Case by Andreas Chatzimpatzakis

Many modern, tooth-coloured dental materials enable us to achieve more with less. By using high-strength ceramics with a multi-layered colour structure and natural translucency, for example, the path to the desired outcomes involves fewer components, smaller layers and a reduced number of bakes. A possible streamlined procedure is illustrated below. The main materials used were KATANA™ Zirconia HTML PLUS for the screw-retained implant-supported superstructure and CERABIEN™ MiLai (both Kuraray Noritake Dental Inc.) for vestibular micro-layering.

Fig. 1. Zirconia-based screw-retained implant-supported prosthesis after milling and carving to obtain a natural surface texture.

Fig. 2. Restoration after sintering. To intensify the colour characteristic of the multi-layered blanks, the surface was treated with Esthetic Colorant (mainly in the incisal area and the gum parts).

Fig. 3. Appearance after the application of CERABIEN™ MiLai SS Fluoro.

Fig. 4. Restoration after the application of CERABIEN™ MiLai internal stains. They add some natural shading effects to the tooth and gum areas.

Fig. 5. Restoration on the model after micro-layering. In the cervical area, CERABIEN™ MiLai LT1 was mainly used, while the middle and incisal areas were individualized with E2 and Tx, the latter adding a seamless gradient in translucency. For the gingiva, the choice fell on the tissue porcelains 1, 5 and 6.

Fig. 6. Finished restoration on the model.

Fig. 7. The micro-layer of porcelain has a brilliant effect.

Fig. 8. The lifelike appearance is due to a smart combination of surface texturing …

Fig. 9. … and micro-layering with a comprehensive set of internal stains plus porcelains.

CONFIDENCE AND CONTROL

Full ceramic layering can produce beautiful results, but can be quite complex and time-consuming. In times with limited availability of skilled personnel and high-performance materials being offered, it may be a valuable strategy to opt for micro-layering with CERABIEN™ MiLai whenever appropriate. The system provides precise control over the layering and shading procedure, so that highly aesthetic and functional outcomes are easily and confidently obtained.

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..

TEETHMATE™ DESENSITIZER RECOGNIZED AS TOP PRODUCT YET AGAIN

Dental Advisor has recognized TEETHMATE™ DESENSITIZER as a Top Product in the category of Hygiene – Desensitizer yet again. This year’s recognition – the eleventh in a row (2015 – 2025) – was announced in the January/February 2025 issue of the publication. TEETHMATE™ DESENSITIZER allows an effective non-invasive approach to the treatment of hypersensitivity – a painful condition that generally occurs when dentinal tubules are exposed – when used as directed by dental professionals.

HOW IT WORKS

TEETHMATE™ DESENSITIZER is designed to crystalize hydroxyapatite (HAp), a mineral that is naturally found in enamel and dentin, and is the human body’s strongest material. When applied to exposed, mechanically treated, or freshly prepared dentin, the calcium phosphate-based mixture blocks the exposed tubules and provides immediate pain relief. During setting, HAp is formed, providing for long-term prevention of hypersensitivity. Further, when used in the context of restorative treatment, TEETHMATE™ DESENSITIZER does not have a negative effect on the bond strength of subsequently utilized dental adhesives or cements.

BENEFITS IN A NUTSHELL

TEETHMATE™ DESENSITIZER is a versatile solution providing hypersensitivity relief independent of the cause. It is perfectly suited for

• Treatment of dentin exposed by toothbrush abrasion, gingival recession, periodontal disease and/or acid erosion.
• Treatment of dentin after mechanical tooth cleaning, scaling and/or root planing.
• Treatment of the tooth surface before and after bleaching.
• Treatment of prepared dentin for fillings and/or prosthetic restorations.

The use of the product is also beneficial as it is

• Easy to mix and apply.
• Proven to be effective.
• Tissue-friendly and highly biocompatible.

OUTSTANDING CLINICAL PERFORMANCE RATING: 96 PERCENT

In a clinical evaluation, the Dental Advisor consultants found TEETHMATE™ DESENSITIZER effective in providing hypersensitivity relief immediately following and for up to six months after application. The study evaluated 27 patients diagnosed with gingival recession-related hypersensitivity, which was diagnosed using thermal testing with cold air. For the initial assessment, patients were asked to evaluate their level and frequency of hypersensitivity per tooth on a five-point scale. They were questioned about their level of sensitivity immediately after TEETHMATE™ DESENSITIZER was applied, according to the instructions for use, and again six months later. At baseline, 91 percent of the patients stated that they had no or only mild, sporadic sensitivity, which was still the case for 85 percent after six months.

Among the consultants’ comments were

• “TEETHMATE DESENSITIZER is easy to apply and seems to provide consistent relief.”
• "At six months, the majority of patients continue to experience marked improvement from their preoperative sensitivity or no sensitivity at all."

As a result, the product received a clinical performance rating of 96 percent.

ABOUT DENTAL ADVISOR

The Top Product and Preferred Product Awards from Dental Advisor, a US-based organization, were initiated to help busy practitioners navigate the variety of new dental solutions available, particularly for less invasive techniques and standardized procedures. These awards aim to identify products that improve outcomes consistently. Dental Advisor conducts clinical evaluations and product performance tests shortly after a product’s launch and publishes annual results online to help practitioners identify high-quality dental materials suited to their specific needs.

For more information, visit Dental Advisor at: www.dentaladvisor.com

Interview with Dr. Ludivine Facon

Individual prophylaxis, early defect detection and treatment, minimally invasive restorative techniques: In her joint dental practice in Anstaing, France, Dr. Ludivine Facon does everything in  her power to keep her patients’ teeth healthy for their lifetime. When we met her at the International Dental Show in Cologne, where she was a speaker for Kuraray Noritake Dental Inc., we asked her to share information about her treatment philosophy and how flowable injection fits into her overall approach.

Your treatment philosophy seems to be minimally invasive. Would you please tell us a bit more about it?

Ever since I started treating patients, my priority has always been to preserve the dental tissues and to be as minimally invasive as possible when restoration is required. My interest in prevention started with my thesis in 2000, which focused on oral health prevention in Quebec, Canada, a country where prophylactic care is an integral part of dental treatment. I have always been highly interested in individual prophylaxis, which naturally led me to focus on minimally invasive treatments. My goal is to stay as low as possible on the therapeutic gradient, always thinking about the long-term benefits for the patient.

What are the benefits of this approach for your practice?

Integrating prophylaxis for every patient into my practice allows me to work with excellent surface conditions for bonding. The oral environment is sanitized before applying conservative restorations, and carious lesion removal is kept to a minimum.

When defects – be it a carious lesion or severe tooth wear – are present, I use the following instruments and materials that allow for truly minimally invasive interventions:

• Rondoflex 50-micron sandblaster to roughen the surface,
• Micro diamond burs to remove what is necessary,
• Layered composites for single-tooth restorations,
• Injected composites when multiple teeth are involved.

Case predestined for composite injection, as multiple teeth in the maxilla need to be treated (smile makeover).

What dental materials do you use for your restorative procedures?

I am a hands-on dentist, and in my daily practice, I strictly follow surface preparation and bonding protocols recommended for CLEARFIL™ Universal Bond Quick 2 (Kuraray Noritake Dental Inc.). In addition, I use high-quality composites from Kuraray Noritake Dental Inc. For layering, CLEARFIL MAJESTY™ ES-2 Premium Enamel and Dentin are my got-to solution, while I use CLEARFIL MAJESTY™ ES Flow Low for injection.

What are the benefits of a conservative approach for your patients?

Patients appreciate the fact that my treatment approach is as conservative as possible while still allowing for easy reintervention if necessary, preserving as much healthy dental tissue as possible. Another significant advantage is the moderate cost, which makes the treatment more accessible.

How does composite injection fit into this philosophy?

This technique allows for an easy reconstruction of multiple teeth by transferring a wax-up designed in the lab into the mouth via an injection of modern flowable composite into a transparent silicone index. Patients like this technique because it is aesthetic, reliable, reproducible and minimally invasive. A major advantage is that it allows for touch-ups and repairs, making it a reassuring solution. In some cases, no tooth preparation is needed at all—we simply add material, making the whole treatment truly non-invasive.

Why do you think this technique is promising?

It is a trendy and promising technique because:

• It is non-invasive --> preserves tissues --> aligns with minimally invasive dentistry.
• It is predictable --> due to the index, the technique is reproducible.
• It is easier than traditional layering --> saves chair time and improves patient comfort.
• It is cost-effective --> a cheaper alternative to ceramic veneers.
• It allows for repairs at any time, making it a reassuring option.

How did you proceed before knowing this technique?

In the anterior region, I used traditional composite layering with a wax-up and a palatal silicone index. It allowed me to rebuild the palatal wall and provide for precise incisal edge placement. In the posterior region, I used inlays, onlays, or overlays made of lab-processed reinforced composite or lithium disilicate.

Transparent silicone index with injection hole used to inject the flowable composite and restore the tooth to its planned shape.

What made you start using the new technique?

There has been an explosion in demand for smile enhancements, especially among young adults. The composite injection technique is an appealing alternative for reshaping smiles in young patients with intact teeth but unsatisfactory size or shape. It is less invasive than veneers, which have gained popularity due to social media trends, but often require significant tooth preparation.

How did you proceed in the beginning?

I first discovered the technique in a specialized journal in 2019, then trained myself using online tutorials. Of course, there were some trial-and-error moments, but it is a very accessible technique—even for beginners. To achieve optimal results, I believe that proper case selection and treatment planning are key. One of the most important preconditions for aesthetic outcomes is that the patient’s teeth have a simple shade structure. If the shade structure of the teeth is complex or the required restoration is large, it is better to layer the dentin before injecting the enamel. Moreover, it is essential to produce two models in the wax-up phase, not just one: An “intermediate wax-up model” with every other tooth featuring the wax-up, while the remaining teeth remain unmodified. The second is a “full wax-up model” with all teeth reshaped.

Considering these aspects, it is possible to obtain great outcomes quite quickly. The learning curve is steep, however – as with every new technique to be implemented – you need to step out of your comfort zone.

Apart from CLEARFIL™ Universal Bond Quick 2 and CLEARFIL MAJESTY™ ES Flow Low you already mentioned, what instruments and materials do you use?

For treatment planning including the wax-up, I use digital technology via Smilecloud, but a traditional wax-up works just as well. The production of the silicone index is the most delicate part when doing it in-house. I recommend using EXACLEAR (GC), the only truly effective transparent silicone currently available. Adjacent teeth are isolated with PTFE tape. Finishing instruments that have proven their worth are:

• Scalpel Blade No. 12,
• 3M™ Sof-Lex™ Contouring and Polishing Discs (Solventum),
• Red-ring fine diamond burs,
• TWIST™ DIA for Composite polishers (Kuraray Noritake Dental Inc.).

Intermediate wax-up model: One tooth with wax-up followed by one tooth without.

Full wax-up model.

Do you believe that the quality of the outcome is affected by the composite material you use?

Absolutely! New high-filled flowable composites, like CLEARFIL MAJESTY™ ES Flow Low, offer excellent mechanical properties and polishability, making them very promising.

Highly aesthetic treatment outcome after injection of CLEARFIL MAJESTY™ ES Flow Low.

What material characteristics impact overall quality?

First of all, the optical properties or shade matching ability of the material are crucial. I like the fact that I can select from a variety of shades when using CLEARFIL MAJESTY™ ES Flow. Once the right shade is selected and the thickness of the injected layer does not exceed 1 mm, the optical properties of the restorations may be expected to be exceptional.

Moreover, we need a material with great flow properties (fluid, but not too runny), which is virtually void-free. I prefer using low viscosity flowable composites like CLEARFIL MAJESTY™ ES Flow Low (two other flowabilities – HIGH and SUPER LOW – are also available). The physical properties (mechanical strength) and polishability plus polish retention are also important. They are usually excellent with premium flowable composites.

What are your most important clinical tips and tricks?

For beginners:

• Press firmly on the cervical area of the silicone index to reduce excess material upon removal.
• Finish the proximal area thoroughly before moving to the next injection step. This way, you provide for perfect key positioning for the following teeth.

If you follow the protocol, the technique is very beginner friendly!

What is your opinion about the emerging hybrid "layering & injection" technique?

This hybrid technique complicates the original injection technique, which is meant to simplify composite restorations. However, it is very useful in cases where aesthetic complexity requires layering. For maximum mimicry with this technique, I would love to have injectable composites in an enamel shade at my disposal.

Would you please share your final thoughts with us?

Take your time planning! Observe, document, take photos, use digital tools! Less is more.

Dr. Facon, thank you very much!

Dentist:

LUDIVINE FACON

Dr. Ludivine Facon graduated from the University of Lille, where she developed a solid foundation in dentistry. Passionate about periodontology and dental aesthetics, Dr. Facon pursued specialized training to refine her skills in these fields. In 2007, she completed clinical periodontology training at the Charon Clinic, followed by individual dental prophylaxis training with Michel Blique in 2008. From 2013 to 2014, she attended the long cycle program at the Académie du Sourire in Aix-en-Provence, enhancing her expertise in dental aesthetics. Dr. Facon continued to build on her knowledge with international training, including at the International Institute of Periodontology in Montreal in 2015, and a veneer training course at the GAD Center in Bordeaux the same year. In 2016, she further advanced in mucogingival surgery at the Académie de Parodontologie in Aix-en-Provence. Always keeping up with the latest developments, she participated in the CIDAE training in Brussels in 2022. More recently, in 2024, Dr. Facon completed a course in composite layering and injection, led by Guillaume Piskorski, the French specialist in injected composite technique, in Lille. With extensive expertise, Dr. Facon is also an educator in direct aesthetic composites, having taught at the University of Lille in 2020, 2022, 2023, and 2024.

In part two of this veneer workflow, Roberto Rossi completes the restoration by applying CERABIEN™ MiLai lusters to the pre-stained and sintered KATANA™ Zirconia YML. Watch as he enhances surface texture, gloss, and lifelike detail through precise finishing techniques.

With just a few simple steps, Roberto creates depth, dynamic light effects, and natural contours that rival real enamel. The process is intuitive and efficient, delivering a high-end finish—culminating in a final self-glazing fire for a polished, natural result.

An intelligent solution for dental technicians seeking efficiency without compromising on aesthetics.

In the first part of this aesthetic veneer workflow, dental technician Roberto Rossi demonstrates how to apply internal stains to KATANA™ Zirconia YML. This crucial step enhances the restoration by adding depth, translucency, and natural character from within.

After refining the anatomy and surface texture, Roberto skillfully blends and applies selected shades such as A+, Fluoro, and Incisal Blue. These shades create depth, opalescence, and inner vitality that radiate through the final restoration.

A must-watch for dental technicians looking to elevate their zirconia restorations with advanced, yet straightforward, internal staining techniques.

EUROPEAN KOLS EXPERIENCE INNOVATION AND CRAFTSMANSHIP IN JAPAN

This September, seventeen of Kuraray Noritake Dental’s Key Opinion Leaders (KOLs) from across Europe—representing nine countries—embarked on a remarkable journey to Japan. The program offered a rare opportunity to experience the heart of Kuraray Noritake Dental’s culture of innovation, craftsmanship, and collaboration.

A JOURNEY OF INSIGHT AND INSPIRATION

The tour began in Tokyo, where the group traveled by bullet train to Nagoya to explore some of Japan’s cultural and professional landmarks. Visits to Nagoya Castle and the historic Noritake Garden provided glimpses into the artistry and heritage that continue to inspire our company’s ceramic technologies today.

Nagoya castle.

That evening, an official dinner in Nagoya brought together the European guests and key members of the Kuraray Noritake Dental team, including Ms. Kiyoko Ban, Mr. Yoshihisa Yamada, and Mr. Kazuhiro Yamada. It was an evening filled with rich conversations, meaningful connections, and a shared vision for the future of dental excellence.

FROM CONCEPT TO CREATION: VISITING THE MIYOSHI AND NIIGATA FACTORIES

The following day, the KOLs visited the Miyoshi Factory, where the company’s ceramic products such as KATANA™ Zirconia are manufactured, and  attended insightful presentations by their European peers — including Jorgen Gad, Sophie Dallem, Dumitru Leahu, Marios Georgoulis, Stratos Chatzichristos, and Kamila Krzepkowska — followed by a comprehensive factory tour and in-depth discussions  with R&D experts on zirconia and dental lab materials, providing unique professional insights.

Discussion with Kuraray Noritake Dental team at Miyoshi Factory.

Presentation given by DT Sophie Dallem and DT Dumitru Leahu at Miyoshi Factory.

Presentation given by DT Marios Georgoulis at Miyoshi Factory.

The tour also brought our KOLs to Niigata, where participants experienced firsthand the research and development process behind Kuraray Noritake Dental’s renowned products. A highlight was the hands-on demonstration of CLEARFIL MAJESTY™ ES Flow Universal, allowing each participant to engage directly with the materials and processes that define the company’s quality.

Hands-on course at Niigata plant.

CONNECTING THROUGH COLLABORATION

Between technical sessions, the group visited the Tokyo office and showroom, sharing open discussions with our Japanese colleagues at the headquarters, followed by a sightseeing tour through Tokyo’s landmarks — from the Imperial Palace to Tokyo Tower. These shared experiences strengthened the sense of partnership and mutual respect not only between the European and Japanese teams but also between the KOLs themselves and the company.

“It was an incredible experience meeting exceptional people worldwide, among them top specialists.” 
—    DT Kamila Krezpkowska, Poland

Discussion with Kuraray Noritake Dental team at the Tokyo headquarters.

WORDS FROM OUR KOLS

The feedback from participants was overwhelmingly positive:

“It was truly a lifetime experience — both inspiring and invaluable for me as a dental technician. Witnessing how the materials we use every day are created gave me an even deeper appreciation for the craft behind them.”
— DT Marios Georgoulis, Greece

“I’m so impressed by the organization, the endless friendliness, the openness, and the willingness to answer all my questions. It was a wonderful time, filled with so many experiences.” 
— Dr. Bernhild Stamnitz, Germany

“It was a life experience I will never forget and I am very grateful I got this opportunity to be there.[…] The drive and compassion of all the workers in office, but also at the factory were very impressive to see. The view I had about the quality of your product improved more than it already was.” 
—  Dr. Mark Laske, Netherlands

A SHARED COMMITMENT TO EXCELLENCE

The KOL Japan Tour 2025 was more than a professional visit—it was a bridge between continents, uniting people through shared values of precision, innovation, and artistry. Kuraray Noritake Dental extends heartfelt thanks to all participants and to the teams in Japan who made this unforgettable experience possible.

Group picture at the Kuraray Noritake Dental office in Tokyo.

Arigato!

Case by Andreas Chatzimpatzakis

A CONCEPT EVEN FOR AESTHETICALLY DEMANDING CASES

The micro-layering technique is regarded as a more efficient, streamlined approach used as an alternative for full porcelain layering. It requires aesthetic, high-strength ceramics like lithium disilicate or zirconia as a base and – ideally – a set of porcelains specifically designed for reduced layer thicknesses that allows users to focus on imitating the characteristics of enamel. A high-quality example is CERABIEN™ MiLai (Kuraray Noritake Dental Inc.). Consisting of a set of internal stains and porcelains with a firing temperature of just 740 °C and a coefficient of thermal expansion in the range of 9.5~11.0×10-6/K (50 °C – 500 °C), this product works well on lithium disilicate and zirconia.

Its aesthetic potential is surprisingly high: Depending on case-specific requirements, users are given the choice between maximum efficiency using a single-bake technique and maximum aesthetics achieved with more complex layering. The latter option is demonstrated below using the example of six maxillary anterior veneers.

Fig. 1. Lithium disilicate frameworks (Amber Press) on the model.

Fig. 2. CERABIEN™ MiLai Value Liner 1 applied to the framework. This porcelain is typically used on lithium disilicate for wash baking.

Fig. 3. First build-up with CERABIEN™ MiLai CCV2 in the cervical section, …

Fig. 4. … Value Liner 2, …

Fig. 5. … Creamy Enamel in the middle area …

Fig. 6. … and Tx used to add ultimate translucency.

Fig. 7. Appearance of the restorations after the first bake.

Fig. 8. Outcome of the internal staining procedure.

Fig. 9. Application of CERABIEN™ MiLai LT1 for a standard translucency and opalescence effect, …

Fig. 10. … E2, …

Fig. 11. … a mixture of E2 and ELT1 (mixing ratio: 50:50) for translucency and brightness and along the marginal ridges, …

Fig. 12. … Tx mixed with Royal Blue (mixing ratio 70:30) for a blueish translucency in the incisal area…

Fig. 13. … as well as a final layer of LTx to add ultimate translucency and opalescence to the whole enamel surface.

Fig. 14. Outcome of the third bake.

Fig. 15. Cutback for the final layer of porcelain.

Fig. 16. Final layer of CERABIEN™ MiLai added to the central and lateral incisors for translucency.

Fig. 17. Situation after the fourth bake, grinding and use of a rubber polisher.

Fig. 18. Outcome of the fifth bake (self-glaze).

Fig. 19. Beauty shots …

Fig. 20. … of the restorations …

Fig. 21. … on the model.

TRULY BEAUTIFUL OUTCOMES POSSIBLE

This case example reveals that CERABIEN™ MiLai is much more than just a maximum-efficiency solution: With the current line-up of porcelains and internal stains, truly beautiful restorations can be produced. Hence, users are given high flexibility regarding not only the high-strength framework material they prefer, but also the effort and time they would like to invest. This makes CERABIEN™ MiLai a versatile porcelain system that meets many needs and covers a wide range of applications in the dental laboratory.

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..

Kaasaegses hambaravis on suur nõudlus materjalide järele, mis ühendavad käsitsemismugavuse ja efektiivsuse esteetiliste ning vastupidavate tulemustega. Sellised materjalid aitavad hambaarstidel saavutada soovitud tulemusi tõhusamalt, võimaldades neil pühendada rohkem aega patsientidega suhtlemisele.

Direktsete restauratiivsete ravimeetodite puhul mõjutab valitud vaigukomposiit oluliselt nii protseduuride lihtsust kui ka lõpptulemuse kvaliteeti. Seetõttu on universaalsed pastatüüpi komposiidid, nagu CLEARFIL™ MAJESTY ES-2 Universal (Kuraray Noritake Dental Inc.), muutumas üha populaarsemaks. Sama ettevõte on toonud turule ka voolava komposiidi CLEARFIL™ MAJESTY ES Flow Universal, mis pakub sarnaseid eeliseid. Need on esitatud allpool vastustena teil tekkida võivatele küsimustele.

Kuidas saavutada esteetilisi ja vastupidavaid restauratsioone, säilitades samas voolava materjali kasutusmugavuse?

CLEARFIL™ MAJESTY ES Flow Universal on voolav komposiit kahe teineteist täiendava tooniga, mis võimaldavad intuitiivset toonide sobitamist ja sobivad mitmesugusteks restauratiivseteks protseduurideks. See ühendab praktilised voolavusomadused, suurepärase toonide segunemise võime ning silmapaistvad mehaanilised omadused.characteristics with advanced shade-blending ability and outstanding mechanical properties.

Madal (Low)

• Paindetugevus 151 MPa.
• Survetugevus 373 MPa.
• Täiteaine sisaldus 75 massi% / 59 mahu%.
• Röntgenkontrastsus 140% Al.

Eriti madal (Super low)

• Paindetugevus 152 MPa.
• Survetugevus 374 MPa.
• Täiteaine sisaldus 78 mass% / 60 mahu%.
• Röntgenkontrastsus 150% Al.

Mis on CLEARFIL™ MAJESTY ES Flow Universal?

CLEARFIL™ MAJESTY ES Flow Universal on valguskõvastuv röntgenkontrastne komposiit, mis on ette nähtud kasutamiseks erinevates kliinilistes olukordades ning on saadaval kahes viskoossuses ja kahes toonis. See põhineb nanotäiteosakeste tehnoloogial, mis tagab kontrollitud voolavuse, hea läike püsivuse ja loomuliku välimusega restauratsioonid. Komposiidi sulandumine hambastruktuuri saavutatakse tänu emaililaadse läbipaistvuse, dentiinilaadse värvsuse ja valgusdifusiooni tehnoloogia (LDT) nutika kombinatsiooni abil. Emaililaadne läbipaistvus võimaldab valgusel materjalist läbi tungida, parandades selle värvi sobitumist ümbritsevasse hambastruktuuri. LDT muudab restauratsioonid valguse hajutamisel sarnaseks emaili ja dentiiniga. Koos täpselt tasakaalustatud värvsusega aitavad need omadused tagada materjali sujuva optilise sulandumise ümbritsevasse hambastruktuuri.

Kus saab CLEARFIL™ MAJESTY ES Flow Universali kasutada?

See voolav komposiit on ette nähtud väga erinevateks restauratiivseteks kasutusvajadusteks. Võimaldades kõike alates I–V klassi restauratsioonidest kuni aukude ja fissuuride sulgemise ning parandusteni sobib see materjal nii konservatiivseteks kui ka ulatuslikeks raviskeemideks.

CLEARFIL™ MAJESTY ES Flow Universali saab kasutada järgmistel juhtudel.

• Direktseteks restauratsioonideks kõikide kaviteediklasside korral ning hambakaela kahjustuste (nt juurepinna kaaries, V-kujulised defektid), hammaste kulumise ja erosiooni raviks.
• Kaviteedi aluskihina / lainerina.
• Hammaste asendi ja kuju korrigeerimine (nt diasteemi sulgumine, hammaste väärareng).
• Murdunud restauratsioonide suuõõnesiseseks parandamiseks.

Kuidas toimub toonide valik?

CLEARFIL MAJESTY™ ES Flow Universaliga on sobiva tooni leidmine ülimalt lihtne. Kaks üksteist täiendavat tooni – universaalne (U) ja universaalne tume (UD) – võimaldavad toone sobitada lihtsalt ja intuitiivselt, ilma et toonijuhendit oleks vaja kasutada. Toon U sobib enamikeks esi- ja tagahammaste restauratsioonideks. UD annab parima tulemuse tumedama tooniga hammaste puhul (B3 ja tumedamad), kui ümbritsevat hambakude on vähe, sealhulgas III ja IV klassi kaviteetide korral. Saate valida kõige sobivama tooni kaviteedi klassi ja patsiendi vanuse põhjal.

Värvi sobitamine esi- ja tagahammaste restauratsioonidega.

Mis on CLEARFIL™ MAJESTY ES Flow Universali toime taga?

Selle koostises on mitmeid kliinilist tõhusust toetavaid omadusi.

• Nanotäiteosakeste tehnoloogia: optimaalse täiteaine sisaldus vähendab kahanemist, parandab kulumiskindlust ja säilitab pikaajalise läike.
• Universaalse tooni kohandumisvõime: sobitub visuaalselt ümbritseva hambakoega, lihtsustades toonide valikut.
• Tiksotroopne käsitsemine: voolab lisamisel surve all, kuid jääb asendis stabiilseks, võimaldades täpset pealekandmist.

Miks valida CLEARFIL™ MAJESTY ES Flow Universal?

Arstid võivad eelistada CLEARFIL™ MAJESTY ES Flow Universali, sest see võimaldab:

• prognoositavat kasutamist ja pealekandmist;
• esteetilisi tulemusi nii esi- kui ka tagahammaste restauratsioonidel;
• kulumis- ja pinna lagunemiskindlust;
• röntgenkontrastsust, mis võimaldab täpset radiograafilist hindamist;
• paindlikkust erinevate restauratiivsete vajaduste korral.

Kuidas kasutada CLEARFIL™ MAJESTY ES Flow Universalit?

Kasutamine on lihtne ja sobitub tavapärasesse kliinilisse töövoogu.

1. Valmistage preparatsioon ja isoleerige piirkond.
2. Kandke peale sobiv adhesiiv (nt CLEARFIL™ Universal Bond Quick 2).
3. Doseerige materjali süstla ja peene otsaga aplikaatori abil.
4. Valguskõvastage vastavalt tootja juhistele (tavaliselt 20 sekundit, sõltuvalt toonist ja kasutatavast valguslambist).
5. Viimistlege ja poleerige.

Süstlapõhine doseerimine võimaldab kontrollitud pealekandmist ja mugavat kasutamist.

Direktne restauratsioon CLEARFIL MAJESTY™ ES Flow Universaliga.

Kas CLEARFIL™ MAJESTY ES Flow Universali on hinnanud sõltumatud eksperdid?

Jah. Hambaravispetsialistid on hinnanud CLEARFIL™ MAJESTY ES Flow Universali (Super Low) kolmandate isikute katsete ja eelretsenseeritud tagasiside põhjal. Hiljuti pälvis see Dental Advisori 2025. aasta teadusauhinna. Selle USA-s avaldatava ajakirja hindajad märkisid oma kokkuvõttes:

“Testide tulemused näitavad, et selle komposiidi füüsikalised omadused kuuluvad voolavate komposiitide seas parimate hulka, olles paindetugevuse ja survetugevuse poolest võrreldavad tugevaimate pakitavate komposiitidega ning ideaalse röntgenkontrastsusega”

Mitmekülgne voolav lahendus: CLEARFIL™ MAJESTY ES Flow Universal

CLEARFIL™ MAJESTY ES Flow Universal on ette nähtud kasutamiseks restauratiivsetes protseduurides ning seda iseloomustavad head käsitsemisomadused, esteetilisus ja mehaaniline vastupidavus. See võib tulla kasuks hambaarstidele, kes otsivad töökindlat voolavat vaiktsementi, mis sobib paljudeks kliinilisteks kasutusnäidustusteks.

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Universal Excellence – lihtsalt nutikad lahendused

Kuraray Noritake Dental Inc.-is mõistame kaasaegsete hambaravipraksiste vajadusi. Keeruliste protseduuride, tiheda graafiku ja patsientide eripärade tasakaalustamine ei ole lihtne ülesanne. Seetõttu oleme aastakümneid tegelenud teie töö iga sammu lihtsustamise, tõhustamise ja täiustamisega. Meie visioon on selge: luua maailm, kus materjalid ja tööriistad toimivad sujuvalt teie käe all, kus keerukus on viidud miinimumini ja kus teil on piisavalt aega keskenduda sellele, mis on kõige olulisem: iga patsiendi soovid ja vajadused. See on hambaravi tulevik, mida üheskoos oleme teoks tegemas.

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Dr Julien Molia juhtum

JAH, SEE TÖÖTAB!

Paljude hambaarstide jaoks on saanud selgeks, et voolavaid komposiite on hea kasutada tugevamate pakitud komposiitide ja indirektsetele restauratsioonide alusmaterjalina või ajutise materjalina. Paljud neist aga eeldavad, et nende kasutusala on kehvade mehaaniliste omaduste tõttu piiratud.

UUS VOOLAVATE KOMPOSIITIDE PÕLVKOND

Õnneks ei vasta see enam tõele. Mitmed uusima põlvkonna voolavad komposiidid – näiteks CLEARFIL MAJESTY™ ES Flow ja CLEARFIL MAJESTY™ ES Flow Universal (Kuraray Noritake Dental Inc.) – on mehaaniliste omadustega, mis on võrreldavad paljude pakitavate alternatiividega. Seetõttu on näidustuste valik oluliselt laienenud. Näiteks CLEARFIL MAJESTY™ ES Flow Universalil on tootja andmetel kõrge täiteaine sisaldus (75–78 massiprotsenti), paindetugevus üle 150 MPa ning survetugevus üle 370 MPa. Tänu oma tugevusele on see usaldusväärne ja püsiv lahendus, sobides ka koormustkandvatesse piirkondadesse, nagu on tagumiste hammaste oklusaalpinnad.

Sellel voolaval komposiidil on aga eeliseid veelgi. See on saadaval kahes voolavuse astmes – LOW ja SUPER LOW –, et vastata nii erinevatele isiklikele eelistustele kui ka spetsiifilistele näidustustele, ning vaid kahes toonis (universaalne ja universaalne tume). Kahe tooniga saab toone intuitiivselt valida isegi esihammaste piirkonnas. Seda võimaldavad erinevad tehnoloogiad, sealhulgas optimeeritud valgusdifusiooni tehnoloogia ja emaililaadne läbipaistvus.

Järgnev kliiniline juhtum näitab, kuidas CLEARFIL MAJESTY™ ES Flow Universal muudab tagahammaste restauratsioonide teostamise oluliselt lihtsamaks.

JUHTUMIUURING

Patsient pöördus vastuvõtule eesmärgiga asendada alalõua parempoolsetes molaarides (hambad nr 46 ja 47 vastavalt FDI tähistusele) kaks amalgaamrestauratsiooni (joonis 1). Et hõlbustada täitmist ja tagada kohandumine kaviteedi seintega, otsustati kasutada ainsa materjalina CLEARFIL MAJESTY™ ES Flow Universali (LOW). Restaureeritavate hammaste asetus tegi tooni valiku lihtsaks. Toon U (universaalne) on loodud sobima ideaalselt kõigi tagahammaste restauratsioonideks.

Amalgaamrestauratsioonid eemaldati ja kaaries puhastati, säilitades seejuures võimalikult palju tervet hambakude (joonised 2 ja 3). Valiti selektiivne emaili söövitusmeetod, millele järgnes universaalse adhesiivi (CLEARFIL™ Universal Bond Quick 2, Kuraray Noritake Dental Inc.) pealekandmine. Seejärel täideti kaviteet CLEARFIL MAJESTY™ ES Flow Universali LOW versiooniga ja kaviteetidele kanti valitud toon U (joonis 4). Tänu süstla uuenduslikule disainile ei sisalda pealekantav voolav komposiit sisuliselt üldse tühimikke. Järgides toote kasutusjuhiseid, ei ületanud iga kihi paksus 2 millimeetrit (joonised 5 ja 6). Sellel on otsustav mõju lõpliku restauratsiooni pikaajalisele toimivusele. Igat kihti tuleb põhjalikult valguskõvastada 10 kuni 20 sekundit (sõltuvalt valguslambist) enne, kui järgmine kiht peale kantakse. Nagu näidatud joonisel 7, saab valitud materjali vähese voolavuse tõttu oklusaalpinna morfoloogiat mõningal määral vormida. Täpsemate anatoomiliste detailide restaureerimise vajadusel võib kasutada püsivamat SUPER LOW varianti. Restauratsiooni läikivaks poleerimiseks kulus vaid mõni sekund (joonis 8).

Joonis 1. Välja vahetatavad kaks amalgaamrestauratsiooni.

Joonis 2. Olukord pärast olemasolevate amalgaamrestauratsioonide eemaldamist.

Joonis 3. Suurema kaviteedi põhjas on nähtav amalgaamist tihti tekkiv määrdumine.

Joonis 4. Täitmise protseduur: voolava komposiidi esimese kihi pealekandmine.

Joonis 5. Teine molaar on juba täidetud, esimene molaar vajab veel ühte kihti voolavat komposiiti.

Joonis 6. Täidis valmiskujul.

Joonis 7. Pinnal on hea morfoloogia ja toonid sobituvad loomulikul viisil.

Joonis 8. Ravi tulemus pärast kofferdami eemaldamist. Restauratsioonid sulanduvad loomulikult ümbritsevasse hambastruktuuri – nii tooni kui ka pinna läike poolest.

LIHTSASTI KASUTATAV ALTERNATIIV PAKITAVATELE KOMPOSIITIDELE

Eriti suu raskesti ligipääsetavates piirkondades võib hästi tasakaalustatud mehaaniliste omadustega voolava komposiidi kasutamine olla hea alternatiiv pakitavatele komposiitidele. Parem toonisobivus, mullideta pealekandmine, hea kohandumisvõime ning lihtne vormimine ja kiire poleerimine muudavad hambaarsti töö oluliselt lihtsamaks. 

Dentist:

JULIEN MOLIA

Dr Julien Molia lõpetas ülikooli 2008. aastal, kaitstes lõputöö arvutipõhise implantoloogia teemal. Ta asutas Saint-Jean-de-Luzis üldhambaravi praksise, kus on sellest ajast alates keskendunud implantoloogiale ja lõualuu rekonstrueerimisele. 2017. aastal omandas ta teise ülikoolikraadi implantoloogias, et oma teadmisi ajakohastada ja täiendada. Samuti on ta läbinud täiendkoolitusi digitaalse hambaravi, ortodontiliste minikruvide ja mukogingivaalkirurgia alal. Hinnates kudede säilitamist, täiendas ta end eraviisiliselt dr Gil Tirlet’ ja Jean-Pierre Attali juures Pariisis. Dr Molia on kliinilistele uuringutele ja innovatsioonile pühendunud koostöörühma Sud-Ouest Bioteam asutajaliige.

CLEARFIL MAJESTY™ ES Flow Universal VÕITIS TEADUSAUHINNA

Kuraray Noritake Dental Inc. on äsja turule toonud lihtsustatud toonikontseptsiooniga voolava komposiidi: CLEARFIL MAJESTY™ ES Flow Universal. USA Dental Advisori 2025. aasta jaanuari/veebruari numbris avaldati, et see täiesti uus toode pälvis oma veenva in vitro toimivuse eest maineka teadusauhinna.

LÜHIDALT SELLE OMADUSTEST

Euroopas toodi hiljuti turule CLEARFIL MAJESTY™ ES Flow Universal kahes viskoossuses – madal (Low) ja eriti madal (Super Low), samas kui Ameerika Ühendriikides on saadaval ainult ülimadala viskoossusega variant. Tooni valimise hõlbustamiseks on materjalis nutikalt kombineeritud emaililaadne läbipaistvus, dentiinilaadne värvus ja ainulaadne valgusdifusiooni tehnoloogia (LDT). See tagab erakordse toonide sobitamise võime ja võimaldab kasutada minimaalset toonivahemikku, mis koosneb vaid kahest üksteist täiendavast toonist – universaalne (U) ja universaalne tume (UD). Pärast valguskõvastamist sulandub materjali värvus märkamatult ümbritseva hambastruktuuri omaga.

 
Lisaks intuitiivsele toonivalikule pakub voolav komposiit veel ühte olulist eelist: see on erakordselt tugev. Paindetugevuse 152 MPa ja survetugevuse 374 MPa poolest on CLEARFIL MAJESTY™ ES Flow Universal (Super Low) sama tugev kui paljud pastatüüpi komposiidid. Selle tõttu sobib see kasutamiseks isegi koormustkandvates piirkondades ja selle kasutusnäidustused on järgmised:

• direktsed restauratsioonid kõikide kaviteedi klasside, hambakaela kahjustuste (nt juurepinna kaaries, v-kujulised defektid), hammaste kulumise ja erosiooni korral
• kaviteedi aluskiht / lainer
• hammaste asendi ja kuju korrigeerimine (nt diasteemi sulgumine, hammaste väärareng)
• murdunud restauratsioonide suusisene parandamine
• keraamiliste ja komposiidist inlay’de, onlay’de ja alla 2 mm paksuste laminaatide tsementimine

VAPUSTAV TOIMIVUS IN VITRO

Ameerika Ühendriikidele pakutavat ülimadala voolavusega varianti testiti Dental Advisori biomaterjalide uurimiskeskuses ja võrreldi kahe teise voolava komposiidiga. Hinnatud omaduste hulka kuulusid materjalide paindetugevus, elastsusmoodul, purunemiskindlus, survetugevus ja röntgenkontrastsus. Lisaks hindasid uurijad materjalide toonisobivust V klassi kaviteetide taastamisel A1, B2, C3 ja D4 tooniga proteeshammastel. Lõpuks testisid nad röntgenkontrastsust ja voolavusomadusi

 
CLEARFIL MAJESTY™ ES Flow Universal toimis igas kategoorias suurepäraselt. Füüsikalised omadused olid voolavate komposiitide seas ühed parimad ja sarnased pastatüüpi alternatiividega. Röntgenkontrastsus ja viskoossus olid ideaalsed, kuna materjal säilitab pärast pealekandmist oma algse kuju. Kuigi saadaval on vaid kaks tooni, kinnitasid uurijad, et CLEARFIL MAJESTY™ ES Flow Universal sobitub hästi paljude loomulike hambatoonidega.

TEAVE DENTAL ADVISORI KOHTA

USA-s asuva organisatsiooni Dental Advisor parima ja eelistatud toote auhinnad loodi selleks, et aidata hõivatud hambaravitöötajatel leida uusi hambaravilahendusi, eriti vähem invasiivsete tehnikate ja standardiseeritud protseduuride jaoks. Auhindade eesmärk on tuvastada tooteid, mis annavad järjepidevalt häid tulemusi. Dental Advisor viib läbi kliinilisi hinnanguid ja toote toimivuse teste vahetult pärast toote turuletulekut ning avaldab iga-aastased tulemused veebis, et aidata hambaravitöötajatel leida kvaliteetseid hambaravimaterjale, mis vastaks nende spetsiifilistele vajadustele. Teadusauhinnad loodi, et tunnustada hambaravitoodete tootjaid, kes on pühendunud teadustööle, arendamisele ja hambaravimaterjalide täiustamisele ravi kvaliteedi parandamiseks.

Lisateabe saamiseks külastage Dental Advisori veebilehte aadressil: www.dentaladvisor.com