Invisible transition from tooth to composite Article by Peter Schouten. We've seen them all: composite fillings that function present clinically, but are too ‘visible’ to be called aesthetic. The much-used term 'white filling' is probably quite appropriate here. In comparison to the tooth structure, these restorations are too opaque, or sometimes too transparent. How much better would it be if the composite helped to create a seamless transition between tooth structure and composite? The so-called 'blending'. But what enables this 'blending’ of composite and tooth structure to occur? The secret lies in utilizing the right mix of different filler particles and resins which give CLEARFIL MAJESTY™ ES-2 its light-diffusing properties. By varying the proportion of light-diffusing particles and the amount of pigment, it's possible to create composites with differing light-scattering properties and opacities. The most opaque variants contain more light-diffusing particles and more pigment. The more translucent ones contain obviously less. All CLEARFIL MAJESTY™ ES-2 variants have the same filler content. This is important, as it means that the mechanical properties of all the CLEARFIL MAJESTY™ ES-2 variants are the same. The more translucent variants contain more barium glass than the more opaque variants. A higher barium glass content can lead to a less workable composite. With CLEARFIL MAJESTY™ ES-2, this is not the case. Kuraray has mastered the silanization process to such an extent that all variants, whether translucent or opaque, have the same filler amount, without compromising on workability. Light diffusion test Light diffusion properties are easy to see if the thin composite slices are placed on a black and white paper background and then held a few millimeters above the paper. Composites with high diffusion properties make the black strip virtually invisible. They blend in more readily with their surroundings. Oct 28, 2021
Single-shade concept: an adequate option in direct posterior restorations Case by Dr. Salvatore Scolavino After decades of developing and improving the matrix chemistry and filler technology contained in resinbased composites, the products available for direct restorative procedures finally seemed technically mature. What remained challenging, however, was the management of the extremely wide range of tooth shades and opacities available for each product: The dentin, body and enamel masses had to be selected and combined in the right way to obtain a perfect colour match and optical integration with the surrounding tooth structure. The difficulties associated with shade selection and calibration of layer thicknesses (particularly the top enamel layer) required to obtain the desired optical (desaturation) effects have now also finally been overcome. The reason is that further improvements of the composites’ optical properties, mainly achieved through a careful selection and combination of fillers, have enabled the production of materials with optimized light diffusion properties. These properties enable the restorations to blend in smoothly with the adjacent tooth structure, thus paving the way for a single-shade concept (SSC). This concept involves the use of a single mass of composite to restore the function and aesthetics compromised by the loss of dental structure. This translates into a significant saving of chair time and a high predictability of aesthetic outcome. A composite material supporting a single-shade technique needs to have medium opacity and a technology ensuring that the incoming light is absorbed, reflected and scattered in the right way to merge effortlessly with the surrounding natural dentition and create a biomimetic effect. The following clinical case reveals how the Light Diffusion Technology used in the CLEARFIL MAJESTY™ ES-2 Universal composite system (Kuraray Noritake Dental Inc.) leads to a highly predictable aesthetic integration obtained using the SSC. Case description The 30-year-old female patient presented for a check-up, during which it appeared that her composite restorations in the second quadrant (the maxillary left first and second molar) needed to be replaced due to marginal leakage (Fig. 1). Once the rubber dam was in place (Fig. 2), the existing composite restorations were removed using a round multi-blade bur, which allowing for a selective removal of composite and carious tissue. The extension of the cavity was performed with a truncated cone diamond bur (fine). Once the cavity preparation was completed (Fig. 3), the enamel and dentin surfaces were cleaned by sandblasting with aluminium oxide (50 μm). Selective etching of the enamel was performed with K-ETCHANT Syringe (Kuraray Noritake Dental; Fig. 4), followed by thorough rinsing and drying of the tooth (Fig. 5). For the adhesive procedure with CLEARFIL™ SE BOND 2 (Kuraray Noritake Dental), the primer was applied first (Fig. 6), rubbed into the tooth surface for 40 seconds and air-dried. The bond was subsequently applied in the same manner (Fig. 7). After several seconds of air flowing to create homogeneous surface the adhesive was light-cured for 40 seconds (Fig. 8). As the last phase of the adhesive procedure, a 1-mm-thick layer of flowable composite (CLEARFIL MAJESTY™ ES-Flow Super Low A3, Kuraray Noritake Dental) was applied to cover the adhesive on the dentin (Figs. 9 and 10). Fig. 1. Pre-operative clinical image. Fig. 2. Isolation with rubber dam. Fig. 3. First and second molar after cavity preparation. Fig. 4. Selective etching of the enamel. Fig. 5. Cavities ready for the adhesive procedure. Fig. 6. Application of the tooth primer. Fig. 7. Glossy appearance of the cavities after application of the bond. Fig. 8. Light-curing of the adhesive layer. Fig. 9. Application of flowable composite. Fig. 10. Cusp-by-cusp modelling of the universal composite. In the modelling phase, the posterior shade U of the composite CLEARFIL MAJESTY™ ES-2 Universal was placed using the cusp-by-cusp technique (Figs. 11 and 12). In order to improve the optical integration of the restorations, some brown stain (CHROMA ZONE™ COLOR STAIN Dark Brown, Kuraray Noritake Dental) was added to the fissures (Fig. 13). For finishing, we used a multi-blade ball-shaped bur and an Arkansas Flame abrasive stone (Fig. 14). Polishing of the restorations was accomplished with the TWIST™ DIA system (EVE; Fig. 15). After rubber dam removal, the occlusal check was performed with articulating paper (Fig. 16), minimal adjustments were made and the surfaces repolished. The integration of the restorations after 30 days fully meets the clinical expectations (Figs. 17 to 20). Fig. 11. Glossy appearance of the cavities after application of the bond. Fig. 12. Completed occlusal anatomy. Fig. 13. Stained fissures. Fig. 14. Matte surfaces after finishing. Fig. 15. High-gloss surfaces after polishing. FINAL SITUATION Fig. 16. Whole quadrant after rubber dam removal and the occlusal check. Fig. 17. Whole quadrant at the 1-month-recall. Fig. 18. Occlusal view of the restorations … Fig. 19. … after one month. Conclusion The innovative composite system CLEARFIL MAJESTY™ ES-2 Universal, which consists of two shades for the anterior and a single shade option for the posterior region, offers the properties needed for a successful implementation of the single shade technique. Used in the posterior region, the material is sufficiently opaque to mask optical irregularities of the underlying tooth structure, while it is translucent enough to provide for an imperceptible optical transition from the tooth structure to the restoration. Irrespective of the tooth shade, the restoration merges smoothly with the surrounding natural dentition, creating a harmonic overall picture. Dentist: DR. SALVATORE SCOLAVINO Dr. Salvatore Scolavino, graduated with honors in Dentistry and Dental Prosthesis from the University of Naples. Dr. Salvatore is a specialist in aesthetics and direct and indirect anterior and posterior adhesive restorations. His focus lies with Conservation, Endodontics and Prosthetics in particular. He is an active member of prestigious academies and scientific societies: AIC -Italian Academy of Conservation, IAED -Italian Academy of Esthetic Dentistry and SIDOC (Italian Society of Conservative Dentistry. Since 2004, he has private practice Nola, Italy. Dr. Scolavino is a founder of werestoreit.it, an inspiring site that offers abundance and variety of aesthetic clinical cases. Author of the book published by Quintessence Publishing „Direct Restorations in the posterior regions“, author of scientific publications in national and international journals, he is speaker at courses and conferences in Italy and abroad. Oct 21, 2021
Treatment of primary caries in a third molar Case by Dr. Michał Pokojski When restoring primary carious lesions in the posterior area with composite, I wish to use a material that allows me to produce high-quality outcomes in an efficient procedure. The most important qualities of the restoration are its perfect marginal integrity and reliable long-term behaviour, which set the stage for a long and healthy life of the otherwise healthy tooth. Reliability paired with ease of use is what I expected from the selected material combination: CLEARFIL™ SE Bond 2, a popular self-etch adhesive containing the original MDP monomer, and CLEARFIL MAJESTY™ ES-2 Universal. According to Kuraray Noritake Dental, the innovative resin composite comes with a universal shade concept and mechanical properties such as shrinkage, wear resistance and colour stability similar to those of proven CLEARFIL MAJESTY™ products. As a single shade is available for the posterior region, the need for shade determination is eliminated, which allows the dental practitioner to focus on the clinical work steps. In this case, a small primary defect in a third molar was restored. The outcome speaks for itself. Fig. 1. Situation during cavity preparation revealing the carious lesion. Fig. 2. Prepared cavity after the application of the bonding agent. FINAL SITUATION Fig. 3. Treatment outcome with the composite harmoniously integrated into the surrounding structure. Dentist: DR. MICHAŁ POKOJSKI Dr. Michał Pokojski is a graduate of the Medical University of Łódź, Poland. He maintains his private practice in Starachowice, Świętokrzyskie Voivodeship. His passion is endodontics and esthetic conservative dentistry. In his everyday duties microscope and camera are his main tools to provide his patients with professional and precise procedures and to ensure proper level of communication and understanding. His practice was guided by EBD from the very beginning, because in his opinion knowledge, scientific facts and dedication for what you do are the fundamentals of medicine and dentistry as well. His goal is to treat patients at the highest level of quality using the best available materials, instruments and procedures. His cases are well-known in the world thanks to modern ways of communication like Facebook and Instagram. Feb 16, 2021
Light diffusion technology – key to the success of your composite restorations With CLEARFIL MAJESTY™ ES-2, the shade transition from composite to tooth is virtually invisible. The secret to this lies in light diffusion technology. How does this work? Before we discuss the technology in detail, here are some more information about our CLEARFIL MAJESTY™ ES-2 composites. All CLEARFIL MAJESTY™ ES-2 composites are suitable for both anterior and posterior applications. The different variants within the ES-2 family are characterized by supreme handling and a long working time, and the fact that they do not slump during modeling. A key feature of these composites is the ease with which restorations blend into their surroundings. This results in durable and aesthetic restorations. In CLEARFIL MAJESTY™ ES-2 composites, two types of fillers are used. Barium glass particles form the basis of the filler. Alongside this, advanced prepolymerized filler particles are added. The latter type is called light diffusion filler, since it is primarily these filler particles that achieve a light-scattering effect within the composite. The way in which a restoration 'adjusts itself', to the shade of the tooth to be restored, is not the same for all composites. Most composite manufacturers make use of the so-called 'chameleon effect'. A composite that is sufficiently translucent allows light to pass through. Light is reflected off the walls of the cavity, whereby the composite restoration assumes the shade of the adjacent tooth structure. In cavities that aren't too large with a sufficient amount of surrounding tooth structure, this chameleon effect works well enough. However, with larger cavities or in the absence of underlying tooth structure, as is often the case with anterior restorations, the aesthetic blending effect is limited. The brightness is far from satisfactory, and the restoration looks gray. At Kuraray Noritake Dental Inc., we do things differently. Besides the optimized translucency in CLEARFIL MAJESTY™ ES-2 composites, it's the light diffusion technology that makes the restoration blend seamlessly with the adjacent tooth structure. Thanks to the combination of these two parameters — translucency and light diffusion — the capabilities are far more extensive than with just translucency. The different dental tissues have different opacities. Enamel is more translucent than dentin. However, the degree of translucency/opacity of both tissues is not always the same. Age, thickness of the structure and various intrinsic and extrinsic factors all play a role. Depending on the desired end result, the most appropriate member(s) of the CLEARFIL MAJESTY™ ES-2 family is/are selected for the restoration. In aesthetic restorations in which opacity differences need to be considered, a layering system is necessary. More uniform restorations are easily constructed with a composite that has broad shade and opacity coverage. CLEARFIL MAJESTY™ ES-2 Premium for highly esthetic restorations. CLEARFIL MAJESTY™ ES-2 Universal for routine aesthetic restorations involving few or no opacity differences. Oct 12, 2021
Special MAJESTY ES-2 Universal - Clinical Cases Brochure Compact, time-saving and aesthetic How many different shades of composite do you need to create appealing restorations in virtually every clinical situation? If you opt for “CLEARFIL MAJESTY™ ES-2” Universal shade concept, a few shades will do the trick. With wonderful support of our internationally recognized key opinion leaders, we have prepared a Clinical Case brochure of “CLEARFIL MAJESTY™ ES-2” Universal for you. The brochure highlights a variety of clinical cases in the anterior and posterior region to show the all about excellent properties of our latest composite. Let the pictures speak for themselves! Click here to view. Enjoy! Start Reading: Special MAJESTY ES-2 Universal - Clinical Cases Brochure Mar 17, 2022
Replacement of an amalgam restoration in a maxillary first molar Case by Dr. Michał Pokojski Universal resin composites with a simplified shade concept are popular as they streamline direct restoration procedures. Unfortunately, many of the available products that claim to blend in well with the surrounding tooth structure independent of its shade need a blocker or opaquer to mask dark areas. According to Kuraray Noritake Dental, CLEARFIL MAJESTY™ ES-2 Universal is different. This is why I decided to test its Universal shade (U) designed for all kinds of restorations in the posterior region in the context of replacing an amalgam restoration. The restoration that needed to be replaced due to secondary caries was located in the maxillary molar region of a male patient. As usual under amalgam restorations, the remaining healthy tooth structure showed some discolouration. The cavity was prepared, the enamel etched and the whole bonding surface treated with CLEARFIL™ SE Bond. Subsequently, the restoration was built up using CLEARFIL MAJESTY™ ES-2 Universal in several layers. For a natural appearance, some brown tint was added to the fissures before finishing and polishing. The restoration shows a natural integration into the surrounding structure and is able to mask the discolouration on the cavity floor. Fig. 1. Pre-operative image showing the amalgam restorations to be replaced. Fig. 2. Appearance of the tooth after removal of the amalgam, caries excavation and cavity preparation. Fig. 3. Tooth built up with CLEARFIL MAJESTY™ ES-2 Universal (U shade). FINAL SITUATION Fig. 4. Immediate treatment outcome. Dentist: DR. MICHAŁ POKOJSKI Dr. Michał Pokojski is a graduate of the Medical University of Łódź, Poland. He maintains his private practice in Starachowice, Świętokrzyskie Voivodeship. His passion is endodontics and esthetic conservative dentistry. In his everyday duties microscope and camera are his main tools to provide his patients with professional and precise procedures and to ensure proper level of communication and understanding. His practice was guided by EBD from the very beginning, because in his opinion knowledge, scientific facts and dedication for what you do are the fundamentals of medicine and dentistry as well. His goal is to treat patients at the highest level of quality using the best available materials, instruments and procedures. His cases are well-known in the world thanks to modern ways of communication like Facebook and Instagram. Mar 11, 2021
REALITY review of CLEARFIL MAJESTY™ ES-2 Universal Would you like to skip shade matching in direct posterior restorative procedures? You can, with CLEARFIL MAJESTY™ ES-2 Universal. See what the REALITY Evaluators have to say about the innovative product with a single posterior shade! Read the report to learn more! Content Highlights: Product overview Strengths and Weaknesses Manufacturer's page Start Reading: REALITY | RATINGS & REVIEWS | CLEARFIL MAJESTY™ ES-2 Universal Jan 17, 2022
Premolar case with CLEARFIL MAJESTY™ ES-2 Universal Case by Dr. Clarence P. Tam, HBSC, DDS, AAACD, FIADFE Case background A stable ASA 2 65 year old female presented to the practice for restorative dentistry with a medical history significant for a non-descript immunoglobulin deficiency, for which she receives regular infusions. She reports no known drug allergies. Clinically, she was diagnosed with an occlusal peripheral rim fracture leaving a food trap on tooth 14 (FDI notation). Tooth 15 featured an extensive amalgam with extreme proximity to the distal marginal ridge, which exhibited distal vertical axial fractures as a result of cyclic expansion-contraction over time. The restorative goal of minimally invasive direct dentistry would be complicated by the undoubtedly dark dentin substrate under the amalgam. A material was sought that featured both an excellent chameleon mechanism as well as physical properties to maximize the prognosis of direct restorations in this area. Restorative procedure The patient was subjected to topical anesthetic prior to buccal infiltration using 1 carpule of 2% Lignocaine with 1:100,000 epinephrine. A rubber dam was affixed prior to preparation of tooth 15MO with dissection of the distal vertical marginal ridge fracture. The margins of tooth 14O and 15MOD were refined before bevelling as the ends of enamel rods facilitate better bonding relative to the sides of enamel rods. A 27 micron aluminum oxide micro air abrasion treatment was completed prior to affixing, wedge and matrix to reconstruct the mesial marginal ridge of tooth 15. A matrix-in-matrix solution was used to recreate the proximoaxial contour of 15D. This provided hermetic closure at the proximogingival cavosurface margin as well as an ideal contour for the missing axial wall. Following a total etch technique, a 2% Chlorhexidine scrub was completed for 30 seconds and the dentin blot dried to a moist state. A 5th generation bond was applied, air thinned and cured as per manufacturer instructions. Microlayers are important during the delicate first 5 minutes of hybrid layer formation, and were completed using 0.25 mm increments of CLEARFIL MAJESTY™ Flow (Kuraray Noritake Dental Inc.). This technique can be expected to increase significantly the shear bond strength to dentin1,2. This was completed both in the proximal box floor area as well as mid-occlusally. The marginal ridge was completed using CLEARFIL MAJESTY™ ES-2 Universal (Kuraray Noritake Dental Inc.). Since the dentin base was heavily stained, CLEARFIL MAJESTY™ Flow was used before utilizing CLEARFIL MAJESTY™ ES-2 Universal in a lobe-by-lobe creation of occlusal anatomy. Post-operative occlusal checks verify that the restoration is conformative to occlusion and esthetically excellent with no visible marginal show. Rationale for material choice The marginal ridges were micro-layered horizontally as was the floor of the resulting Class I preparation as per a reduced layer thickness-technique modification of Nikolaenko et al3, whereas the highest shear bond strengths were found when a 1mm horizontal layering technique was used. CLEARFIL MAJESTY™ ES-2 Universal is at the forefront of a simplified restorative armamentarium for the modern practice. It takes cloud-shading one step further by offering a “Universal” shaded composite featuring Light Diffusion Technology (LDT) with simultaneous ideal sculptability, optical metamerism and physical properties for use in any restorative situation in the mouth. Featuring barium glass nano fillers and proprietary pre-polymerized nanoparticle fillers, the latter boasts a high refractive matrix that is able to disperse light and fool the eye with even the thinnest of layers, obviating the need for opaquer composites in cases like the one featured. When paired with CLEARFIL MAJESTY™ Flow in a conservative layered technique, the 81% filled flowable produces a radiographically well-demarcated layer, and the superficial CLEARFIL MAJESTY™ ES-2 Universal boasts an easy-to-polish robust single shade restorative solution that will virtually fulfil all of your restorative needs for non-bleaching patients. Physically, with compressive strength is rated at 348 MPa and flexural strength at 116 MPa, CLEARFIL MAJESTY™ ES-2 Universal is in the range of natural enamel and dentin. The built-in fluorescence is very enamelomimetic, which is excellent for nightclub social situations. FINAL SITUATION Dentist: DR CLARENCE P. TAM, HBSC, DDS, AAACD, FIADFE Clarence is originally from Toronto, Canada, where she completed her Doctor of Dental Surgery and General Practice Residency at the University of Western Ontario and the University of Toronto, respectively. Clarence’s practice is limited to cosmetic and restorative dentistry and she is well-published to both the local and international dental press, writing articles, reviewing and developing prototype products and techniques in clinical dentistry. She frequently and continually lectures internationally. Clarence is the Immediate Past Chairperson of the New Zealand Academy of Cosmetic Dentistry. She is currently one of two individuals in Australasia to hold Board-Certified Accredited Member Status with the American Academy of Cosmetic Dentistry. Clarence is an Opinion Leader for multinational dental companies Kuraray Noritake, J Morita Corp, Henry Schein NZ, Ivoclar Vivadent, Dentsply Sirona, 3M, Kerr, GC Australasia, SDI and Coltene and is the only Voco Fellow in Australia and New Zealand. She holds Fellowship status with the International Academy for DentoFacial Esthetics and is a passionate and approachable individual, committed to having an interactive approach with patients in all of her cases to maximize predictability. References 1. Bertschinger C, Paul SJ, Luthy H, Scharer P. Dual application of dentin bonding agents: effect on bond strength. Am J Dent. 1996;9(3):115-119.2. Magne P, Kim TH, Cassione D, Donovan TE. Immediate dentin sealing improves bond strengths of indirect restorations. J Prosthet Dent. 2005;94(6):511-519.3. Nikolaenko SA, Lohbauer U, Roggendorf M, Petschelt A, Dasch W, Franenberberger R. Influence of C-Factor and layering technique on microtensile bond strength to dentin. Dental Mater. 2004;20(6):579-585. Sep 20, 2022
CLEARFIL MAJESTY™ ES-2 Universal by Peter Schouten The introduction of universal composites, which are not only universal in terms of application range but also in terms of shade adaptation, effectively marks the dawn of a new type of composite. This prompts a reinterpretation of the term "universal composite." CLEARFIL MAJESTY™ ES-2 is a nanohybrid composite family. Nowadays, nanohybrid composites are commonly used as universal composites. They have a high filler content, they are strong, and they have exceptionally good polishability characteristics1. The newest variant in the CLEARFIL MAJESTY™ ES-2 range is CLEARFIL MAJESTY™ ES-2 Universal shade concept. For this composite; we expand the definition of universal and include shade coverage. Posteriorly, a single material in a single shade is sufficient to cover the entire VITA™ range. This means that no shade determination is required. For the anterior zone, we offer two shade variants: a lighter and a darker variant (UL and UD). The lighter variant is used in the A1-A2 range and the darker for shades from A3 onwards. There is sufficient overlap between UL and UD ensuring no specific shade determination is necessary. Finally, for situations that require extra lightness and brightness, an additional UW shade is available. What makes CLEARFIL MAJESTY™ ES-2 Universal unique in comparison to other universal or single-shade composites? The difference with CLEARFIL MAJESTY™ ES-2 Universal, is that without using an additional opaque composite, sometimes called a blocker, a successful, superbly matching restoration can be constructed. Not only with smaller cavities, but also with larger class I and II restorations. And, when used anteriorly, even an extensive Class IV restoration can be successfully constructed using CLEARFIL MAJESTY™ ES-2 Universal. So, it is not only for those small class III or V lesions. Why Kuraray Noritake Dental Inc. can do this where others cannot, is to a large extent, thanks to optimized light diffusion technology (LDT). By using this technology in composites with the right translucency, the light is scattered and reflected in such a way that the composite blends in with the surrounding tooth structure. Where others use the widely-employed chameleon effect, Kuraray Noritake Dental Inc. adds an extra dimension in the form of LDT. With the chameleon effect, light passes through the material and is reflected off the walls of the cavity. The perceived shade of the restoration is therefore the shade of the cavity walls. If the cavity is too large, thus requiring a larger amount of filling material, the light has to travel further and a large proportion of the light is absorbed. With this, the brightness of the restoration is reduced and the shade of the cavity walls no longer accurately reflected. Our LDT allows light to be scattered within the composite itself, in addition to being reflected off the cavity walls. As a result, CLEARFIL MAJESTYTM ES-2 Universal is a particularly forgiving composite. This feature will be familiar to those who have used CLEARFIL MAJESTY™ ES-2 family products before. CLEARFIL MAJESTY™ ES-2 Universal is the result of sophisticated filler, matrix and silane technology. It offers a solution for all your routine composite work. A consistently superb restoration where shade determination is a thing of the past. Reference 1 Ilie, N., & Hickel, R. (2011). Resin composite restorative materials. Aust Dent J, 56 Suppl 1, 59-66. doi:10.1111/j.1834-7819.2010.01296.x Sep 28, 2021
Simplifying esthetic composite reconstructions using CLEARFIL MAJESTY™ ES-2 Universal Article by Dr. Clarence Tam HBSc, DDS, FIADFE, AAACD A CHAMELEON SUPERCOMPOSITE INTRODUCTION The name of the game in modern-day esthetic and restorative dentistry is that of Responsible Esthetics. The goal of treatment typically strives to correct any structural and cosmetic shortfalls in both biologically-driven and trauma-affected teeth with the precise, artistic placement of various replacement layers, all whilst respecting and retaining a maximal volume of residual tooth structure. Anterior teeth can be affected by enamel and dentin dysplasia, caries and sclerotic conditions and are characterized by a laundry list of genetically-derived and environmentally-acquired conditions with an esthetic deficit that often threaten an individual’s functional and psychosocial integrity if not restored to the seamless picture of health. Missing and defective tooth structure must be categorized into its attendant enamel and dentin components. Both substrates are distinctly different in composition, with enamel being highly inorganic in nature and dentin proportionately more collagenous in nature. The latter stratum is responsible for the refraction of light, the expression of the true color of the tooth, namely the hue and the endowment of fracture toughness or resilience in functional performance. The value and chroma are the other elements of color and are modified by the thickness of enamel. The replacement of enamel has been found to be best substituted from a biomechanical perspective by adhesively-bonded indirect porcelain restorations, and dentin using both composite resin and short fiber reinforced composite (SFRC), the latter imparting increased fracture toughness in large volume replacement restorations, especially those with pericervical structural deficits. In adolescent patients, the gold standard of treatment involves direct composite resin, as often zero to minimal tooth structure preparation is required as a foundation to the bonded restorative. It would be impractical to use bonded indirect restorations when the development of the dentition in puberty is continuous, especially with the retraction of gingiva as one progresses to young adulthood. Resin composite allows prescience in the opportunity to predictably modify and/or add to the existing restoration if dental bleaching for the other teeth is desired or if a further traumatic incident is encountered. The ability to modify bonded porcelain is not predictable and frequent marginal failures occur due to a lower shear bond strength to bonded composite, especially after thermocycling. This is despite our ability to establish a chemical linkage via silane coupling agents from silicate ceramics to resin composite especially at a blended interface. STATEMENT OF PROBLEM Dental shades in clinical dentistry have long been classified using the VITA* Classical A1 – D4 shade guide. Despite being ubiquitous in dental practices, composite resin systems with corresponding shade systems do not satisfactorily match to their purported shade1. Floriani et al found that various mixtures of different shades in one system was required to achieve an acceptable color match with the VITA* Classical shades using the CIEDE2000 formula. Testing another composite resin, they found that none of the A1, A2 or A3 shades matched acceptably to the standard shade guide2. Indeed, even with indirect ceramic layering systems, a wide range of unacceptable discrepancy was noted between VITA* labeled porcelain shades and the actual shade guide3. The VITA* Classical shade guide became the standard in dental shade classification with the release of its A1-D4 shade guide in 1985. The majority of human-tested dental shades has been found to be in the A-family (78.5%), followed by C (13.2%), D (5.2%) and B (3.1%)1. As such, the shade accuracy of a given composite system must be important if they are to be visually naturomimetic. CHAMELEON EFFECT DEVELOPMENT There are myriad composite resin systems featuring a simplified shade Universal system that have acceptable chameleon effects due to their balance of translucency, light transmission, diffusion and refractive index properties. There is a concern over how these optical properties may change after both thermocycling and wet storage, potentially compromising the excellent initial esthetic blend4. Refractive index (RI) is best optimized when the RI of the inorganic fillers match closely with the RI of the cured organic matrix, typically in a range between 1.47 and 1.525. If the match is dissimilar, this drives up the opacity of the restoration due to heightened refraction and reflection at the filler/matrix interface6. Layering of composite to mask an intraoral defect is complicated by the need to mask any linear defects such as fracture lines superimposed over the shadowing of the dark intraoral cavity in addition to regional color variations. It is confounded by the requirement to recreate natural maverick and translucent effects particularly in the incisal window region of upper and lower incisors and canines, giving the illusion of a virgin, healthy tooth. This has been historically difficult to accomplish in anterior teeth given the need to block out restorative interfaces with natural tooth structure and recreate a seamless internal structure and details. This detailed layer belies a well contoured enamel layer with realistic translucency, polishability and accurate primary and secondary anatomy. Adding to the complexities described above, the histoanatomical approach to composite layering dictates that missing enamel is replaced by enamel shades, and dentin by the corresponding dentin shade in the appropriate shade. This shade must be selected at the very start of the appointment, as often even a minute of dehydration has a negative effect on both the perceptibility threshold and acceptability threshold of teeth7, resulting in the incorrect shade. DEVELOPMENT CLEARFIL MAJESTY™ ES-2 is a value-based super-nanofilled composite system that covers 15 VITA* shades in just 4 shade options with its Universal series. This Universal series provides a chameleon effect and has 4 variants: Universal (U), Universal Light (UL), Universal Dark (UD) and Universal White (UW). It is the VITA*-approved shading concept relative to color accuracy. Incorporating nano-fillers that consist of silanated barium glass fillers and slanted silica nanoclusters, its wear resistance is high and features minimal abrasiveness against the functional antagonist. The RI of both inorganic filler and organic matrix are well-matched, and the high refractive index of the composite mimics and is extremely similar to natural enamel (1.613) and dentin (1.540), thanks to an innovation labeled Light Diffusion Technology (LDT), which distorts light in a similar way dental tissue does8. There is comfort that the stability of refractive index and other optical transmission properties remains statistically stable even after artificial thermocycling and water-storage aging studies4. The color stability of CLEARFIL MAJESTY™ ES-2 has been proven over time, where a direct comparison to Filtek Ultimate showed CLEARFIL MAJESTY™ ES-2 to feature significantly less color variation from baseline and marginal functional wear over a three to four year period in teeth featuring amelogenesis imperfecta9. This color substantivity is important as dietary and environmental stressors applied over time should have as minimal effect on the restoration to ensure continued esthetic integration. CLINICAL PROTOCOL CLEARFIL MAJESTY™ ES-2 Universal is a monochromatic solution that covers the five key shades featured in the CLEARFIL MAJESTY™ ES-2 Premium. As such, it exhibits the most significant LDT relative to all five shades, as its ability is equal when blending to higher value translucent shades as it does to cervical chromatic shades. In a Class IV restoration with a defined fracture line, the challenge is to restore the tooth in a minimal volume of available space. The alchemy requires a complete visual occlusion of the fracture line position, and recreation of internal and external opaque and translucent anatomy along with maverick staining, craze lines and effects. In anterior teeth, the idiom of “the less you see, the less you notice” is not true, especially due to the presence of incisal edge window effects as above, however, materials with the best light diffusion and structure transference properties should be utilized to ensure the highest probability of success. A 15 year old ASA I female presented to the practice exhibiting aged, chromatic composite restorations with poor marginal integration and gross axial overhangs; essentially a gross failure of primary anatomy and esthetics. She had been involved in a bike accident where she high-sided off braking sharply in a face-meets-concrete scenario, resulting in an uncomplicated moderate enamel-dentin fracture with blushing, affecting both the facial and palatal aspects of tooth 1.1 and a mild uncomplicated enamel dentin fracture affecting the distoincisobuccolingual aspect of tooth 2.1. The restoration overhangs were significant, extending into the proximal contour zone, thus obviating effective interdental cleaning. Vitality tests were confirmed along with radiographs to exclude the presence of apical pathology. The patient accepted the option of pre-prosthetic whitening, to improve the value characteristics of the adjacent teeth, allowing the selection of a brighter value shade combination. Intraoral digital scans were acquired and custom bleaching trays with a no reservoir, cervical seal-priority design were fabricated. The patient was instructed to bleach overnight for a 2 week period using a 10% carbamide peroxide solution (Opalesence, Ultradent Products, UT) until her maximal value was reached. Her baseline shade of the incisors was a 1M1/2M1 combination in the upper incisors and a 2M1 in the lower incisors. On final post-bleach assessment she exhibited a lightened shade of VITA* 0M3 in all incisors. The patient was instructed to use a fluoride-containing, amorphous calcium phosphate complex (ToothMousse Plus, GC America) during the following 2 weeks after cessation of whitening whilst the residual oxygen radical species dissipated from the teeth. Fig. 1. Pre-operative unrestricted smile 1:2 ratio view, teeth 1.1 and 2.1 with old, defective composite restorations with excessive chroma. On the day of the procedure, the pre-dehydrated shade was assessed using the supplied “real composite” shade guide tabs featured in the CLEARFIL MAJESTY™ ES-2 Premium system, with the enamel shade being WE (White Enamel) and the dentin shade WD (White Dentin). It was assessed that both white maverick effects as well as a moderate halo effect was desired along with moderate to strong translucency in the incisal window. The patient was anesthetized using 1.5 carpules of 2% Lignocaine with 1:100,000 epinephrine (Septodont) before a rubber affixed with individual ties for the central incisors (NicTone Medium). Excavation of the old restorative material was undertaken, and the residual natural incisal edge was found to be undermined by a through-and-through fracture. Thus, the preparation was converted into a true Class IV design, with the facioincisal cavosurface margin subjected to an infinity bevel. The maxillary central incisors were isolated from the lateral incisors by way of a serrated metal strip (Komet) and the prepared surfaces subjected to micro particle abrasion using a 29 micron aluminum oxide powder in 17.5% ethanol carrier (Aquacare). The surfaces were subsequently treated with a calcium sodium phosphosilicate powder (Sylc, Aquacare) to increase the inorganic content of the prepared surface especially extending into the exposed tubules. The teeth were etched using a 33% orthophosphoric acid before a 1 minute 2% chlorhexidine scrub (Vista Products). The surface was reduced to a moist dentin surface before the bond applied, air thinned and cured. A Mylar strip was pre-crimped in the palatoproximal line angles and positioned on the linguoaxial surface of both teeth 1.1 and 2.1. There is no shade guide for the CLEARFIL MAJESTY™ ES-2 Universal U shade, as it bears a significant chameleon effect however it does come in a light (L) and dark (D) variant. The UL shade was deemed the most suitable for the palatal or lingual shelf, with an average thickness of 0.3mm. This layer was applied in a freehand fashion with a focus on establishing the desired outline form of the tooth relative to the contralateral 2.1. The Mylar matrix setup was removed and a precurved metal matrix (Garrison Slickband, Garrison Dental) was oriented in a position perpendicular to its normal placement interproximally, and the end of the curved band tucked into the sulcus before being secured by a wedge. In this way, there is light separation of the central incisors and an intimate contact between the matrix band and the mesial edge of the freshly applied lingual shelf. A 0.5mm frame extending more than halfway through the contact point was created and cured. The process was repeated on tooth 2.1 with the goal of recreating both lingual and proximal walls of the restoration, leaving only the facial volume to be replaced. Fig. 2. Pre-crimped Mylar matrix repeated on the DIBP aspect of tooth 2.1 to close the available space. CLEARFIL MAJESTY™ ES-2 Universal UL is used here. Block-out of the composite extensions against the natural tooth structure was achieved by opacification using an opaque composite resin (WD, CLEARFIL MAJESTY™ ES-2 Premium, Kuraray Noritake Dental Inc.) layered in both horizontal and vertical increments. It is noted that the restorative join line must be completely obscured at the end of layering the dentin volume, otherwise the case will have almost certain esthetic failure. The internal dentin anatomy and its inherent variation was created to mirror that of the 2.1, which had minimal compromise of its incisal window with details intact. A super translucent composite resin (Clear, CLEARFIL MAJESTY™ ES-2 Premium, Kuraray Noritake Dental Inc.) was placed between the lobes of the dentin layers and cured. A 9:1 ratio of white: orange tint was mixed and placed on the incisal edge and proximoincisal corners to recreate the halo effect. A pure white tint was placed in gentle dentin mamelon-connecting spider legs up to the incisal edge to impart the realism. This was layered in a manner consistent with the appearance of the 2.1. Fig. 3. Both horizontal and vertical dentin composite increments are demonstrated mimicking the contralateral tooth. Fig. 4 & 5. Final immediate post-operative result after finishing and polishing. DISCUSSION The esthetic merit of this case is foundationally supported by composite resin technology on multiple levels. The color and physical stability over time needs to be proven in order for the clinician to have faith in its prognostication. Specifically, the material needs to have an excellent and well-matched refractive index, and one that is unaffected by both water and thermocycling stressors. The palatal shelf was fabricated using a new-generation super nano-filled universal composite system that boasts a strong chameleon effect. If it is our intention to fool the eye, to obscure, then this first layer works well to start the blockout process of the darkness of the mouth behind the fracture line of the restored tooth. Following this, the chroma and value of the tooth are corrected using the dentin, simultaneous to its continued opacification of the fracture line and intraoral darkness. Both dentin and enamel layers are applied histoanatomically, that is, in a manner respecting the various thickness zones observed in nature. Ultimately, esthetic success in direct composite resin is not dictated on the first day post-operatively. Factors are in play, from dehydration to occlusal wrinkles that need to be ironed out and corrected. The win depends on what material is used, along with how that material was developed to what standards, and why shade accuracy is so important in a world of variety. In a dental world with myriad composite options, we are looking for precision. Precision in technology leads to efficiency and physicoesthetic maintenance in clinical results. This ultimately results in a boost to clinician-patient confidence and an optimal prognosis. Dentist: CLARENCE TAM *VITA is a trademark of VITA Zahnfabrik, Bad Sackingen, Germany References 1. Elamin HO, Abubakr NH, Ibrahim YE. Identifying the tooth shade in group of patients using Vita Easyshade. Eur J Dent. 2015 Apr-Jun;9(2):213-217. doi: 10.4103/1305-7456.156828. PMID: 26038652; PMCID: PMC4439848.2. Floriani F, Brandfon BA, Sawczuk NJ, Lopes GC, Rocha MG, Oliveira D. Color difference between the vita classical shade guide and composite veneers using the dual-layer technique. J Clin Exp Dent. 2022 Aug 1;14(8):e615-e620. doi: 10.4317/jced.59759. PMID: 36046166; PMCID: PMC9422970.3. Gurrea J, Gurrea M, Bruguera A, Sampaio CS, Janal M, Bonfante E, Coelho PG, Hirata R. Evaluation of Dental Shade Guide Variability Using Cross-Polarized Photography. Int J Periodontics Restorative Dent. 2016 Sep-Oct;36(5):e76-81. doi: 10.11607/prd.2700. PMID: 27560681.4. Almasabi W, Tichy A, Abdou A, Hosaka K, Nakajima M, Tagami J. Effect of water storage and thermocycling on light transmission properties, translucency and refractive index of nanofilled flowable composites. Dent Mater J. 2021 May 29;40(3):599-605. doi: 10.4012/dmj.2020-154. Epub 2020 Dec 24. PMID: 33361663.5. Arai Y, Kurokawa H, Takamizawa T, et al.. Evaluation of structural coloration of experimental flowable resin composites. J Esthet Restor Dent. 2020;e12674.6. Ota M, Ando S, Endo H, et al.. Influence of refractive index on optical parameters of experimental resin composites. Acta Odontol Scand. 2012;70(5):362–367.7. Suliman S, Sulaiman TA, Olafsson VG, Delgado AJ, Donovan TE, Heymann HO. Effect of time on tooth dehydration and rehydration. J Esthet Restor Dent. 2019 Mar;31(2):118-123. doi: 10.1111/jerd.12461. Epub 2019 Feb 23. PMID: 30801926.8. Meng Z, Yao XS, Yao H, Liang Y, Liu T, Li Y, Wang G, Lan S. Measurement of the refractive index of human teeth by optical coherence tomography. J Biomed Opt. 2009 May-Jun;14(3):034010. doi: 10.1117/1.3130322. PMID: 19566303.9. Tekçe N, Demirci M, Sancak EI, Güder G, Tuncer S, Baydemir C. Clinical Performance of Direct Posterior Composite Restorations in Patients with Amelogenesis Imperfecta. Oper Dent. 2022 Nov 1;47(6):620-629. doi: 10.2341/21-106-C. PMID: 36281978. Dec 31, 2024
Interview: Dr Adham Elsayed discusses CLEARFIL MAJESTY™ ES-2 Universal In this interview, Dr Adham Elsayed, certified specialist in dental prosthodontics and implants and clinical and scientific manager at Kuraray Noritake Dental, details the benefits of the company’s new CLEARFIL MAJESTY™ ES-2 Universal composite and explains its application in the daily dental workflow. Though dentists are becoming increasingly specialised, there’s a growing demand for products that can be used for all indications. How does CLEARFIL MAJESTY™ ES-2 Universal fit this model? First, we need to explain the meaning of the term ‘universal’ in this context. Previously, there have been two types of composites that differ according to the area of application: anterior composites, used in Class III, IV and V restorations where the aesthetic outcome is the priority, and posterior composites, in which the mechanical properties like strength and wear rate are more important. Universal composites, then, are those that can be used for all types of restorations in the anterior as well as the posterior region. Another way in which ‘universal’ can be considered is in relation to shade. In this case, the term is used to describe a restorative composite system that exists in fewer shades, one that can adapt to the tooth structure independent of the colour of the tooth. A major benefit of this type of composites is that it offers a simplified workflow. CLEARFIL MAJESTY™ ES-2 Universal is essentially universal in both meanings: it is one system that can be used for posterior and anterior restorations, and it is also provided in only three shades—one for posterior, and two for anterior. Universal products, whether they are luting cements, bonding agents or composites, are attractive to dentists as long as they offer simplification of the treatment procedure without compromising quality and durability. How does CLEARFIL MAJESTY™ ES-2 Universal build upon the success of the CLEARFIL MAJESTY™ range? The CLEARFIL MAJESTY™ family is very well established at this stage. It includes such products as CLEARFIL MAJESTY™ Posterior, one of the most popular posterior composites owing to its superior mechanical properties and minimal polymerisation shrinkage. CLEARFIL MAJESTY™ ES-2 is an extensive system that is highly beneficial thanks to its outstanding optical properties and ability to produce high-end aesthetics in the anterior region using Kuraray Noritake Dental’s multilayering technique. The three flowable alternatives of CLEARFIL MAJESTY™ ES Flow, with different consistencies, are also other successful members of the family. Kuraray Noritake Dental now continues the success story of CLEARFIL MAJESTY™ with the latest innovative product that can change the definition of the universal composite. CLEARFIL MAJESTY™ ES-2 Universal incorporates several attributes from the well-established ES-2 and ES Flow, including Kuraray Noritake Dental’s light diffusion technology (LDT). Speaking of LDT—how does this technology benefit the composite? LDT allows the material to scatter and reflect light rays at many different angles, which, in turn, allows the composite restoration to diffuse light in a similar way to the surrounding tooth structure. Hence, it eliminates aesthetic problems like the visibility of restoration and preparation borders. Thanks to innovative LDT, optimal particle fillers and opacity, CLEARFIL MAJESTY™ ES-2 Universal blends seamlessly with the surrounding tooth structure and emulates natural teeth, eliminating the need for shade selection. As you mentioned, CLEARFIL MAJESTY™ ES-2 Universal comes with one shade for posterior restorations and two for anterior restorations. Can such a reduced shade range still truly deliver aesthetic restorations? CLEARFIL MAJESTY™ ES-2 Universal is not the first composite on the market with a reduced shade system. However, we can safely say that it is the first to focus on aesthetics and not just on reducing the number of shades. We know from experience that using one-shade composite systems in the anterior region mostly leads to unsatisfying aesthetic results, even with the use of an opaquer composite to reduce shade-matching interference. This is due to the fact that trying to provide one shade for all posterior and anterior restorations, and for all tooth shades, compromises the aesthetic to a high extent. In other words, using a highly translucent material to try to match all restorations and shades will result in the interference of other objects in the mouth, such as the tongue, gingivae and so on. Kuraray Noritake understood this fact well and solved the problem by introducing three shades with translucencies designed to match specific indications. It is important to note the simplicity of the workflow, since only one syringe per restoration is required. This makes CLEARFIL Majesty™ ES-2 Universal a true game-changer, as it provides the perfect match between simplicity and aesthetics. What other advantages does this new composite deliver? Other advantages include the superior mechanical properties for which the CLEARFIL MAJESTY™ family is already known, such as favourable wear properties, low shrinkage stress and high strength. It can be polished easily and retains its gloss. Moreover, the handling of the material is a huge advantage: this includes a long working time of about 270 seconds under ambient light. It is non-sticky and can be sculpted easily. Which dental professionals would benefit most from this product? The perfect match between simplicity and aesthetics offers the clinician several benefits. It delivers a very straightforward time-saving procedure without compromising aesthetic results. There is no need for exact shade selection, thereby excluding visible errors of non-matching shades, and there is also a reduced amount of material stock needed. Therefore, in my opinion, this should be the product of choice for most cases in everyday practice. Advances and developments in dental materials are rapidly accelerating, and clinicians should integrate these innovations and make their daily practice more efficient with simplified workflows, time-saving procedures, fewer material selections and, accordingly, less technique sensitivity and less need for dental practice personnel to become acquainted with an abundance of materials. Feb 9, 2021
Answering your needs In modern dental practice, there is a strong need for materials that combine convenient handling and procedural efficiency with aesthetic, durable results. These materials enable dental practitioners to achieve desired outcomes more efficiently, enabling them to spend more time on personal interaction with their patients. In the context of direct restorative treatments, the selected resin composite has a strong impact on the simplicity of procedures and the quality of the outcomes: This is why universal paste-type composites, such as CLEARFIL™ MAJESTY ES-2 Universal (Kuraray Noritake Dental Inc.) are becoming increasingly popular. With CLEARFIL™ MAJESTY ES Flow Universal, the same company has now introduced a flowable composite that offers similar benefits, summarized below by answering your key questions. How can you achieve aesthetic, durable restorations with flowable ease? CLEARFIL™ MAJESTY ES Flow Universal is a flowable solution with two complementary shades designed for intuitive shade matching that supports a range of restorative procedures. It combines practical flow characteristics with advanced shade-blending ability and outstanding mechanical properties. Low Flexural strength 151 MPa. Compressive strength 373 MPa. Filler load 75 wt/% / 59 vol%. Radiopacity 140 % Al. Super Low Flexural strength 152 MPa. Compressive strength 374 MPa. Filler load 78 wt/% / 60 vol%. Radiopacity 150 % Al. What is CLEARFIL™ MAJESTY ES Flow Universal? CLEARFIL™ MAJESTY ES Flow Universal is a light-cured, radiopaque composite resin designed for a variety of clinical situations, available in two viscosities and 2 shades. It features nano-filler technology that allows for controlled flow, polish retention, and natural-looking restorations. Seamless blending of the composite is achieved by having a smart combination of an enamel-like translucency, dentin-like chroma and Light-Diffusion Technology (LDT). The enamel-like translucency allows light to transmit through the material, enhancing the color integration with surrounding tooth structure. LDT makes restorations diffuse light in a similar way as enamel and dentin. Together with the fine-tuned chroma, these characteristics contribute to a smooth optical integration of the material into the surrounding tooth structure. Where can you use CLEARFIL™ MAJESTY ES Flow Universal? This flowable composite is intended for a wide scope of restorative needs. From Class I-V restorations to pit and fissure sealing and repairs, it is formulated for use in both conservative and comprehensive treatment plans. CLEARFIL™ MAJESTY ES Flow Universal may be used for: Direct restorations for all cavity classes, cervical lesions (e.g. root surface caries, v-shape defects), tooth wear, and tooth erosion. Cavity base / liner. Correction of tooth position and tooth shape (e.g. diastema closure, tooth malformation). Intraoral repair of fractured restorations. How is shade selection accomplished? Shade selection is virtually effortless with CLEARFIL MAJESTY™ ES Flow Universal. The two complementary shades, universal (U) and universal dark (UD), are intuitively selected – no shade guide needed. Shade U is suitable for most posterior and anterior restorations. UD performs best in darker-shade teeth (B3 and above) with a low amount of surrounding tooth structure, including Class III and IV cavities. Depending on the cavity class and age of the patient, you may pick the shade that fits best. Color matching with anterior and posterior restorations. What contributes to the performance of CLEARFIL™ MAJESTY ES Flow Universal? The formulation includes several features aimed at clinical effectiveness: Nano-filler technology: Maintains an optimal filler load for reduced shrinkage, enhanced wear resistance, and long-term polish retention. Universal shade adaptation: Offers good visual integration with surrounding tooth structure, supporting streamlined shade selection. Thixotropic handling: Flows under pressure during placement but remains stable once in position, enabling precise application. Why consider CLEARFIL™ MAJESTY ES Flow Universal? Clinicians may find CLEARFIL™ MAJESTY ES Flow Universal beneficial due to its: Predictable handling and delivery. Aesthetic outcomes for both anterior and posterior restorations. Resistance to wear and surface degradation. Radiopacity that supports radiographic evaluation. Adaptability across a variety of restorative needs. How do you apply CLEARFIL™ MAJESTY ES Flow Universal? The application is straightforward and fits into standard clinical workflows: Prepare and isolate the area as required. Apply a compatible adhesive (e.g., CLEARFIL™ Universal Bond Quick 2). Dispense the material using the syringe and fine-tip applicator. Light-cure according to the manufacturer’s guidelines (typically 20 seconds, depending on the shade and curing light used). Finish and polish to complete the restoration. Syringe-based delivery supports controlled application and convenience. Direct restoration with CLEARFIL MAJESTY™ ES Flow Universal. Has CLEARFIL™ MAJESTY ES Flow Universal been evaluated by independent sources? Yes. CLEARFIL™ MAJESTY ES Flow Universal (Super Low) has been evaluated by dental professionals through third-party testing and peer-reviewed feedback. Most recently, it received Research Award 2025 from The Dental Advisor. In their conclusion, the evaluators from the U.S.-based publication stated: “Testing shows this composite to have among the highest physical properties for flowable composites that rivals the strongest packable composites in flexural strength, and compressive strength with an ideal radiopacity.” A versatile flowable option: CLEARFIL™ MAJESTY ES Flow Universal CLEARFIL™ MAJESTY ES Flow Universal is intended to support restorative procedures by combining controlled handling, aesthetic integration, and mechanical durability. It can be a practical choice for clinicians seeking a dependable flowable resin for a wide range of clinical scenarios. Read more > Universal Excellence - Smart Streamlined Solutions At Kuraray Noritake Dental Inc., we understand the demands of modern dental practices. Balancing complex procedures, tight schedules, and patient needs is no easy task. That is why we have been on a relentless journey to streamline, enhance, and refine every step of your work for decades. Our vision is clear: a world where your materials and tools work seamlessly in your hands, where complexity is minimized, and where you are given enough time to focus on what matters most: the individual desires and needs of every single patient. This is the future of dentistry, and together, we’re making it happen. Read more > Jul 29, 2025
