artificial aging⁹.

Conclusion

The data summarized above reveals that after 40 years in clinical service, the Original MDP Monomer from Kuraray Noritake Dental is still a class of its own. It has everything needed to establish a strong and long-lasting bond to tooth structure, resin composite and metal oxides, and is therefore a valuable component in virtually every adhesive system. In order to provide for a high bond quality, however, it may be best to use an MDP monomer with a confirmed high purity – the Original MDP Monomer.

References

1. Nagaoka N, Yoshihara K, Feitosa VP, Tamada Y, Irie M, Yoshida Y, Van Meerbeek B, Hayakawa S. Chemical interaction mechanism of 10-MDP with zirconia. Sci Rep. 2017 Mar 30;7:45563.
2. Fehrenbach J, Isolan CP, Münchow EA. Is the presence of 10-MDP associated to higher bonding performance for self-etching adhesive systems? A meta-analysis of in vitro studies. Dent Mater. 2021 Oct;37(10):1463-1485.
3. Carrilho E, Cardoso M, Marques Ferreira M, Marto CM, Paula A, Coelho AS. 10-MDP Based Dental Adhesives: Adhesive Interface Characterization and Adhesive Stability-A Systematic Review.
4. Peumans M, De Munck J, Van Landuyt K, Van Meerbeek B. Thirteen-year randomized controlled clinical trial of a two-step self-etch adhesive in non-carious cervical lesions. Dent Mater. 2015 Mar;31(3):308-14.
5. Kern M, Barloi A, Yang B. Surface conditioning influences zirconia ceramic bonding. J Dent Res. 2009; 88: 817–822.
6. Özcan M, Bernasconi M. Adhesion to zirconia used for dental restorations: a systematic review and meta-analysis. J Adhes Dent. 2015 Feb;17(1):7-26.
7. Kern M, Passia N, Sasse M, Yazigi C. Ten-year outcome of zirconia ceramic cantilever resin-bonded fixed dental prostheses and the influence of the reasons for missing incisors. J Dent. 2017 Oct;65:51-55.
8. Bilir H, Yuzbasioglu E, Sayar G, Kilinc DD, Bag HGG, Özcan M. CAD/CAM single-retainer monolithic zirconia ceramic resin-bonded fixed partial dentures bonded with two different resin cements: Up to 40 months clinical results of a randomized-controlled pilot study. J Esthet Restor Dent. 2022 Oct;34(7):1122-1131.
9. Yoshihara K. et al. Functional monomer impurity affects adhesive performance. Dent Mater. 2015 Dec;31(12):1493–1501.

Is it safe to use the single-component PANAVIA™ SA Cement Universal to lute virtually all your indirect restorations?

Did you ever ask yourself how many components are really needed to safely cement your silicate-ceramic, zirconia or resin-based restorations? With PANAVIA™ SA Cement Universal, a single component is usually sufficient. Containing an unreacted silane coupling agent – the LCSi monomer – and the original MDP monomer, the dual-cure, self-adhesive resin cement adheres to tooth structure and to various restorative materials including the popular silica-based ceramics without the need for a separate primer.

For those wondering how it works and if it really works as well as desired, Kuraray Noritake Dental Inc. has created a scientific brochure. It contains in-depth information about the drivers of chemical adhesion contained in PANAVIA™ SA Cement Universal and its characteristic properties. The main part, however, focuses on the results of scientific studies – most of which have been conducted in external laboratories. With the aid of artificial aging, different testing devices and various experimental set-ups, the researchers have checked the resin cement thoroughly. The study results shed light on the behaviour of the material when used in the context of bonding to different restorative materials and different types of tooth structure. Self- and light-curing modes are compared, aging effects investigated and different moisture conditions taken into account.

As a whole, the collected data allows for a precise prediction of the clinical behaviour of PANAVIA™ SA Cement Universal. This valuation has already been confirmed by clinical experience of dental practitioners from all around the world. Moreover, the results of a first clinical study, which is also found in this compilation, are a proof of its exceptional performance.

Download the brochure to learn more about the properties and behaviour of the single-component universal resin cement!

VOUS ÊTES-VOUS DÉJÀ DEMANDÉ POURQUOI LES PRODUITS DE LA MARQUE PANAVIA™ OFFRENT D‘AUSSI BONNES PERFORMANCES?

Vous savez probablement qu‘ils contiennent tous le monomère MDP original développé au début des années 1980. Ce monomère adhésif a beaucoup fait parler de lui pour son excellence. Monomère d‘ester de phosphate, il forme une très forte adhésion à la structure dentaire, à la zircone et aux métaux dentaires. Il a été utilisé dans chaque produit PANAVIA™. Outre le MDP, d‘autres technologies et ingrédients catalytiques sont d‘importants contributeurs qui soutiennent les performances de nos solutions de collage.

INGRÉDIENTS INFLUANÇANT LA RÉACTION DE POLYMÉRISATION

Parmi ces autres technologies et ingrédients déterminants, notons le catalyseur qui provoque le processus de polymérisation. Différent du monomère MDP utilisé dans chaque produit PANAVIA™, le catalyseur de polymérisation a été amélioré en permanence depuis l’introduction de PANAVIA™ EX en 1983. Ainsi, de nouvelles versions ont été développées pour PANAVIA™ 21, PANAVIA™ Fluoro Cement et PANAVIA™ V5, entre autres. Un autre important composant qui influence également le processus de polymérisation est la Touch Cure Technology utilisée dans deux des trois principaux produits de la ligne PANAVIA™ actuelle : PANAVIA™ V5 et PANAVIA™ Veneer LC. Cette technologie est intervenue pour la première fois dans PANAVIA™ 21, qui a été lancé en 1993. Lorsque l’activateur chimique de polymérisation contenu dans l’apprêt à auto-mordançage entre en contact avec la pâte de ciment de résine, la polymérisation de la colle de l’interface adhésive est accélérée, apportant ainsi une meilleure adhésion du ciment de résine. En développant PANAVIA™ V5, nous avons revu et actualisé considérablement la composition chimique des produits PANAVIA™ existants. La Touch Cure Technology a également été adoptée pour le cas d’une utilisation de PANAVIA™ V5 Tooth Primer en concomitance avec PANAVIA™ V5 Paste. Pour coller des facettes avec PANAVIA™ Veneer LC, nous utilisons aussi PANAVIA™ V5 Tooth Primer afin de préparer les dents. Cet apprêt recourt lui aussi à la Touch Cure Technology pour obtenir une connexion adhésive avec la dent sans affecter le temps de travail de la pâte de ciment.

MONOMÈRES ADHÉSIFS ADDITIONNELS

Dans le domaine des monomères adhésifs également, nous n’avons pas ménagé nos efforts : Nous avons développé le monomère LCSi, un agent combinant le silane à longue chaîne carbonée qui a permis d’intégrer la fonction d’un apprêt céramique à notre ciment de résine auto-adhésif universel PANAVIA™ SA Cement Universal. Avec son degré élevé d’hydrophobie, ce monomère apporte une force d’adhésion stable sur le long terme. D’une manière générale, on peut dire que la durabilité d’adhésion peut baisser en raison d’une réaction hydrolytique endommageant l’adhésion chimique entre la silice contenue dans la vitrocéramique et l’agent combinant le silane.

TROIS PRODUITS COUVRANT PRATIQUEMENT TOUS LES BESOINS

En combinant intelligemment ces technologies et ingrédients, nous avons réussi à développer une gamme de ciments de résine qui couvre pratiquement tous les besoins. Avec PANAVIA™ V5, PANAVIA™ SA Cement Universal et PANAVIA™ Veneer LC, il est possible de traiter une grande variété de cas. Ces produits permettent l’assemblage de nombreux types de restaurations, d’appareils prothétiques et la pose de tenons pour offrir d’excellents résultats à condition d’être utilisés conformément aux consignes d’utilisation.

PANAVIA™ V5 est le ciment de résine offrant le champ d’utilisation le plus vaste parmi les trois systèmes de collage que nous venons d’évoquer. Il couvre pratiquement toutes les utilisations visées par les deux autres ciments. C’est pourquoi le praticien dentaire peut, en fonction des cas se présentant à la clinique et des besoins des patients, trouver le bon système de collage pour le traitement en choisissant parmi ces trois principaux produits de ciment de résine : PANAVIA™ V5, un ciment de résine avec un vaste champ d’applications, PANAVIA™ SA Cement Universal, un ciment de résine auto-adhésif simple et facile à manipuler et PANAVIA™ Veneer LC quand il s’agit d’adhésion de facettes stratifiées.

EXPLORER DE NOUVELLES OPPORTUNITÉS

L’avantage du développement de technologies au sein d’une société telle Kuraray Noritake Dental est que leur application ne se limite pas à un certain produit ou groupe de produits. Le département R&D étudie toujours comment tirer profit des bénéfices de ces technologies pour d’autres applications. C’est le cas par exemple pour KATANA™ Cleaner, qui a été mis sur le marché en 2019. Ce nettoyant peut être utilisé pour éliminer la salive, le sang, la colle provisoire et d’autres contaminants qui peuvent adhérer aux surfaces des dents ou des appareils prothétiques pendant les essayages et le collage provisoire d’une prothèse. Ce produit unique a été développé en exploitant la fonction tensioactive du monomère MDP.

CONCLUSION

L’excellence de la gamme PANAVIA™ actuelle découle principalement de nos connaissances et de notre expérience de longue date dans le développement de ciments de résine et solutions adhésives dentaires. Nous savons comment améliorer nos technologies existantes, ne cessons jamais d’en développer de nouvelles et recherchons continuellement la meilleure façon de combiner les composants éprouvés avec les nouveaux pour obtenir le meilleur résultat possible. Au fil des étapes de la procédure de développement de produits, des tests cliniques sont réalisés et les retours de praticiens dentaires sont recueillis afin de prendre en compte les conditions extrêmes dans l’environnement bucco dentaire. Cette stratégie a brillamment fait ses preuves tout au long des 40 dernières années, et nous sommes convaincus qu’elle nous aidera à développer de nombreux autres produits innovants qui offrent un soutien idéal dans nos efforts pour améliorer la santé bucco-dentaire des patients.

ADHESIVE LUTING: A DRIVER OF INNOVATION

What would modern restorative treatments be like without the availability of high-performance (self-)adhesive resin cements? Tooth preparations would still be much more invasive due to the need for sufficient mechanical retention between the tooth and the restoration. At the same time, it would be impossible to restore teeth with many innovative, tooth-coloured materials such as low-strength ceramics and composite. In short, restorative dentistry would be much less developed than it is today.

When the first resin cements were introduced several decades ago, however, the achieved progress came at the expense of simplicity: Adhesive luting procedures were highly complex and the many different components quite technique sensitive. Luckily, this has changed over the years due to continued development efforts ultimately resulting in the products that are currently available. The resin cement line-up of Kuraray Noritake Dental Inc. consists of three main products: the dual-cure three-component system PANAVIA™ V5, the single-component dual-cure universal resin cement PANAVIA™ SA Cement Universal and the light-curing PANAVIA™ Veneer LC.

For those who would like to learn more about the three systems, this 10^th issue of the BOND Magazine is definitely worth reading. It reveals important details about the 40-year history of the PANAVIA™ brand, sheds light on the strengths of each resin cement to facilitate indication-specific cement selection and provides in-depth information about their clinical use. In addition, two articles are dedicated to hot topics around the luting of restorations made of zirconia, a popular restorative material that some still consider to be unsuitable for adhesive luting procedures. For everyone wondering how it is possible to successfully lute minimally invasive restorations made of zirconia, the article titled “Innovative resin cements forming the basis of minimally invasive prosthodontics” is highly recommended. Those unsure about how to proceed with 5Y-TZP should read the article “How to cement restorations made of high-translucency zirconia”. Interesting information about cleaning options prior to adhesive luting rounds out the content of this magazine.

Click here to read. Enjoy reading!

Start Reading: BOND | VOLUME 10 | 10/2023

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BOND | VOLUME 9 | 08/2022

BOND | VOLUME 8 | 12/2021

BOND | VOLUME 7 | 10/2020

Case by Kanstantsin Vyshamirski

A male patient (47 years of age) presented to his dentist with severe damage to his teeth. His main request was to increase aesthetics, to achieve a more pleasing envisaged aesthetic area. A side request was to achieve a ‘whitening but natural look’. This was achieved by using a lighter colour palette of zirconia and porcelain materials.

The final result was achieved through the creation of a wax-up, followed by a mock-up, provisional restoration and finally adhesive bonding of the zirconia crowns.

INITIAL SITUATION

Fig. 1. Initial situation. Male patient (47 years of age).

Fig. 2. Planning the new smile according to patient’s aesthetic and functional parameters.

Fig. 3. Mock-up in place to check the new look in the patient’s mouth.

Fig. 4. KATANA™ Zirconia YML shade A1 crowns with labial cutback after milling.

Fig. 5. Crowns after sintering on the plaster model.

Fig. 6. Noritake CERABIEN™ ZR porcelain layering map.

Fig. 7. Finishing the labial surface using both polishing and selfglaze. On the palatal side of the crowns only CERABIEN™ FC Paste Stain stains and glaze were used for finishing. To aid in optimisation of the soft tissue condition the palato-cervical and near proximal areas were polished.

Fig. 8. Finished crowns on the plaster model.

Fig. 9. Try-in using PANAVIA™ V5 White try-in paste, to confirm the proper appearance. For the final adhesive cementation PANAVIA™ V5 White has been used.

FINAL SITUATION

Fig. 10. Situation after seven months. The result is aesthetically pleasing and the gingival condition excellent.

Fig. 11. Recall after 1.5 years.

Dentist:

KANSTANTSIN VYSHAMIRSKI

Kanstantsin started his dental technician career in 2014. His speciality is aesthetic prosthetic porcelain works. Kanstantsin is an experienced user of KATANA™ Zirconia and Noritake porcelains. He owns his lab in Riga, Latvia.