TiBase cementation is a routine step in many dental laboratory workflows — yet it remains a critical one. Getting the bond right between zirconia restorations and titanium bases is essential for the long-term success of implant-supported restorations.

 
In this video, we walk through a complete, step-by-step lab protocol using PANAVIA™ V5, covering all key stages from surface preparation and controlled sandblasting to priming, cement application, and final finishing. The workflow is designed to help you achieve consistent, high-strength adhesion while maintaining efficiency and control in your daily lab work.

By following this structured approach, you can minimise risk, improve predictability, and deliver durable clinical outcomes.

 
Discover more: Explore PANAVIA V5 and the KATANA™ Zirconia range.

Article by Peter Schouten

The restoration of endodontically treated teeth often requires the use of core build-ups to provide a foundation for the final restoration. Historically, root posts served as a common method to enhance retention and stability for core build-ups. However, resin composite materials have gained popularity for core build-ups due to their excellent aesthetics, adhesive properties, and versatility. As the reinforcement of the remaining tooth structure (and replacing the missing tooth structure) remains fundamental, the decision to use a root post is a subject of ongoing debate.

This article aims to explore several key factors related to restoring endodontically treated teeth using resin composite with or without the introduction of a root post.

HISTORY

Core build-ups with a root post originally used metal as a post material for their strength. Stainless steel, titanium, and gold were popular choices. However, concerns about potential complications like root fractures prompted a shift in treatment philosophy.

The advent of adhesive dentistry brought about the rise of resin composite core build-ups, offering a less invasive and more conservative alternative. The possibility of bonding restorative materials to dental tissue reduced the need to remove sound dental tissue. This shift in perspective allows for a more conservative approach, prioritizing tooth preservation while still providing sufficient strength and retention for long-term success.

POST OR NO POST

Preserving as much tooth structure as possible is a general prerequisite in modern dentistry. Therefore, omitting the use of a post must be considered, especially in cases where root dentine must be sacrificed to create sufficient space and access to insert the post. The decision to use a post should consider the following factors:

1. The amount and quality of the remaining tooth structure*
2. The presence of a ferrule effect
3. The clinician's experience

*Several studies suggest that in cases where an adequate amount of tooth structure remains and when the remaining tooth structure is of good quality, root posts may not be necessary.

THE AMOUNT AND QUALITY OF THE REMAINING TOOTH STRUCTURE

Preserving as much dental tissue as possible is the first requirement. The presence of at least two intact axial walls is considered ideal for optimal clinical outcomes. Teeth with no- or only one residual wall appear to have reduced survival rates compared to teeth with more than one wall.

THE PRESENCE OF A FERRULE EFFECT

The ferrule effect refers to the presence of a circumferential band of tooth structure encircling the coronal portion of the tooth. This effect has been shown to contribute significantly to the resistance of the restored tooth to fracture. Minimal ferrule dimensions are not set in stone. Some general recommendations can be given to help evenly distribute forces, resist occlusal forces, and give enough retention. The ferrule should ideally extend at least 2 mm above the cementoenamel junction, have a circumferential width of approx. 1 mm and a thickness of 1 to 1.5 mm. Finally, the axial walls should have a slight taper towards the occlusal plane.

*This flowchart has been put together with the greatest care. The “workflows” shown in this article only intended as a brief indication of the actual procedure to follow. This procedure is for general information purposes only and no rights may be derived from it. Always follow the instructions for use (IFU) that come with the product(s).

THE ADHESIVE APPROACH

Proper adhesive techniques should be employed to maximise the bond strength between the post, luting agent, and root canal walls. Here are several issues to look out for:

Debonding

It is believed that debonding is one of the most common failures in teeth restored with adhesively cemented endodontic posts and can be directly associated with adhesive bonding issues within the root canal (e.g., insufficient polymerisation, inadequate application of adhesive, resin and reduced evaporation of solvents). The right choice of materials plays an important role here.

Appropriate Post-Cementation Procedure

First of all the selection of the proper adhesive system should consider factors such as bond strength, biocompatibility, and ease of use. Various adhesive strategies have been suggested for cementing posts, ranging from the separate application of adhesive (etch-and-rinse as well as self-etch adhesives) and resin cement, to the use of self-adhesive resin cement. Compared to etch-and-rinse adhesives, the bond strength of self-etch systems to root canal dentine seems not strongly affected by the post-space region. Zenthöfer et al. concluded the performance of self-etch adhesives to be comparable with that of materials processed using the total-etch technique, at least in the short term.

Clean Surface

An adequately performed adhesive cementing procedure, including a clean dentine surface, seems important for the success of the coronal restoration of endodontically treated teeth.** Remaining sealer after post-space preparation negatively influences the bondability of the root canal dentine. Tian et al. conducted a study comparing the effectiveness of different sealer cleaning methods prior to bonding procedures. They found KATANA™ Cleaner to be capable of restoring the bonding potential to sealer contaminated dentine.

Direct Composite Resin Core Build-Ups

Today, the use of direct composite resins for core build-ups has become popular. Their use permits the conservation of dentine and facilitates adhesive bonding to the radicular and root dentine. The continuous development of (self-adhesive) resins, both cement and build-up materials, has provided greater applicability to endodontically treated tooth restoration. With proper tooth preparation, adhesive techniques and protocols, direct composite resin can provide predictable and long lasting results.

CLEARFIL Universal Bond Quick 2 and CLEARFIL DC CORE PLUS

Using adhesives in core build-ups and post & core restorations can be challenging because of the need for adequate energy from the curing light to polymerise the adhesive properly. To overcome curing problems in deeper root canal regions, manufacturers have developed self-cure promoters that can be added to light-curable adhesives. These, however, can lead to pooling of the adhesive in the apical area of post preparations, hampering the insertion of the post to the desired depth and also limit the working time. Kuraray Noritake Dental Inc. addressed this clinical issue with an advanced and improved single-component self-etch adhesive, CLEARFIL™ Universal Bond Quick 2, when combined with CLEARFIL™ DC CORE PLUS dual-cure core build-up resin composite. New initiators have been added to the adhesive and core build-up resin as an alternative to using a self-cure promoter, causing CLEARFIL Universal Bond Quick 2 to set when CLEARFIL DC CORE PLUS contacts the adhesive.

Improved properties

Kuraray Noritake Dental Inc. has improved their dual-cure core build-up resin, CLEARFIL DC CORE PLUS, to offer better flow during dispensing and stability afterwards of the uncured resin core material. The filler technology has been modified in a way that the paste became thixotropic. This "non-slumping formula" enables easy dispensing and allows the creation of a build-up without the need for a matrix. The improved flow also permits its use, combined with CLEARFIL Universal Bond Quick 2, for the cementation of posts, resulting in a product that is suitable for post cementation as well as the build-up.

Core composite or adhesive cement?

In clinical situations where a post is included, the post-cementing process can be covered with either CLEARFIL DC CORE PLUS or PANAVIA™ SA Cement Universal. The latter one can be used with or without CLEARFIL Universal Bond Quick 2. Choosing between the two products is, for a large part, dependent on the space between the post and the canal wall:

1. Tight-fit: So-called tight-fit situations, meaning the post snugs tightly to the canal, might benefit from using a highly bondable resin cement of low thickness (PANAVIA SA Cement Universal).
2. Loose-fit: Loose-fit cases need a larger amount of resin-based material and are better off using a material that has better physical properties for use as a filling material (CLEARFIL DC CORE PLUS) instead of cement.

CONCLUSION

The general prerequisite in modern dentistry is to preserve as much tooth structure as possible. Based on the premises identified in this article, the choice for the placement of a post and the use of the restorative materials can be decided based on the case in front of the clinician. The stability of core build-ups is no longer dependent on the support by a post. After analyzing the remaining tissue and keeping in mind the success factors for a strong bond, patients can be offered highly aesthetic and sustainable restorations without large interventions.

*This flowchart has been put together with the greatest care. The “workflows” shown in this article only intended as a brief indication of the actual procedure to follow. This procedure is for general information purposes only and no rights may be derived from it. Always follow the instructions for use (IFU) that come with the product(s). Please note that only a selection of treatment options have been explored. Our main focus is on the use of a core build-up composite and fibre post placement.

The following sources of information were used in writing this article:

• Zenthofer, A., Bermejo, J. L., Bomicke, W., Frese, C., Gulmez, R., Rammelsberg, P., & Ohlmann, B. (2022). Early failures when using three different adhesively retained core build-up materials-a randomized controlled trial. Clin Oral Investig, 26(2), 1927-1936. doi:10.1007/s00784-021-04170-6
• Tian, F., Jett, K., Flaugher, R., Arora, S., Bergeron, B., Shen, Y., & Tay, F. (2021). Effects of dentine surface cleaning on bonding of a self-etch adhesive to root canal sealer-contaminated dentine. J Dent, 112, 103766. doi:10.1016/j.jdent.2021.103766
• Bhuva, B., Giovarruscio, M., Rahim, N., Bitter, K., & Mannocci, F. (2021). The restoration of root filled teeth: a review of the clinical literature. Int Endod J, 54(4), 509-535. doi:10.1111/iej.13438
• Ozcan, M., & Volpato, C. A.M. (2020). Current perspectives on dental adhesion: (3) Adhesion to intraradicular dentine: Concepts and applications. Jpn Dent Sci Rev, 56(1), 216-223. doi:10.1016/j.jdsr.2020.08.002
• Lazari, P. C., de Carvalho, M. A., Del Bel Cury, A. A., & Magne, P. (2018). Survival of extensively damaged endodontically treated incisors restored with different types of posts-and-core foundation restoration material. J Prosthet Dent, 119(5), 769-776. doi:10.1016/j.prosdent.2017.05.012
• Carvalho, M. A., Lazari, P. C., Gresnigt, M., Del Bel Cury, A. A., & Magne, P. (2018). Current options concerning the endodontically-treated teeth restoration with the adhesive approach. Braz Oral Res, 32(suppl 1), e74. doi:10.1590/1807-3107bor-2018.vol32.0074
• Magne, P., Lazari, P. C., Carvalho, M. A., Johnson, T., & Del Bel Cury, A. A. (2017). Ferrule-Effect Dominates Over Use of a Fiber Post When Restoring Endodontically Treated Incisors: An In Vitro Study. Oper Dent, 42(4), 396-406. doi:10.2341/16-243-L
• Scotti, N., Rota, R., Scansetti, M., Migliaretti, G., Pasqualini, D., & Berutti, E. (2012). Fiber post adhesion to radicular dentine: The use of acid etching prior to a one-step self-etching adhesive. Quintessence Int, 43(7), 615-623. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/22670257
• Ferrari, M., Vichi, A., Fadda, G. M., Cagidiaco, M. C., Tay, F. R., Breschi, L., Goracci, C. (2012). A randomized controlled trial of endodontically treated and restored premolars. J Dent Res, 91(7 Suppl), 72S-78S. doi:10.1177/0022034512447949
• Breschi, L., Mazzoni, A., De Stefano Dorigo, E., & Ferrari, M. (2009). Adhesion to Intraradicular
• Dentine: A Review. Journal of Adhesion Science and Technology, 23(7-8), 1053-1083. doi:10.1163/156856109X440957
• Watzke, R., Blunck, U., Frankenberger, R., & Naumann, M. (2008). Interface homogeneity of adhesively luted glass fiber posts. Dent Mater, 24(11), 1512-1517.doi:10.1016/j.dental.2008.03.022
• Fokkinga, W. A., Kreulen, C. M., Bronkhorst, E. M., & Creugers, N. H. (2007). Up to 17-year controlled clinical study on post-and-cores and covering crowns. J Dent, 35(10), 778-786. doi:10.1016/j.jdent.2007.07.006
• Fokkinga W.A. Post it? Reconstruction of the endodontically treated tooth. Thesis. ISBN: 978-90-9021726-0
• Fokkinga, W. A., Kreulen, C. M., & Creugers, N. H. (2006). [In vitro fracture behaviour of composite crowns with and without posts]. Ned Tijdschr Tandheelkd, 113(8), 313-318. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/16933594

By Dr. Gintautas Rumbaitis, DDS

A CLINICAL CASE EXAMPLE

Low polymerization shrinkage, high strength and excellent wear resistance are among the most important criteria when selecting a restorative material for the posterior region. Low shrinkage supports marginal integrity after curing, while high mechanical strength provides for long-term stability even under high occlusal load. High wear resistance, in turn, contributes to long-term morphological stability. Together, these characteristics form the basis for the long-term success of posterior restorations.

The CLEARFIL MAJESTY™ family from Kuraray Noritake Dental Inc. offers materials designed to meet these requirements. They enable the creation of restorations that not only provide an appealing aesthetic outcome, but - more importantly - effectively restore the function and anatomy of the teeth. The portfolio includes a range of paste-type composites supporting different shade concepts, from single-shade to multi-shade approaches, as well as high-strength flowable composite materials.

CLEARFIL MAJESTY™ ES Flow is available in three levels of flowability and multiple shades. The universal alternative introduced in 2025, CLEARFIL MAJESTY™ ES Flow Universal, is offered in Low and Super Low flowabilities and two shades. These flowable materials provide the mechanical properties required for the successful restoration of all cavity classes. They can be used alone or in combination with paste-type composites, allowing clinicians to select the restorative concept best suited to each clinical situation.

A restoration procedure combining the new flowable material with a paste-type composite from the MAJESTY family (CLEARFIL MAJESTY ES-2) is demonstrated below using a clinical case example.

The patient presented for replacement of existing composite restorations in the posterior region. Clinical examination revealed that the restoration on the maxillary left first molar (FDI notation: tooth #26) showed marginal leakage as well as insufficient anatomical structure and occlusal height (Fig. 1). Replacement of the restoration was therefore planned. The clinical procedure is illustrated and described in Figures 2-12, while Figures 13-15 show the treatment outcome.

Fig. 1. Restoration on the first molar that needs to be replaced.

Fig. 2. Situation after removal of  the existing restoration. Removal  of the remains near the cavity floor performed using a carbide burr, without water, at slow speed.

Fig. 3. Cavity checked using Caries Detector (Kuraray Noritake Dental Inc.) for remaining decay.

Fig. 4. A distal crack is observable on the proximal wall of the first molar.

Fig. 5. Appearance after dissection of the cracked area and careful removal of the remnants of the composite restoration.

Fig. 6. Tooth after placement of a sectional matrix and sandblasting of the surface with 27 µm aluminium oxide powder.

Fig. 7. Selective etching with phosphoric acid etchant for 15 seconds.

Fig. 8. Strengthening of the cavity floor with fibres embedded in CLEARFIL™ AP-X composite (Kuraray Noritake Dental Inc.)

Fig. 9. Application of CLEARFIL MAJESTY ES Flow Universal in the shade UD (Universal Dark) in 2 mm increments, primarily to replace the dentin.

Fig. 10. Modelling of the occlusal area with CLEARFIL MAJESTY ES Flow Universal in the shade U (Universal).

Fig. 11. Modelling finished.

Fig. 12. Brown stains and CLEARFIL MAJESTY ES-2 in the shade WD applied for optical effects.

Fig. 13. Result of the polishing procedure.

Fig. 14. Buccal view of the polished restoration.

Fig. 15. Immediate treatment outcome with the tooth structure still being dehydrated.

CONCLUSION

The presented clinical case demonstrates how posterior teeth can be restored predictably and efficiently using materials from the CLEARFIL MAJESTY ES-2 portfolio. The combination of CLEARFIL MAJESTY ES Flow Universal as a flowable base layer and CLEARFIL MAJESTY ES-2 as a paste-type composite enables controlled placement, excellent adaptation to the cavity walls and the precise reconstruction of anatomical structures.

Thanks to their low polymerization shrinkage, high mechanical strength and excellent wear resistance, the materials support marginal integrity and functional stability over time. At the same time, the wide range of flowabilities and shade concepts provides dental practitioners with the flexibility desired to adapt the restorative concept to individual preferences and clinical situations.

CHOOSE AWARD-WINNING TEETHMATE DESENSITIZER

Immediate relief, long-term protection, and easy application — these are key requirements when managing dentin hypersensitivity. With TEETHMATE™ DESENSITIZER, Kuraray Noritake Dental Inc. offers a non-invasive, clinically proven solution designed to provide rapid and lasting relief.

TEETHMATE DESENSITIZER is a powder-liquid formulation that, once mixed, creates a hydroxyapatite slurry. Applied to exposed or freshly prepared dentin, this slurry seals open dentinal tubules. As the material sets, hydroxyapatite crystals are formed, providing a biomimetic barrier that supports both immediate pain relief and long-term sensitivity reduction — without affecting bond strength when applied in the context of restorative procedures.

Key benefits of TEETHMATE DESENSITIZER include:
•    Ease of mixing and application
•    Scientifically proven long-term effect
•    Tissue-friendliness and biocompatibility
•    Compatibility with restorative procedures – no effect on bond strength

DENTAL ADVISOR TOP PRODUCT AWARD

Hydroxyapatite formation: a true game changer

The clinicians who tested TEETHMATE DESENSITIZER in clinical practice identified the material's ability to form hydroxyapatite in an easily applicable slurry consistency as a top feature. In a long-term study conducted by the Dental Advisor, hypersensitivity relief was achieved in 85% of patients.

Representative comments included: "TEETHMATE DESENSITIZER is easy to apply and seems to provide consistent relief…" and "at six months, the majority of patients continue to experience marked improvement from their preoperative sensitivity or no sensitivity at all."

These outcomes contributed to a high overall clinical performance rating and the product's continued recognition as a Top Product in its category – the twelfth time in a row.

DEMONSTRATING LONG-TERM EFFECTIVENESS

By earning another Dental Advisor Top Product Award in 2026, TEETHMATE DESENSITIZER continues to demonstrate long-term effectiveness in managing dentin hypersensitivity. Its biomimetic mechanism of action, ease of use, and clinically proven relief make it a trusted solution for both preventive and restorative treatment protocols.

For more information, visit Dental Advisor.

WITH AWARD-WINNING CLEARFIL SE Protect

While many clinical situations call for a bonding agent that delivers strong, durable adhesion quickly and easily, some cases demand more than that. Developed by Kuraray Noritake Dental Inc., CLEARFIL™ SE Protect goes beyond dependable bonding performance by offering additional protective benefits – most notably an antibacterial cavity-cleansing effect.

CLEARFIL SE Protect is a proven two-step self-etch adhesive built on the same trusted platform as the recognized Gold Standard - CLEARFIL™ SE BOND, known for its excellent bond strength to tooth structure. 

In addition, CLEARFIL SE Protect incorporates two advanced technologies: long-term fluoride release and the antibacterial MDPB monomer, which destroys bacteria on contact. These added benefits eliminate the need for a separate cavity cleanser, contributing to both clinical efficiency and restorative longevity. As a result, the product has once more been named a Top Product in the Direct Restoratives – Bonding Agent: Self-Etch category by Dental Advisor.

The key features of CLEARFIL SE Protect include:

• Fast, simple application with minimal technique sensitivity
• A tried-and-tested two-step self-etch system providing high bond strength to enamel and dentin
• An effective antibacterial cavity-cleansing action
• Virtually no post-operative sensitivity

DENTAL ADVISOR RECOGNITION: LONG-TERM PERFORMANCE AND ANTIBACTERIAL PROPERTIES

This year, Dental Advisor consultants highlighted CLEARFIL SE Protect's long-term clinical performance and antibacterial effectiveness as top features. Long-term studies confirmed strong resistance to microleakage and the absence of marginal staining.

The antibacterial cavity-cleansing effect is achieved through the MDPB monomer, which contains a positively charged pyridinium group that attracts negatively charged bacterial cells. Upon contact, the bacterial cell membrane is disrupted, resulting in bacteriolysis and a clean cavity surface – an ideal foundation for durable restorations. Once polymerised, the MDPB monomer becomes immobilised, remaining latently active without causing harm to surrounding tissues.

Evaluators also praised the product's handling characteristics and lack of post-operative sensitivity. One evaluator commented, "The flow of the primer and bond is easily controlled using the unique dispensing system".

A DEPENDABLE BONDING SOLUTION

By combining proven adhesive performance with antibacterial protection and long-term success, CLEARFIL SE Protect continues to set itself apart in the self-etch category. Its repeat recognition by Dental Advisor underscores its value as a dependable, multifunctional bonding solution for clinicians seeking both efficiency and enhanced patient outcomes.

For more information, visit Dental Advisor.

Clinical case by Dr. Zygintas Jonaitis

MINIMALLY INVASIVE INDIRECT RESTORATION PROCEDURE IN THE POSTERIOR REGION

The aim of preserving as much natural tooth structure as possible is ever-present in modern restorative concepts. No matter whether a direct or indirect restorative procedure is preferred, a whole array of tools, techniques and materials are available that help make the clinician's life easier and treatment outcomes more predictable and durable. Those solutions are designed to facilitate identification of tooth structure that needs to be removed, aid cavity cleansing or maximise the bonding performance without adding complexity to the treatment. Using the following clinical example, a possible restorative workflow is described.

RESTORATION REPLACEMENT REQUIRED

This patient presented with a composite restoration on a first molar that attracted our attention. The very extensive composite restoration was worn, lacked good anatomical form and proper occlusal contacts, showed leakage and signs of secondary caries (Fig. 1). The tooth reacted to sweets and cold. It was clear that repair was not the best option: the restoration needed to be replaced. Due to the size of the existing composite filling, it was decided to place an indirect partial restoration that would allow us to save as much natural tooth structure as possible while providing for long clinical service life.

Fig. 1. Initial clinical situation.

SELECTIVE CARIES REMOVAL

After rubber dam placement, the existing restoration was removed carefully, revealing secondary caries underneath the composite (Figs. 2 and 3). To facilitate selective caries removal down to remineralisable (non-infected) dentin, Caries Detector was applied (Fig. 4). This liquid stains only the infected tissue, so that it is easily identified and selectively removed using diamond instruments (Fig. 5). This helps users preserve remineralisable (affected) dentin that may be left untouched and – whenever well-sealed – does not pose a risk for the future restoration.

Fig. 2. Isolation of the working field with rubber dam.

Fig. 3. Removal of the old composite restoration.

Fig. 4. Application of Caries Detector to visualise infected dentin.

Fig. 5. Cavity after the removal of infected dentin.

ADHESIVE PROCEDURE AND BIO-BASE CREATION

To create a stable basis for the indirect restoration, the tooth surface was first cleaned thoroughly using KATANA™ Cleaner (Fig. 6). This cleaning agent developed for intra- and extra-oral use effectively removes contaminants that might compromise adhesion from the surface – a decisive step as a strong and durable bond is the creation of a stable foundation. Subsequently, CLEARFIL™ SE Protect, a self-etching adhesive with MDPB, an antibacterial monomer was applied according to the manufacturer's instructions for use (Fig. 7). Next, a layer of poly ethylene fiber, wettened with CLEARFIL SE Protect Bond was placed and covered with flowable composite (CLEARFIL MAJESTY™ ES Flow Universal). Hereafter a layer of fiber reinforced flowable composite was placed and cured. An impression was taken with an intra-oral scanner and a glass-ceramic restoration produced in the laboratory.

Fig. 6. Cleaning of the tooth structure with KATANA Cleaner.

Fig. 7. Self-etch adhesive with anti bacterial effect applied to the tooth structure.

Fig. 8. Foundation created with fibres, bond and flowable composite.

Fig. 9. Completed with a layer consisting of short-fibre reinforced composite.

TOOTH PREPARATION AND ADHESIVE CEMENTATION

Tooth preparation was performed (Fig. 10). followed by pre-treatment of all surfaces to provide for a strong and durable connection between the foundation and the indirect restoration. The bonding surface of the glass ceramic restoration was etched with hydrofluoric acid before applying a ceramic primer (CLEARFIL™ Ceramic Primer Plus) . Followed by applying PANAVIA™ V5 Paste onto the restoration (Fig. 12). The tooth structure and foundation were treated according to the manufacturers instructions with the system-specific PANAVIA V5 Tooth Primer before placing the restoration. The cement was light-cured thoroughly, restoration margins were cleaned and polished (Fig. 13) and the rubber dam was removed. Figures 14 and 15 show the treatment outcome.

Fig. 10. Prepared tooth prior to adhesive cementation.

Fig. 11. Pre-treatment of the bonding surface of the restoration with a ceramic primer.

Fig. 12. Application of the selected adhesive resin cement onto the restoration.

Fig. 13. Restoration in place.

Fig. 14. Occlusal view of the final restoration.

Fig. 15. Occlusal view of the final restoration

CONCLUSION

The described procedure shows the restoration of a posterior tooth's anatomy and occlusal contacts in cases with severe loss of sound tooth structure. The remaining tissue is preserved wherever possible, while the protective foundation provides for a tight seal of the underlying tooth structure. Utilizing the indirect restoration method supports the restoration's marginal integrity. A long clinical service life may be expected.

ACCORDING TO DENTAL ADVISOR: CLEARFIL MAJESTY ES Flow

Exceptional aesthetics, precise handling, and dependable performance are the hallmarks of a flowable composite clinicians return to year after year. With CLEARFIL MAJESTY™ ES Flow, Kuraray Noritake Dental Inc. delivers a highly filled flowable composite designed to offer versatility across a wide range of restorative procedures, without compromising aesthetics.

In 2026, the medium viscosity variant of CLEARFIL MAJESTY ES Flow (Low) was once again recognised by Dental Advisor. It earned a Top Product Award in the category Direct Restoratives – Composite: Highly-Filled Flowable for the 10^th time! This continued recognition underscores its consistent clinical performance and long-standing trust among dental professionals.

CLEARFIL MAJESTY ES Flow is available in three flowability options in Europe, allowing clinicians to select the ideal viscosity for each indication.

Containing Kuraray Noritake Dental Inc.'s Light Diffusion Technology, the material delivers natural-looking restorations that blend seamlessly with the surrounding tooth structure.

Key advantages of CLEARFIL MAJESTY ES Flow include:
•    Outstanding aesthetics with lifelike opacity and shade blending
•    Three flowability options for maximum clinical flexibility
•    Excellent handling properties 
•    Easy finishing and polishing
•    A syringe design that helps prevent voids and dripping

ELEVEN-TIME RECOGNITION FOR AESTHETICS AND HANDLING

CLEARFIL MAJESTY ES Flow's eleventh Dental Advisor Award reflects its ability to deliver reliable results in everyday clinical practice. Evaluators consistently highlighted the composite's excellent handling, controlled viscosity, and highly aesthetic outcomes.

Minimal finishing and polishing were necessary thanks to the material's natural opacity and shade behaviour, while the high filler content was found to support stability without slumping. The updated syringe design was also praised for contributing to smooth dispensing and reduced risk of air bubbles.

Evaluator feedback included comments such as: "The material blended so well with the tooth structure that you had to look hard to find the interface" and "My go-to flowable composite. Looks beautiful in any clinical case, any class, anywhere".

A PROVEN FAVOURITE

Earning a Product Award for the eleventh time, CLEARFIL MAJESTY ES Flow stands as a proven favourite in highly filled flowable composites. Its combination of aesthetic excellence, dependable handling, and clinical versatility continues to make it a trusted choice for restorative dentistry – year after year.

For more information, visit Dental Advisor.

THE IMPACT OF A MATERIAL SWITCH IN THE DENTAL LABORATORY

Switching to a different type of zirconium is not something you do lightly. Was the leap to KATANA™ Zirconia worth it? Three dental lab owners share their experience!

Not all zirconium oxide materials are created equal. Dental technicians worldwide recognise that zirconium oxide discs vary significantly in quality depending on their composition and manufacturing process. The most noticeable differences lie in their mechanical and optical properties, both of which are determined during production.

At first glance, zirconium oxide products from leading manufacturers may seem similar. However, -sometimes invisible- differences can exist. Achieving the highest quality requires the use of premium raw materials, advanced cleaning and pressing techniques, and precise pre-sintering methods. These factors help ensure superior results while minimizing the risk of remakes.

Selecting a high-quality zirconium oxide product is crucial, particularly when working with complex structures or specialised processing techniques. The right choice can significantly impact the final outcome and durability of dental restorations.

We had a conversation with three decision makers of Norwegian dental laboratories to learn more about their reasons to switch to the KATANA™ Zirconia Multi-Layered Series (Kuraray Noritake Dental Inc.) and their path to success with these materials. Espen Rørstad is the owner and general manager of Vestfold Dental in Tønsberg, Lucas Andvik the general manager of Cicero Dental AS in Trondheim and Egil Berg the general manager of dental technology at Berg Dental in Askim. They are happy to share their experience and practical tips and tricks.

TIME FOR CHANGE

The reasons to start testing alternative zirconium oxide materials were different: Espen Rørstad, who has been a dental technician for 24 years, was looking for improvements in strength and aesthetics: "Nowadays, zirconium materials are evolving quickly, and specifically those blanks with multi-layered colour, translucency and flexural strength attracted my attention. I first tested a material from another leading manufacturer. Then, I received a single disc of KATANA™ Zirconia YML. I was immediately impressed by the homogeneous, densely pressed material and its optical properties. Ever since my first trial case with KATANA Zirconia YML, I have not used any other zirconium oxide again."

"I was immediately impressed by the homogeneous, densely pressed material and its optical properties."

- Espen Rørstad -

CHOOSING THE RIGHT MATERIAL

Egil Berg uses KATANA Zirconia YML for most indications, and KATANA™ Zirconia HTML Plus for large reconstructions of ten or more units. The design is predominantly monolithic with a small (vestibular) cutback. The approach of Espen Rørstad is similar. He also uses KATANA Zirconia YML on a regular basis for reconstructions with up to ten units, even on implants in combination with Ti-bases. "For larger-span restorations, I most frequently opt for KATANA Zirconia HTML Plus or, occasionally KATANA™ Zirconia HT combined with a traditional layering approach". Lucas Andvik uses all four types of multi-layered zirconia from Kuraray Noritake Dental Inc. (KATANA Zirconia UTML, STML, HTML Plus and YML) to have the best of all worlds.

ESTABLISHING WORKFLOWS

Switching materials always means investing time and effort until processes run smoothly and predictably. According to Espen Rørstad, it did not take long with KATANA Zirconia to get the parameters right and obtain high-quality results. According to him, a factor that is critical for good outcomes with KATANA Zirconia YML is positioning of the restoration in the disc. "Proper positioning is key to success - long-span reconstructions are only stable if positioned according to the manufacturer's recommendations. The learning curve is quite steep and we have no issues with fractures," he says. Lucas Andvik slightly adjusted his production procedure to provide for great outcomes: "Initially, we tried to position our restorations in blanks of the heights we had used before, and this turned out to be quite challenging. In order to have enough space for the connectors and be able to position long-span restorations in the middle of the disc as recommended, we started utilising higher blanks. With this strategy, the initial challenges were a thing of the past."

EASY CARVING

One of the practical benefits of using KATANA Zirconia is the fact that it is perfectly suitable for carving. Lucas Andvik states: "Carving is easier with KATANA Zirconia than with other materials. It is even possible to go close to the margins without increasing the fracture risk. Other materials seem to be much less dense and softer, which may result in marginal fractures. Carving is really a feature that transformed our inhouse production procedure and contributes to great outcomes." Espen Rørstad and Egil Berg agree that carving feels great with this material, while the former also stresses that the overall aesthetics when using the carving technique are very well received by partners from dental offices.

"Carving is easier with KATANA Zirconia than with other materials."

- Lucas Andvik -

MASTERING THE SINTERING PROCESS FOR OPTIMAL RESULTS

A procedure known as a critical step in the production procedure is the sintering. Virtually every leading manufacturer of high-translucency zirconium oxide advises users to calibrate furnaces and check the achieved temperatures on a regular basis to provide for optimal outcomes. The actual sintering protocols recommended for each material, however, are very different. Kuraray Noritake Dental Inc. offers three sintering programms valid for all four materials of the KATANA Zirconia Multi-Layered series: The standard seven-hour programme is available for all kinds of prostheses, while the high-speed 54-minute and 90-minute programmes are suitable for restorations with up to three units. For KATANA™ Zirconia Blocks, even 18-minute sintering is possible. Lucas Andvik uses the seven-hour programme for over-night sintering of all large restorations, and speed sintering for single-tooth restorations and small bridgeworks during the day. With his new furnace, he simply adopted the recommended protocols. Espen Rørstad  modified the protocols slightly for his furnace and regards speed sintering as a great option for rush cases. Egil Berg prefers over-night sintering. He reports: "It is really important to have a high-quality, modern furnace, calibrate it regularly and follow the manufacturer's instructions. My recommendation for everyone experiencing issues is to pay extra attention to warming up and cooling down properly. That way, you achieve the highest possible strength and aesthetics, including an absolutely smooth transition between the different layers in the blank."

MICRO-LAYERING: A GAME CHANGER FOR FINISHING

In all three dental laboratories, the integration of KATANA Zirconia has led to a shift towards higher-efficiency finishing approaches. Espen Rørstad reports: "The switch to KATANA Zirconia enabled us to increase the amount of monolithic and micro cut-back zirconium oxide restorations from around 40 to 80 percent. In the anterior area, we use a minimal vestibular cutback and micro-layering, while the restorations are purely monolithic and only minimally pre-coloured in the posterior area. Classical layering is only delivered on special request." Egil Berg states: "We completely stopped using traditional porcelain layering approaches and prefer micro-layering instead - especially in combination with KATANA Zirconia YML. The aesthetic outcomes are so good that a cosmetic dentist recently called me and asked if I had used lithium disilicate instead of zirconium." Lucas Andvik also likes to add a little bit of porcelain: "We moved away from a full cutback to micro-layering approaches, using the same porcelain system for lithium disilicate and zirconium oxide," he says. In subgingival areas, he often just polishes the restorations for highest biocompatibility, a concept that is very well received by dental practitioners.

HAPPY WITH THE RESULTS?

Egil Berg concludes: "Once you have implemented the workflow and set all parameters, working with KATANA Zirconia is really great. My staff likes its handling during carving, the efficient workflows and predictable results. Although sometimes the product may be more expensive than other brands' zirconium oxide, the total economy is a lot better: We do no longer face any issues with fractures and remakes, and due to the homogeneous material structure, the service life of our milling tools is extended, while, at the same time, the edge stability of the milled restorations is increased. The blanks are so homogeneous that I am able to sinter long-span restorations without a lateral support!"

The conclusion of Lucas Andvik is similarly good: "everyone in my laboratory working with KATANA Zirconia is more than satisfied. My co-founder, Katharina, has tested many different materials on behalf of notable manufacturers and has never seen anything that compares to KATANA. All the technicians that work with KATANA here consider it to the most versatile and aesthetic we have ever utilized. I think that all four variants are super nice to work with. My personal recommendation is to attend one of the courses offered by Kuraray Noritake Dental Inc. The instructors are super knowledgeable and we got a completely new conception of zirconium oxide as well as practical advice that was really useful for our daily work."

"The blanks are so homogeneous that I am able to sinter long-span restorations without a lateral support!"

- Egil Berg -

Espen Rørstad is sure that "in terms of aesthetics, KATANA Zirconia is the best zirconium oxide tested, and I really tested a lot in the past decades! I am happy with the material, the interaction with the Kuraray Noritake Dental team and the support offered. My team is also happy with the material, but even more important is the positive feedback of my customers: One of them requested a specific zirconium all the time, and when we switched, we did not tell him immediately. Now he knows and is very happy with what he gets." Espen is sure that economically, KATANA Zirconia YML is even able to compete with cheap zirconium oxide brands, as the production procedure is much more efficient and the results are predictable.

Switching zirconium oxide materials is a significant investment in both time and resources, but for many dental laboratories, the results speak for themselves. The experiences shared by these Norwegian technicians demonstrate that KATANA Zirconia offers a balance of aesthetics, strength, and efficiency. While adapting to new workflows takes effort, the improved outcomes, fewer remakes, and enhanced handling make the transition worthwhile. For those considering the switch, thorough testing and training are key to ensuring a smooth and successful integration.

PANAVIA SA Cement Universal NAMED A TOP PRODUCT BY DENTAL ADVISOR

Strong, durable adhesion in a simplified single-step cementation procedure – this is what clinicians expect from a modern self-adhesive resin cement. With PANAVIA™ SA Cement Universal, Kuraray Noritake Dental Inc. delivers a versatile cementation solution designed to bond to virtually every restorative substrate – without requiring a separate primer or silane.

Key benefits of PANAVIA SA Cement Universal include:
•    Wide variety of indications, including cementation of crowns/bridges, inlays/onlays, posts, splints, and even adhesion bridges
•    Adheres to a wide variety of restorative materials (including lithium disilicate) without separate primers
•    Easy, gingival-friendly excess removal
•    Ready for use immediately as it requires no refrigeration

DENTAL ADVISOR TOP PRODUCT AWARD

Open options and minimized materials are the top features

PANAVIA SA Cement Universal contains two advanced monomers – the LCSi monomer as a silane coupling agent and the original MDP monomer – to establish a strong chemical bond to a wide variety of substrates. It is thus no surprise that "Open Options" (as it adheres to virtually all substrates) and "Minimized Materials" (as it does not need any separate adhesive and primers) were the top features that made the product win a Top Product Award in 2026 (and every year since 2020).

Evaluators also enjoyed its user-friendly handling with an "Amazing viscosity, tack cure-ability and very easy cleanup" as well as the fact that it "can be used in a moist environment with no setting issues".

Its user-friendly handling and predictable outcomes make it a popular choice for clinicians who value both efficiency and performance.

Dependable choice for efficient cementation

By earning the Dental Advisor Top Product Award for the seventh consecutive year, PANAVIA SA Cement Universal once again demonstrates excellent performance in clinical practice. Its innovative monomer technology, simplified protocol, and consistent bonding performance make it a dependable choice for efficient, universal cementation.

PANAVIA SA Cement Universal AS PART OF THE EXPANDING PORTFOLIO

At Kuraray Noritake Dental Inc., we understand the demands of modern dental practices. Balancing complex procedures, tight schedules, and patient care is no easy task. That is why we have spent years refining our materials—so you can focus on what matters most: your patients.

Our Universal Excellence portfolio is designed to streamline clinical workflows, providing high-quality materials that work seamlessly together and support efficient, reliable treatment outcomes.

For more information, visit Dental Advisor and the Kuraray Noritake Dental Europe website.

Article by Peter Schouten

The restoration of endodontically treated teeth often requires the use of core build-ups to provide a foundation for the final restoration. Historically, root posts served as a common method to enhance retention and stability for core build-ups. However, resin composite materials have gained popularity for core build-ups due to their excellent aesthetics, adhesive properties, and versatility. As the reinforcement of the remaining tooth structure (and replacing the missing tooth structure) remains fundamental, the decision to use a root post is a subject of ongoing debate.

This article aims to explore several key factors related to restoring endodontically treated teeth using resin composite with or without the introduction of a root post.

HISTORY

Core build-ups with a root post originally used metal as a post material for their strength. Stainless steel, titanium, and gold were popular choices. However, concerns about potential complications like root fractures prompted a shift in treatment philosophy.

The advent of adhesive dentistry brought about the rise of resin composite core build-ups, offering a less invasive and more conservative alternative. The possibility of bonding restorative materials to dental tissue reduced the need to remove sound dental tissue. This shift in perspective allows for a more conservative approach, prioritizing tooth preservation while still providing sufficient strength and retention for long-term success.

POST OR NO POST

Preserving as much tooth structure as possible is a general prerequisite in modern dentistry. Therefore, omitting the use of a post must be considered, especially in cases where root dentine must be sacrificed to create sufficient space and access to insert the post. The decision to use a post should consider the following factors:

1. The amount and quality of the remaining tooth structure*
2. The presence of a ferrule effect
3. The clinician's experience

*Several studies suggest that in cases where an adequate amount of tooth structure remains and when the remaining tooth structure is of good quality, root posts may not be necessary.

THE AMOUNT AND QUALITY OF THE REMAINING TOOTH STRUCTURE

Preserving as much dental tissue as possible is the first requirement. The presence of at least two intact axial walls is considered ideal for optimal clinical outcomes. Teeth with no- or only one residual wall appear to have reduced survival rates compared to teeth with more than one wall.

THE PRESENCE OF A FERRULE EFFECT

The ferrule effect refers to the presence of a circumferential band of tooth structure encircling the coronal portion of the tooth. This effect has been shown to contribute significantly to the resistance of the restored tooth to fracture. Minimal ferrule dimensions are not set in stone. Some general recommendations can be given to help evenly distribute forces, resist occlusal forces, and give enough retention. The ferrule should ideally extend at least 2 mm above the cementoenamel junction, have a circumferential width of approx. 1 mm and a thickness of 1 to 1.5 mm. Finally, the axial walls should have a slight taper towards the occlusal plane.

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