We are pleased to share with you short training videos for CERABIEN™ ZR (CZR) porcelain.

Check out the below working steps and learn more about how to achieve outstanding aesthetics using this tried and proven material.

It is strong, it is pre-shaded like natural teeth, and it is reliable: KATANA™ Zirconia HTML, the highest strength version among KATANA™ multi-layered zirconia series. Now, Kuraray Noritake Dental Inc. has carefully optimized the product to further improve its optical properties and to harmonize the sintering schedules with all other materials of the KATANA™ Zirconia Multi-Layered Series.

The new KATANA™ Zirconia HTML Plus offers all popular properties of its predecessor, including the multi-layered colour structure and uniform strength distribution throughout the blank. It is suitable for a variety of indications including long-span bridges with a minimum wall thickness of just 0.4 mm in the anterior and 0.5 mm in the posterior region. This allows for minimally invasive preparations, while the user may choose between a monolithic, cut-back or framework design combined with the preferred finishing technique.

The PLUS refers to additional benefits like the material’s improved optical properties: KATANA™ Zirconia HTML Plus offers an increased translucency of 45 percent (compared to 43 percent KATANA™ Zirconia HTML) and an even more natural shade appearance of the manufactured restorations. “As the colour of the restorations appears deeper, more vivid and more saturated, and the translucency is closer to that of natural teeth, a great optical integration is achieved straight away. This leads to a reduced finishing effort”, says Mathias Fernandez Y Lombardi, EU Scientific Manager Dental Ceramics & CAD/CAM Materials at Kuraray Noritake Dental. At the same time, the high flexural strength (1,150 MPa) is maintained, providing for an unlimited range of indications.

Like its predecessor and all other materials of the KATANA™ Zirconia Multi-Layered Series, KATANA™ Zirconia HTML Plus is the result of an in-house development, powder compilation and blank production process that is able to control every detail. This enabled our specialists to achieve a precise alignment of the desired properties, while maintaining a high blank quality that leads to the accurate milling results with smooth surfaces and regular edges users of KATANA™ Zirconia HTML are familiar with.

The unique powder composition and specific in-house blank production procedure also allowed us to streamline the sintering protocols. For single-tooth restorations and bridges with up to three units, three different protocols are available: a 54-minute high-speed sintering programme specifically developed for remake and rush cases, a 90-minute schedule and the traditional seven-hour sintering programme. The latter is also suitable for long-span restorations.

These three options and identical schedules are available for KATANA™ Zirconia HTML Plus, KATANA™ Zirconia UTML, KATANA™ Zirconia STML and the new KATANA™ Zirconia YML with additional flexural strength and technical translucency gradation. With this feature, it becomes extraordinarily easy to standardize procedures despite an indication-specific selection of the best-suited KATANA™ Multi-Layered Zirconia.

Mathias Fernandez Y Lombardi concludes: “KATANA™ Zirconia HTML Plus is completely in line with our philosophy of developing products that support their users in streamlining and simplifying procedures without limiting choices. Users may choose from a whole range of highly specialized or universal zirconia solutions, may opt for their preferred design and finishing technique, and can select the sintering protocol that suits their individual needs. At the same time, the manual effort is reduced and the risk of starting the wrong sintering programme is eliminated.”

One for all: With KATANA™ Zirconia YML (yttria multi-layered), Kuraray Noritake Dental Inc. has launched a true allrounder covering traditional and new zirconia indications. At the KATANA™ Zirconia YML Virtual Kick-Off Symposium on July 3, 2021, professionals from the clinical and technical field as well as scientific experts from Kuraray Noritake Inc. provided insights into the properties and benefits of the innovation. We had a conversation with three of them about the specific features of KATANA™ Zirconia YML and its potential role in the dental practice and laboratory. Mathias Fernandez Y Lombardi, EU Scientific Manager Dental Ceramics & CAD/CAM Materials, provided insights from inside the company, while Prof. Dr. Florian Beuer MME, Charité – Universitätsmedizin Berlin and MDT Nondas Vlachopoulos, owner of the dental laboratory AestheticLab in Athens, shared their external perspectives.

Prof. Dr. Florian Beuer MME and Mathias Fernandez Y Lombardi during the conversation at the Kick-Off Symposium in Munich.

MDT Nondas Vlachopoulos virtually attended the meeting.

What are the most important features and benefits of the new KATANA™ Zirconia YML?

Mathias Fernandez Y Lombardi: KATANA™ Zirconia YML is a 5^th generation zirconia featuring next-generation multi-layered technology: it offers colour, translucency and flexural strength gradation in one disc – for a virtually unlimited indication range. As it may be used as the only zirconia or even ceramic CAD/CAM material in a laboratory or milling centre, it is designed for everyone who would like to simplify and standardize laboratory procedures. It may be sintered within 54 minutes, offers a high accuracy of fit and may be finished using time-saving techniques.

The new discs presented at the KATANA™ Zirconia YML Virtual Kick-Off Symposium.

Multi-layered structure of KATANA™ Zirconia YML.

What are the benefits of using a single zirconia for every indication from the dental technician’s perspective?

Nondas Vlachopoulos: The use of a universal zirconia solution with a high aesthetic potential and well-aligned mechanical properties allows dental technicians to reduce their inventory and streamline their procedures – from designing to finishing. Nowadays, we all know that, in order to optimize the outcomes, it is essential that we develop a deep understanding of a material’s properties, respect its design parameters (like minimum wall thicknesses) and adhere to the sintering protocols. It is much easier to accomplish this for a single material than for many different ceramics, and the potential for errors is minimized with a single-material approach. With KATANA™ Zirconia YML, this approach enables us to produce very different outcomes depending on where the restoration is placed in the multi-layered blank.

What are the benefits of using KATANA™ Zirconia YML as the only ceramic material from the dental practitioner’s perspective?

Florian Beuer: To my mind, the most important benefit of using a single zirconia every time lies in a simplified documentation. When different ceramic materials are used in the dental laboratory, we need to keep track of the material selected in every single case. Only in this way, it is possible to make the right cementation decisions (regarding cement selection and the appropriate pre-treatment of the restoration). In addition, when it comes to failure of the restoration, we need to know which material was used to prove that it has been processed correctly and is suitable for the actual indication. This is much easier when a single material is used every time. Zirconia is predestined for this approach as it is forgiving, supports minimally invasive preparations and – in case of KATANA™ Zirconia YML – almost everything can be done with it.

What are the secrets of KATANA™ Zirconia YML that allow for excellent treatment outcomes despite the one-for-all approach?

Mathias Fernandez Y Lombardi: KATANA™ Zirconia YML is based on a completely new, seamless multi-layer technology combining different, newly developed raw materials with varying yttria concentrations in a single blank. The inhouse development of the powders and their precise adjustment of each other in terms of properties like shrinkage and coefficients of thermal expansion are prerequisites for a smooth transition from one layer to the next. Only if the layers are very well integrated, it will be possible to reliably produce even long-span restorations with a delicate design, perfect fit and flawless aesthetics (without transition lines). The aesthetic properties were also optimized by integrating clinical instead of purely technical translucency.

Please explain the term clinical translucency.

Mathias Fernandez Y Lombardi: Usually, translucency of dental materials like zirconia is measured in its white, pre-shaded state. This so-called technical translucency value is increased by adding yttria to the formulation, which makes the zirconia itself appear brighter (increasing the whiteness). The translucency of the final restoration, however, is also affected by pigments and other additives in the formulation. Consequently, monolithic restorations made of different materials with the same technical translucency value may vary widely in terms of their actual, clinical translucency, which affect the overall aesthetic potential. The formulation of KATANA™ Zirconia YML has been optimized by carefully selecting and combining the right additives to obtain a natural, tooth-like translucency.

Translucency and shade appearance of KATANA™ Zirconia YML (left column) compared to various other 5^th generation zirconia materials.

Nondas Vlachopoulos, is this measure of optimizing the clinical translucency a key feature enabling the one-for-all approach of KATANA™ Zirconia YML?

Nondas Vlachopoulos: The positive effect attributed to this measure is noticeable, as KATANA™ Zirconia YML has a particularly warm and natural appearance especially in the body area some other materials with flexural strength gradation are lacking. This leads to an exact colour match with the VITA classical A1-D4 shade guide, and reduces the need for manual shade adjustments. This is important for a one-for-all approach, as the material should be a perfect basis for the production of monolithic restorations, which are not covered by a thick porcelain layer able to mask any imperfections. However, there is another key feature that facilitates the zirconia’s use for virtually every indication: Its exceptional design flexibility. It enables users to control the translucency and overall aesthetics by positioning the restoration quite freely within the blank. For restorations with up to three units, there is a complete freedom of placement. Larger restorations with four or more units need to be positioned in a way that at least 50% of the connector cross-section is in the bottom half of the disc. This is easily accomplished and gives us optimal options to exploit the various properties of each layer depending on the aesthetics and strength needed in each specific case.

Positioning guidelines for KATANA™ Zirconia YML.

What is the recommended finishing procedure?

Mathias Fernandez Y Lombardi: In principle, all designs and finishing options are available for KATANA™ Zirconia YML – from a monolithic design individualized with liquid ceramics to microlayering after a minimal vestibular cutback or even full ceramic layering on frameworks. As the aesthetic potential of the zirconia is already high, however, we believe that in most cases, the first option is absolutely sufficient. In this case, a monolithic restoration is milled and the surface subsequently treated with our liquid ceramic system CERABIEN™ ZR FC Paste Stain. The pastes are easily applied in ultra-thin layers, very well controllable and wear resistant.

Anterior and posterior crown made of KATANA™ Zirconia YML after sintering (left part) and after sintering and finishing with CERABIEN™ ZR FC PASTE STAIN (right part).

Nondas Vlachopoulos, what is your preferred finishing procedure for restorations made of KATANA™ Zirconia YML?

Nondas Vlachopoulos: In the posterior area, I often opt for monolithic restorations individualized with CERABIEN™ ZR FC Paste Stain. The technique leads to beautiful outcomes a large majority of patients would love to see even in the anterior region. However, as orders for the production of anterior restorations coming my way are usually placed by clinicians and patients with the highest possible aesthetic demands, I often go for a framework design and full porcelain layering with CERABIEN ZR Porcelains. The materials (like EX-3 portfolio for metal frameworks) are based on synthetic feldspathic porcelain with a structure and particle distribution very similar to natural dentin and enamel. All in all, I like the fact that I can select the most suitable finishing technique for every individual case, and I believe that it is often possible to reduce the finishing effort to a minimum.

Clinical translucency, design flexibility, mechanical properties: Apparently, the differences between the available zirconia materials – even of the 5^th generation – are huge. How can users ensure that the material they select is of high quality and offers favourable mechanical as well as optical properties?

Florian Beuer: When the first-generation zirconia materials appeared on the dental market, laboratory testing revealed that there are huge differences in quality between materials of different manufacturers. Although independent studies comparing the properties and behaviour of 5^th generation zirconia are still scarce, it may be assumed that differences do exist. My recommendation is to select a several materials from well-known manufacturers supporting clinical studies, compare the study results already available, and test the selected options in the laboratory setting. Directly comparing design concepts, the processing quality and final appearance will most likely reveal which material is a dental technician’s favourite. I am sure that KATANA™ Zirconia YML is among the materials worth being tested.

Thank you for this insightful conversation.

The Function that becomes aesthetics

Italian dental technician, CDT Stefano Lograno, demonstrates how it is possible for the medical-technical prosthetic team to adopt a protocol from diagnostics to cementation, in which aesthetics can be functionally guided in a simple, predictable and standardized workflow following the criteria of the gnathological school of Vienna of Prof. Rudolf Slavicek.

Click here to read. Enjoy!

Start Reading: BOND | SPECIAL EDITION | 6/2021

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BOND | VOLUME 7 | 10/2020

Nii paljude turul saada olevate adhesiivide, tsementide ja taastavate materjalide korral on raske otsustada, milline toode sobib individuaalseteks lahendusteks kõige paremini. Otsene testimine hambaravi praksises on võimatu, sest saada olevaid lahendusi on väga palju. Laboratoorsed uuringud annavad teavet üksikute toote omaduste kohta, kuid ei võimalda tavaliselt luua üldpilti. Lisaks on erinevate analüüside tulemused harva erinevate analüüsitingimuste tõttu võrreldavad. Kliinilised uuringud on tavapäraselt väga kasulikud, sest võimaldavad hinnata valitud materjalide kliinilist (pikaajalist) toimivust, kuid need avaldatakse tavaliselt aastaid pärast toote turuletulekut. Seega ei ole need saadaval varajastes staadiumites. Väga heaks teabe allikaks on praksistes teostatud hinnangud, sest nad toetavad võimalikke kasutajaid kõrge kvaliteediga hambaravi materjalide tuvastamisel.

Üheks institusiooniks, mis viib läbi ja avaldab praktikal põhinevaid kliinilisi hinnanguid ning toote toimivuse analüüse, on Ameerika Ühendriikides paiknev DENTAL ADVISOR. Üks kord aastas saavad parima toimivusega hambaravi materjalid ja seaded auhinnad Top Product ja Preferred Product Award. Võitjate nimekiri avaldatakse veebis (www.dentaladvisor.com) ja jaanuari-veebruari numbris ajakirjas DENTAL ADVISOR. Aastal 2021 olid mitmed ettevõtte Kuraray Noritake Dental Inc. tooted auhinnavõitjate seas.

Auhinnad Top Product Award

CLEARFIL™ SE Protect sai auhinna Top Product kategoorias „Otsesed restauratiivmaterjalid, kinnitusmaterjalid: isesöövitavad materjalid“. Isesöövituva adhesiivi moodustumine põhineb kahe-etapilisel isesöövitava adhesiivi moodustumise kuldstandardil, kuid CLEARFIL™ SE BOND sisaldab lisaks MDPB monomeeri, mis on antibakteriaalse kaviteete puhastavate omadustega, ning fluoriidi pikaajaliseks fluoriidi vabastamiseks. Ajakirja DENTAL ADVISOR auhinna väljaandmine põhines materjalianalüüsil, mida viisid läbi 13 DENTAL ADVISOR-i konsultanti ja toimetajat oma hambaarstipraksistes kuue nädala jooksul. Oma suurepärase toimivuse tõttu sai antibakteriaalne isesöövituv adhesiiv 98 protsendilise kliinilise hinnangu.

Kuuendat aastat järjest sai parima Top Product kategoorias „Otsesed restauratsioonid, komposiit, kõrgelttäidetav modelleeritav“ toode CLEARFIL MAJESTY™ ES Flow.

Universaalne voolav komposiit, mis sai ka auhinna Editor’s Choice, on saadaval kolmes voolavusastmes kõrgest väga madalani*. See võimaldab kasutajal valida sobiva viskoossuse igaks kliiniliseks lahenduseks. Kõrge voolavusega variant on parim kaviteetide laineriks ja vaikkatteks IDS protseduuridel. Väga vähe voolav variant on eriti sobilik laminaatide paigaldamisel ja isegi tagumiste tippude ülesehitamiseks. Universaalset voolavat komposiiti testisid 29 ajakirja DENTAL ADVISOR konsultanti rohkem kui 900 kasutuskorra vältel. Hinnatud omadused - paigaldamine/käitlemine, esteetika, viskoossus ja poleeritavus - hinnati suurepärasteks. Selle tulemusena on soovitati toodet 100 protsenti ja üleüldine kliiniline hinnang oli 98 protsenti.

* DENTAL ADVISOR hindas ainult keskmise voolavusastmega toodet (Low), sest kaks teist versiooni ei ole Ameerika Ühendriikides saadaval.

Toode, mis saavutas tunnustuse ajakirja Dental Advisor kollektiivilt juba seitsmendat korda järjest on TEETHMATE™ DESENSITIZER, mida kasutatakse ülitundlikkuse raviks.

Auhinna Top Product võitnud toode disainiti hüdroksüapatiidi (HAp) tootmiseks, mis täidab avatud dentiini tuubuleid ja emailipragusid. See toob endaga kaasa olulise ülitundlikkuse vähenemise, kui seda kanda paljastatud, mehhaaniliselt töödeldud või värskelt ette valmistatud dentiinile. Kui toodet kasutada restauratiivses hambaravis, ei ole tootel TEETHMATE™ DESENSITIZER negatiivset mõju adhesiivide või tsementide sideme tugevusele. Ajakiri DENTAL ADVISOR viis läbi kuus kuud kestnud kliinilise hinnangu, millesse kaasati 27 igeme taandumisega seonduva ülitundlikkusega patsienti. Toote kasutamine oli väga efektiivne kohese ja isegi pikaajalise (kuus kuud) ülitundlikkuse leevendamisel. Tänu sellele sai toode suurepärase hinnangu skooriga 96 protsenti.

Isekinnituva tsemendi kategoorias sai auhinna Top Product PANAVIA™ SA Cement Plus. See kaksikhooldusega isekinnituv vaiktsement eristub oma kasutusmugavuse, meeldiva viskoossuse ja lihtsa jääkide eraldamise poolest pärast valgusimpulssidega kõvastamist.

Tooted Preferred Product

Aastal 2021 toodete Preferred Product seas, mis pääsesid valikusse Editor’s Choice, on PANAVIA™ SA Cement Universal. See aastal 2020 auhinna Top Product võitnud isekinnituv universaalne vaiktsement sisaldab unikaalset LCSi monomeeri. See monomeer on silaanil põhinev ning sisaldab oma molekulis unikaalset pikka süsinikahelat. Süsinikahel loob kestva keemilise sideme portselaniga, liitiumdisilikaadiga ja vaiktsmendiga ilma lisasilaani sisaldava praimeri vajaduseta. Teine valemis sisalduv võtmetehnoloogia on algne MDP monomeer, mis tagab keemilise reaktiivsuse tsirkooniga, dentiiniga ja emailiga. Koos tagavad tehnoloogiad, et PANAVIA™ SA Cement Universal tekitab tugeva ja kestva ühenduse peaaegu kõikide restauratiivsete materjalidega ilma eraldi praimeri vajaduseta. Toote käsitsemisomadused, esteetika ja igemesõbralikkus said väga head kuni suurepärased hinnangust 31-lt kliiniliselt hindajalt, kes kasutasid tsementi 516 rakenduses. Üleüldine kliiniline hinnang oli 96%.

Lisaks oli toode CLEARFIL™ Universal Bond Quick teist aastat järjest ajakirja Dental Advisor konsultantide eelistatud toode Preferred Product.

Universaalset sidusainet võib peale kanda isesöövitava tehnikaga või koos K-ETCHANT süstlaga emailile söövitamise või täieliku söövitamise tehnikaga. Sidusaine sisaldab kiire sideme loomise tehnoloogiat, milleks on algne MDP monomeer koos innovatiivsete hüdrofiilsete amiidide monomeeridega. Sidusaine töötab koheselt ja ilma lisa-ekspositsiooniaja vajaduseta, mitmete kihtide pealekandmisteta ja ilma liigse hambastruktuuri hõõrumiseta. Kiire ja lihtne pealekandmise protseduur oli üks peamistest põhjusteks, miks ajakirja DENTAL ADVISOR konsultandid valisid toote CLEARFIL™ Universal Bond Quick tooteks Preferred Product ja valikuks Editor’s Choice kliinilise hinnanguga 98 protsenti.

Lõpetuseks valiti toode CLEARFIL™ CERAMIC PRIMER PLUS tooteks Preferred Product aastatel 2019, 2020 ja 2021 ning valikuks Editor’s Choice aastal 2021. Toode sisaldab algset MDP monomeeri ja silaani monomeeri, mis tagavad suurepärase sideme tugevuse igasuguste restauratiivsete materjalidega, nt silikaadipõhistele keraamikatele, tsirkoonile, komposiitidele ja isegi metallidele. Kasutajad võidavad protseduuride lihtsusest, sest toode lihtsalt kantakse aluspinnale ja kuivatatakse pärast soovituslikku eeltöötlust. Kliinilises hinnangus saavutas toode soovitustaseme 96 protsenti ja üleüldise DENTAL ADVISOR konsultantide hinnangu 96 protsenti.

Kokkuvõte

Enamus ettevõtte Kuraray Noritake Dental tooteid, mis võitsid käesoleval aastal auhinna, põhinevad vaigu tehnoloogiatel, mis on üheks meie võtmekompetentsidest. Me arendasime oma algse MDP monomeeri välja 1980-ndate aastate keskel. Tegemist on funktsionaalse monomeeriga, mis on hädavajalik komponent meie kõikides sideainetes, mida me oleme turule toonud tänase päevani, sh auhinnatud CLEARFIL™ SE Protect, PANAVIA™ SA Cement Universal, CLEARFIL™ Universal Bond Quick ja CLEARFIL™ CERAMIC PRIMER PLUS. See on ainult üks meie mitmetest ekspertiisivaldkondadest. Me pakume kasutajatele ka ennetavaid tooteid ja mitmeid restauratiivseid materjale komposiidi täitematerjalidest nagu CLEARFIL MAJESTYTM ES Flow kuni hambakeraamikani nagu KATANA™ Zirconia UTML, STML ja HTML. Me näeme auhindade võitmist positiivse tõestusena usaldusväärsest toote töökindlusest, mis toetab hambaarste nende eesmärkide saavutamisel.

Vahel peab see olema voolav, et oleks võimalik täita kõik nurgad, ja vahel on vaja, et see püsiks paigaldatud kohas või oleks sobiva kuju loomiseks modelleeritav. Sama viskoossusega oleks raske teostada kõiki komposiitide vajalikke näidustusi. Selle tõttu pakub Kuraray Noritake Dental Inc. toodet CLEARFIL MAJESTY™ ES Flow kolme erineva voolavusastmega: High, Low ja Super Low. Voolavusaste valitakse vastavalt näidustusele ning kaviteedi geomeetriale ja suurusele. Näiteks on hea voolavusega valik parim kaviteedi laineriks, samas kui väga vähese voolavusega toodet võiks eelistada laminaatide paigaldamiseks.

Kuid materjalil on lisaks veel palju pakkuda. Seda on kinnitanud ka konsultandid ajakirjast Dental Advisor, kes on autasustanud toodet auhindadega Editors’ Choice ja Top Product Award kuuendat korda järjest (Vol 38, number 01, jaanuar–veebruar 2021).

Ajakirja Dental Advisor 29 konsultanti testisid oma hambaarstipraksistes keskmise voolavusega (Low) CLEARFIL MAJESTY™ ES Flow toodet. Nad hindasid toote toimivust paigaldamise/käitlemise, esteetika, viskoossuse ja poleeritavuse osas. Kõigi nelja omaduse osas oli hinnang suurepärane. CLEARFIL MAJESTY™ ES Flow Low ei voola paigalduse ajal, samas kohandub hästi kaviteedi seintega ja voolab ka kitsastesse piirkondadesse. Ettevõtte Kuraray Noritake Dental Inc. kerge difusiooni tehnoloogia võimaldab materjalil sujuvalt ümbritseva hambastruktuuriga ühilduda ja läikiv pind saavutatakse ainult alkoholis immutatud vatitampooniga pühkides.

Tänu nendele omadustele ja veenvale üleüldisele toimivusele, saavutas toode 98 protsendilise hinnangu ja kõik 29 konsultanti märkisid, et nad soovitaksid toodet CLEARFIL MAJESTY™ ES Flow kolleegile. Alates aastast 2015 on toode võitnud korduvalt auhinna Top Product Award ja tänu oma kolmele viskoossusele on toode tõenäoliselt valikuks veel laialdasemate näidustuste korral

Kas ei oleks tore, kui kõiki ülitundlikkusi saaks ravida ühe hambaravi materjaliga? Toode, mis efektiivselt ja püsivalt katab igeme taandumisest, hammaste erosioonist või liigsest harjamisest tingitud dentiini tuublite paljastumise, samas toimib ka professionaalse hammaste puhastajana, hambakivi eemaldajana ja juurte planeerijana, hammaste valgendajana ning restauratiivsetel protseduuridel? Asjaolu, et ettevõtte Kuraray Noritake Dental Inc.TEETHMATE™ DESENSITIZER sobib ideaalselt kõikideks nendeks näidustusteks, pakkudes pikaajalist ülitundlikkuse kergendamist, on üks nendest põhjustest, miks see võitis ajakirja Dental Advisor auhinna seitsmendat aastat järjest

TEETHMATE™ DESENSITIZER on disainitud kristalliseerima hüdroksüapatiiti (HAp) põhjast ülespoole ja see katab paljastatud dentiini tuubulid ja emaili praod usaldusväärselt.

Toode koosneb looduslikust kaltsiumist ja fosfaadist. Seetõttu võib seda kanda värskelt ettevalmistatud hambastruktuurile, ilma järgnevalt kasutatavate hambaravi adhesiivide või tsementide sideme tugevust negatiivselt mõjutamata.

Ajakirja Dental Advisor konsultandid viisid läbi kuus kuud kestva kliinilise uuringu, et hinnata toote TEETHMATE™ DESENSITIZER toimivust. Nad valisid oma praksistest 27 ülitundlikkusprobleemidega patsienti. Mõjutatud hammaste leidmiseks kasutati testimist külma õhuga ning tuvastati 54 mõjutatud hammast. Esialgsel hinnangul paluti patsientidel hinnata iga hamba ülitundlikkust 5-punktilisel skaalal (1 = raske, püsiv ülitundlikkus, 5 = tundlikkus puudub). Järgnevalt kanti peale toodet TEETHMATE™ DESENSITIZER vastavalt kasutusjuhistele. Tundlikkust hinnati uuesti koheselt pärast ravi ja kuue kuu möödumisel. Protseduurijärgselt teatas 91 protsenti patsientidest ainult vähest juhuslikku tundlikkust või tundlikkus puudus. Pärast kuue kuu möödumist oli see sama 85%-l patisentidest. See näitab, et toode on väga efektiivne kohese ja isegi pikaajalise ülitundlikkuse ravis.

Selle tõttu ei ole üllatav, et TEETHMATE™ DESENSITIZER on ajakirja Dental Advisor auhinna Top Product Award võitjate seas olnud igal aastal vahemikus 2015 kuni 2021.

Uuringutulemused kinnitavad materjali efektiivsust operatsioonieelse ja -järgse tundlikkuse vähendamisel hammaste valgendamisel1 ja mitteotsestel taastamisprotseduuridel2. Nii on võimalik usaldada toote kindlat toimimist laialdastel rakendusaladel.

References

1. Mehta D, Jyothi S, Moogi P, Finger WJ, Sasaki K. Novel treatment of in-office tooth bleaching sensitivity: A randomized, placebo-controlled clinical study. J Esthet Restor Dent. 2018 May;30(3):254-258.
2. Shetty R, Bhat AN, Mehta D, Finger WJ. Effect of a Calcium Phosphate Desensitizer on Pre- and Postcementation Sensitivity of Teeth Prepared for Full-Coverage Restorations: A Randomized, Placebo-Controlled Clinical Study. Int J Prosthodont. 2017 Jan/Feb;30(1):38-42.

Conventional Cementation Vs. Adhesive Luting

Proper luting of indirect restoration is critical in achieving long-term success as it highly influences the retention of the restoration.

With the availability of different types of cements, the decision of choosing the suitable luting agent and method can be confusing for the practitioner. Especially with the wide use of contemporary restorative materials such as new generations of highly translucent zirconia as well as reinforced-composites, it is important to take into consideration that the properties of such materials differ highly from metal or earlier generations of zirconia.

Subsequently, the choice of the luting agent must be appropriate to achieve satisfying results and long-term success. Therefore, the aim of this online seminar is to provide insights for the clinicians on choosing the correct luting agent that can help achieve satisfactory results for the dentist as well as the patients.

Dr Adham Elsayed

• PhD degree in Prosthodontics and Implantology from the University of Kiel, Germany
• Certified Specialist in Prosthodontics, German Society for Prosthetic Dentistry and Biomaterials (DGPro)
• Certified Specialist in Implantology, German Society for Implant Dentistry (DGI)
• Clinical & Scientific Manager DACH, Kuraray Europe GmbH

Case by Francesco Ferretti and Marco Nicastro

Aesthetic restoration of anterior teeth using KATANA™ UTML Full anatomical crowns, with vestibular stratification and BOPT*¹.

^{*1 Biologically Oriented Preparation Technique}

Initial situation

Final result

Shows excellent aesthetic properties of KATANA™ UTML and the perfect integration in harmony with pink tissues.

Figure 1. The patient requested a solution for an aesthetic problem due to unnatural look of old restorations and black triangles coming from past history of periodontitis. The resulting retraction of the tissues had left the margins of the prosthesis clearly visible, and the loss of the papilla peaks, together with the numerous black spaces between the crowns, required a complex therapeutic approach.

Figure 2. The treatment plan for the periodontal problems con-sisted of a non-surgical approach, with scaling and root planing, and the replacement of the previously fixed prostheses to recondition the marginal tissues and facilitate the restoration of a new, aesthetically pleasing gingival architecture.

Figure 3. From a functional point of view, we decided to reduce the deep frontal bite to restore a correct overjet-overbite ratio. This reduction was also important from an aesthetic point of view, as it allowed us to shape the various elements correctly.

Figure 4. We usually remove old prostheses before beginning a periodontal treatment, and make a first, provisional restoration to create an environment in which the soft tissues can heal. If we have to work beyond the cement enamel joint (CEJ), we prefer a vertical preparation for posts, and the purpose of the provisional restoration is to condition the marginal tissues using Dr. Loi’s BOPT.

Figure 5. For the BOPT, the vertical preparation of the post has a finish line that extends inside the gingival sulcus. The temporary conditioning of the tissues induced by the provisional prosthesis allows us to modify the level of the gingival parables to a certain extent.

Figure 6. The image on the left shows the clinical healing of the tissues one month after the initial periodontal treatment. The role of the provisional restoration, appropriately realigned, is clear. The conditioning of the tissue has been achieved by means of the provisional restoration, which has modified the level and shape of the marginal tissue. Once filled with correctly fitted crowns, the interproximal spaces will be further reduced after the definitive restoration.

Figure 7. The correct management of the provisional restoration is crucial for the healing of the tissues. The placement of a provisional restoration before the periodontal therapy has allowed us to create the right environment for complete healing. At the same time, the vertical preparation has allowed us to gradually condition the marginal gingival tissue by shortening or lengthening the provisional restoration as necessary.

Figure 8. One of the advantages of a vertical preparation is that taking the final impression is easy, because the absence of a horizontal finish line greatly simplifies the procedure. On the other hand, the BOPT also requires the taking of an impression of the sub-gingival portion of the preparation. The dental technician will have to decide marginal shape of restorations according to the position of the gingival line in consultation of the clinician, and based on the tests conducted with the provisional restoration.

Figure 9. After the casting of the model, we prepared the gingival area to accommodate an ideal configuration of gingival parables.

Figure 10. After making a wax model, we assessed whether the height of the gingival zenith level could be further corrected. This photo shows that gingival level of 21 was not yet ideal, so we stretched it distally.

Figure 11. Once the wax model was complete, we extracted the element from the model and evaluated its protrusion. It was only after joining the gingival protrusion to the arbitrary margin of the preparation that we proceeded to a scan and milled the crowns.

Figure 12. The restoration was carried out with Katana™ UTML zirconia based on the new formulation of cubic zirconium oxide. This ultra tralucent material was chosen because we were working with light and non-discolored posts.

Figure 13. We finished the crowns on a positional impression to help to improve the gingival adaptation; we had some dispersion of the tissues in the first precision impression due to the use of retractors. We finished the crowns with CZR FC Paste Stain colours and glaze.

Figure 14. The surface colours and the slight contrast created are highlighted in this black-and-white image taken with a blue filter.

Figure 15. In this translucent image, we can see the natural translucent effect of KATANA™ UTML and invisible fusion between abutments and crowns.

Figure 16. Clinical image one year after cementation made with PANAVIA V5; this shows the good clinical condition of the marginal tissue, with no signs of inflammation or bleeding. The BOPT allowed us to optimise the level of the gingiva without resorting to periodontal surgery, while the shape of the new crowns has made it possible to close all interproximal spaces for an optimally aesthetic result.

Figure 17. The brightness of the restorations (thanks to the use of a particularly translucent zirconia) combined with the shape of the incisors, has greatly im-proved the aesthetic of the restoration, even though the condition initially appeared to be particularly unfavourable.

Figure 18. Compared to the previous prostheses, the incisal reduction allowed not only for the optimisation of the functional phase by reducing the overbite, but also made it possible to achieve a more natural aesthetic, with the contour of the incisal margins following that of the lower lip.

Dentists:

FRANCESCO FERRETTI

Born in Rome on 15th March 1957, Francesco Ferretti gets his degree as dental technician at the Institute “Edmondo de Amicis”, in Rome. In 1980, he starts working and, from 1987 to 1994, he cooperates with IVOCLAR VIVADENT giving consulting as ceramist. In 1992 he starts working exclusively with Prof. Mario MARTIGNONI.

• After one year cooperation with Prof. Martignoni, he starts working with the ORAL DESIGN CENTER founded in Rome by Mr. Willi Geller, and becomes a partner, improving prosthesis esthetics.
• Is registered outside the course of dentistry at the University of Rome Tor Vergata.
• In 2001, he founds ESTECH DENTAL STUDIOS, in cooperation with Pentron for technical training and consulting.
• He has published articles and studies in Italian and American magazines. He is interested in Metal Free techniques.
• Winner of the 2004 Polcan Aiop.
• He is a member of: ANTLO LAZIO ( National Association of Lab Owners) with the president of the Lazio region 2013-2014.
• National cultural manager ANTLO 2017-2020.
• Teacher of prosthetics perfectioning at the University of Chieti for the year 2002, he has been re-confirmed for the year 2003, 2004, 2005 to deal with Metal Free.
• Teacher of prosthetics perfectioning at the University of Naples 2006.
• He has participated as a speaker at numerous conferences in Italy. ESCD member has participated as a speaker at ten in Florence 2009 and Turin 2013.

MARCO NICASTRO

Marco Nicastro takes a degree in “Odontoiatria e Protesi Dentaria (Dentistry and Dental Prosthesis) at the University of Rome “ La Sapienza in 1989. Since the beginning he is interested in prosthesis restoration dentistry and aesthetic problems.

• From 1990 to 1996 he attends Prof. Martignoni’s studio, where he develops his prosthesis knowledge.
• From 1993 to 1998 he cooperates as lecturer with the Oral Design Centre in Rome, directed by Mr. Ferretti and Mr. Felli, giving lectures and courses about aesthetic restoration either in Italy or in foreign countries. In the same period he enlarges his experience in aesthetics, attending training courses at the University of Geneva, in Switzerland.
• Since 1993 he has been cooperating with Mr. Francesco Ferretti in the organization of Courses and Conferences, paying particular attention to metal free methodology.
• Vice President of the European Society of Cosmetic Dentistry (ESCD).
• Founding member and active member of Gimnasium interdisciplinary CAD-CAM (GICC).
• Active member of the Italian Society of Conservative Dentistry (SIDOC).
• Partner of the Italian Academy of Prosthetic Dentistry (AIOP).
• President of Like Mine Dental Education in Rome since 2001.
• He won, with Francesco Ferretti, the Polcan award of the Italian Accademy of Prosthetic Dentistry in 2004.