429 Too Many Requests

Testimonial article by Dr. Troy Schmedding, USA

From PANAVIA™ EX to PANAVIA™ V5, Kuraray Noritake Dental Inc.‘s flagship product line of cements continues to evolve to offer reliable adhesion, enhanced ease of use, and superior esthetics.

Dentistry has certainly evolved in the years since Kuraray Noritake Dental Inc. developed the phosphate monomer MDP. But over the past 4 decades, it has rooted itself in restorative dentistry as the tried-and-true ingredient that clinicians rely on for strong adhesion to tooth structure as well as metals and zirconia. MDP is a key ingredient in the manufacturer’s flagship PANAVIA™ line of cements, which continues to evolve in line with a growing variety of indirect restorative materials from which to choose.

One example of this evolution is PANAVIA™ SA Cement Universal, one of the first true universal self-adhesive resin cements to hit the market. In addition to the original MDP monomer, it incorporates the LCSi monomer, a silane-based carbon chain in a dual-barrel system that forms a chemical bond with glass and ceramic materials.

“PANAVIA™ SA Cement Universal allows you to achieve a strong bond no matter which substrate is being used.”

- Troy Schmedding, DDS –

A STRONG BOND THAT’S SIMPLE TO CREATE

But all chemistry aside, what’s in it for the clinician? As dental educator and author Dr. Troy Schmedding points out, the key benefit of PANAVIA™ SA Cement Universal is eliminating the confusion over how to treat different substrates. This is because the material adheres to virtually every material without the need for a separate primer. “The plus side for the practitioner is that the confusion of ‚how do I condition zirconia‘ or ‚how do I condition glass ceramics‘ is no longer an issue because the paste formulation allows you to achieve a strong bond no matter which substrate is being used - whether it is the MDP monomer allowing strong adhesion to zirconia or the LCSi monomer forming a chemical bond with glass ceramics,” he shared.

DIALING UP THE AESTHETICS

Kuraray Noritake Dental Inc. considers PANAVIA™ V5 the most esthetic cement it has ever created. Available in 5 shades - White, Brown, Universal, Clear, and Opaque – it took researchers over 10 years to develop and features an anime-free catalyst that allows for superior colour stability and improved bond strength to dentin. And like its predecessors, PANAVIA™ V5 offers a simple cementation procedure that is compatible with all indications, from crown-and-bridge and implant abutments to ceramic inlays and laminate veneers.

“Kuraray Noritake Dental Inc. has an incredibly strong reputation in adhesive dentistry, so it should offer clinicians a lot of comfort and flexibility to partner with not only a reputable company, but one that continues to research and evolve their key products,” concluded Dr. Schmedding.

Dentist:

DR. TROY SCHMEDDING, DDS
USA

Article from Dental product shopper, vol. 14 No. 5

PRESENTATION OF A STUDY WITH ILLUSTRATIVE CASES

by Dr. Yohei Sato, DMD, PhD and Dr. Keisuke Ihara, CDT.

INTRODUCTION

In recent years, the application and advancement of digital technology in dentistry has made it possible to accomplish the fabrication of highly accurate prosthetic zirconia appliances that were difficult to mill using the previously available technology. In addition, thanks to advances in adhesive dentistry and the advent of cements that bond strongly to a diverse range of materials, cements have come into wide clinical use that can cope with the many types of materials used for the fabrication of prosthetic appliances.

At our hospital, we select the treatment method most suitable for each case by appropriately specifying various types of prosthetic appliance according to the status of each case. For example, we may specify zirconia prosthetic restorations fabricated by the CAD/CAM system, or silica-based ceramic prostheses, or those made of lithium disilicate glass, as the case dictates.

PANAVIA™ V5 is a resin cement system that bonds strongly to various types of prosthetic appliance, as well as to tooth structure. PANAVIA™ Veneer LC, a new resin cement system developed by Kuraray Noritake Dental Inc., has suitable characteristics for bonding laminate veneers, using two types of primer that can be used in common with PANAVIA™ V5. Here are some clinical examples of its advantages as a resin cement system used for laminate veneers restorations.

JOIN US to celebrate the 10^th anniversary of Kuraray Noritake Dental Inc. on October 7^th, 2022.

Improving dentistry with high-end dental products and solutions – that was the idea behind the merger of the two multinational companies Kuraray Medical and Noritake Dental Supply exactly ten years ago. By combining their expertise in polymer chemistry, chemical engineering and ceramics, Kuraray Noritake Dental Inc. successfully developed a whole range of innovative products and solutions. They support dental professionals in delivering minimally-invasive, sometimes even bio-active dental treatments in straightforward procedures. In the virtual symposium titled “Up to now and from now on: From innovation to simplification”, ten internationally renowned experts will share their scientific, technical and clinical know-how around these materials and approaches. The programme is divided into five sessions that may be attended separately or as a whole.

An update on modern direct bonding and adhesive luting technologies is provided by two eminent authorities in their field, Prof. Junji Tagami (Tokyo Medical and Dental University, Japan) and Prof. Bart Van Meerbeek (University of Leuven, Belgium). The focus will be on the technology behind and the use of the latest generation of universal adhesives and adhesive resin cements.

Is it a good idea to start processing translucent zirconia in the dental office? According to Dr. Mike Skramstad (CEREC trainer and practitioner form Orono, Minnesota) and Dr. Sameer Puri (Director of CAD/CAM at CDOCS), it clearly is, as it may change everyone’s way of practicing dentistry for the better. In their lecture, the two experts describe their chairside workflow in detail, including finishing and polishing steps.

How to select the best zirconia for a specific case? In their lecture, the popular master ceramists RDT Aki Yoshida (Gnathos Dental Studio in Weston, Massachusetts) and DT Nondas Vlachopoulos (AestheticLab in Athens, Greece) present their success strategies. Their focus is on the selection of the best suitable type of zirconia and finishing technique depending on the indication and on patient-specific needs.

Is it possible to simplify direct restorative procedures without compromising the outcomes? In many situations, it is – provided that the right materials and techniques are selected. Dr. Nicola Scotti (University of Turin, Italy) and Prof. Lorenzo Breschi (University of Bologna, Italy) will focus on the single-shade technique, discussing its capabilities and limitations.

How to condition ceramic surfaces prior to their cementation? And what are the parameters guiding the decision for adhesive, self-adhesive or conventional systems? Dr. Gerard Chiche (Augusta University, Dental College of Georgia) and Prof. Dr. Markus B. Blatz (University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania) know the answers. In their lecture, they share exactly the knowledge needed to achieve predictable results.

Register for free!

The symposium starts on October 7, 2022 at 1:00 pm Central European Standard Time. Registration is required and possible for the whole symposium or for specific sessions. Between the lectures, employees from Kuraray Noritake Dental will provide some company insights by sharing facts and stories from their everyday work. In the president’s closing message, an interesting outlook will be given.

Dental professionals attending the full symposium will receive five CE credits, but attending particular sessions of your interest separately is also possible.

For more information and registration, please visit www.kuraraynoritakecampus.com.

Looking for dental opinion leaders

Kuraray Noritake Dental Inc. is dedicated to the fulfilment and success of every dental professional’s career. That is why we never stop developing high-quality dental products and services, while supporting highest-level functional and enduring aesthetic outcomes. Born in Japan; we are proud to be masters in creating science-based, reliable and predictable dental solutions.

Surround yourself with the right people

In order to set the course for ground-breaking future innovations and to put our dental portfolio to the test, we are looking for you! We have established a team of knowledgeable, approachable and friendly professionals to support you and open up access to a vast network of experienced scientists and clinicians to further your career and research efforts whether that is in vitro or in vivo.

Now you know who we are, how about you?

Your insights, ideas and expertise are invaluable to us whether you are working as a general clinician or as a researcher at the university. We are always on the lookout for persons who are interested in investing time to help the dental world understand our product portfolio in detail.

It is your kind of expertise we cannot wait to utilize, be that:

✔ testing and evaluating our products in different stages of development
✔ conducting in-vitro and in-vivo studies with our products and solutions
✔ documenting clinical procedures executed with our products and describing your path to success.

Interested? Come by at IADR in Marseille, September 15-17, 2022, and meet our Scientific Marketing team at booth No. 23.

Prosthodontic treatment concepts have evolved over the past decades. While some time ago, porcelain-fused-to-metal crowns and bridges were placed wherever a defect was too large for a direct restoration, the current trend is toward less invasive therapies with highly aesthetic, tooth-coloured materials.

These modern treatment concepts can lead to reliable outcomes when a high-performance resin cement system is used that establishes a durably strong bond to tooth structure on one side and the restoration on the other. The reason is that less invasive often means that restorations have minimal or no retentive elements and extremely thin walls, and a strong chemical bond is a mechanism that holds them in place over time. Depending on the type of restoration and area in the mouth, aesthetic properties of the cementation system are also extremely important, as the typically highly translucent, thin restorations tend to reveal the appearance of the structures underneath to a certain extent.

Universal cements

In the context of striving toward the streamlining of clinical procedures in restorative dentistry, several manufacturers have developed resins cements that work with fewer components and are suitable for a large number of indications. PANAVIA™ SA Cement Universal is a popular example. The self-adhesive, dual-cure resin cement is the only product of its category that works as a standalone solution even on glass ceramics (without the need for a separate primer).

The need for specialists

There are specific clinical situations, however, that require more working time than a dual-cure resin cement can offer. This is the case whenever multiple non-retentive restorations are to be placed simultaneously, a technique that is recommended for veneers. The greatest benefits of placing the thin and highly aesthetic restorations at once lie in the proper positioning of the restorations and in the minimized risk of contamination: When the veneers are placed one after the other, a slightly malpositioned and already fixed veneer might hinder proper positioning of the adjacent restorations and haemorrhage occurring in the context of excess cement removal or finishing of the margin might contaminate the working field. When all veneers are placed simultaneously, repositioning is possible, while excess removal and polishing are accomplished in a moment when blood and debris will no longer endanger the integrity of the restorations, which increases the security during the whole procedure. This task is best fulfilled by a light-curing veneer specialist.

Handling of a thin ceramic veneer.

Required properties of veneers cements

Undoubtedly, the key feature of a specialist resin cement system is a long working time sufficient for simultaneous cementation of multiple restorations. In addition, its consistency and handling properties are also important as they can help users overcome the challenge of accurate positioning and reduce the time and effort involved in veneer placement. And finally, the system needs to provide excellent bond strength over time and support long-lasting aesthetics, properties valuable for every kind of resin cement, but the latter being particularly important for thin restorations in the aesthetic zone. Luckily, PANAVIA™ Veneer LC offers all those features.

The system consists of PANAVIA™ V5 Tooth Primer that establishes a strong bond to enamel and dentin, PANAVIA™ Veneer LC Paste as the cement and the CLEARFIL™ CERAMIC PRIMER PLUS that has been part of PANAVIA™ V5 cementation system. The latter is responsible for a high bond strength to all types of restorative materials.

Mastering the working time challenge

The light-curing cement paste offers a long working time of 200 seconds* due to its excellent stability under ambient light. As a consequence, dental practitioners may place multiple veneers simultaneously without having to race against setting. Polymerization may be started whenever the user is ready for it. The one-component self-etching tooth primer (PANAVIA™ V5 Tooth Primer) does not contain any photo initiators and does not cure alone. When applied, it etches and penetrates into the tooth surface for 20 seconds and is ready to bond strongly to PANAVIA™ Veneer LC Paste. The integrated touch-cure technology is the key feature safeguarding a high bond strength to tooth structure without shortening the working time.

*Working time under ambient light on PANAVIA™ V5 Tooth Primer (8000 Lux): 200 seconds

Providing for precise placement

In order to streamline the clinical seating procedure from cement application to polishing, PANAVIA™ Veneer LC has been equipped with a set of well-balanced handling properties. Newly developed spherical silica fillers in the cement provide that it stays put where applied, but flows well when the veneer is seated on the tooth – for easy placement without drifting or sagging. During application across the intaglio surface, the resin cement does not stick to the application tip, a property achieved by the addition of nanocluster filler technology. The special design of the syringe’s application tip optimizes control over the amount of cement applied. Ans last but not least, excess cement may be easily removed in one piece using an explorer after a one-second tack-cure, while polishing of the margins is quickly accomplished.

Hiding the margins

Being extremely thin, highly translucent and mainly used to restore teeth in the exposed anterior region of the maxilla, veneers have to be placed with a cement that is and remains undetectable underneath the restoration and at its margins. PANAVIA™ Veneer LC is available in four highly aesthetic shades with matching try-in pastes, so that a precise shade match with the restoration can be achieved and verified in the patient’s mouth. Additional features contributing to undetectable margins are the resin cement’s flowability and low film thickness: They enable users to easily produce an evenly distributed, thin cement layer for aesthetic outcomes. For those afraid that coffee, tea, acidic drinks or constant tooth brushing might reveal the margins over time, there is good news as well: PANAVIA™ Veneer LC offers a high polish retention and colour stability over time. The well-balanced formulation and the touch-cure technology are responsible for this resistance to discolouration.

Trusted expertise

All these beneficial features make PANAVIA™ Veneer LC worth testing. Additional arguments are the fact that its primers are tried and tested components of the highly popular PANAVIA™ V5 system and that Kuraray Noritake Dental Inc. is a proven expert on adhesive products. It developed the original MDP Monomer in 1981 and introduced the first adhesive resin cement containing this monomer in 1983. Since then, the company has improved existing formulations and developed existing technologies that ultimately resulted in the current line-up of cementation solutions for every need and indication.

Excellent gloss retention is one of the properties providing for undetectable margins over time.

Kuraray Noritake Dental’s reputation as a pioneer in the field of dental adhesives is grounded in its development of the MDP monomer. Patented in 1981, the monomer was used two years later in the composite cement PANAVIA™ EX and has since formed the backbone of many other successful products. Now, the company has combined the original MDP monomer with hydrophilic amide monomers to create rapid bond technology that powers CLEARFIL™ Universal Bond Quick - a universal solution emblematic of Kuraray Noritake Dental’s history of success and commitment to innovation.

Advances in modern dental bonding technology have resulted in a reduction in the number of components needed for total-etching and self-etching processes. However, the basic handling of these adhesives has, by and large, changed surprisingly little. Many adhesives require a shaking of the bottle before usage, extensive rubbing of the liquid and/or waiting for a period of time. Often the application of multiple layers is needed. A reliance on slow penetrating monomers means that, for traditional one-bottle adhesives, bonding to the challenging dentine substrate is a slow and technique-sensitive process.

Through the integration of newly developed amide monomers, rapid bond technology provides CLEARFIL™ Universal Bond Quick with excellent hydrophilic properties and the ability to penetrate the wet dentine fast and effectively. There is no need to wait after the application for air-drying before proceeding - this delay has been eliminated - and a tight and long-lasting seal of the cavity is established after light-curing. Bonding with CLEARFIL™ Universal Bond Quick is easy and efficient and comes with predictable clinical outcomes, thanks to rapid bond technology.

Impressively low water sorption

One of the most important indicators of long-term success in dentine bonding is the level of water sorption in the bond’s organic matrix. A high rate of water sorption has been clinically linked to the ongoing physical deterioration of bonds, which may lead to the development of secondary caries. For this reason, we have chosen to keep the HEMA content as low as possible.

CLEARFIL™ Universal Bond Quick creates a highly cross-linked polymer network owing to the amide monomers used in rapid bond technology. As a result, it demonstrates a relatively low rate of water sorption, meaning that these cross-linked polymers are more stable in the long term.

Aesthetic, effective bonds

Rapid bond technology does not just provide a basis for long-lasting bonding excellence. The thin film layer (5–10 μm) of CLEARFIL™ Universal Bond Quick delivers restorations a clear aesthetic appeal, and its densely cross-linked polymer network reinforces the stability of this outer layer and provides resistance to marginal discoloration.

By combining Kuraray Noritake Dental’s original MDP monomer with hydrophilic amide monomers, rapid bond technology is truly the engine that powers CLEARFIL™ Universal Bond Quick.

By Franklin Tay, BDSc (Hons), PhD

STATE-OF-THE-ART CURRENT ADHESIVES

Manufacturers have adopted an etch-and-rinse approach or a self-etch approach in the design of adhesives for bonding restorative materials to tooth structures, which differ in how these adhesives interact with dental hard tissues. Etch-and-rinse adhesives are offered as two- or three-step systems, depending on whether primer and bonding are separate or combined in a single bottle. Likewise, self-etch adhesives are available as one- or two-step systems. Etch-and-rinse adhesives are often preferred when large areas of enamel are still present, while self-etch adhesives provide more predictable bonds to dentin.

Despite current trends toward fewer and simpler application steps, one-step adhesive systems appear to be less predictable than multi-step etch-and-rinse and self-etch systems. Some manufacturers have recently introduced more versatile single-bottle “universal” or “multi-mode” adhesives that encompass self-etch chemistry but also enable the same adhesive to be used with phosphoric acid-etching in the etch-and-rinse mode. Some universal adhesives also incorporate silane primer for chemical bonding to silica-based ceramics, and methacryloyloxydecyl dihydrogen phosphate (MDP) for chemical bonding to zirconia-based ceramics. Because clinical studies on universal adhesives are short-term, they cannot be considered state-of-the-art in the context of evidence-based dentistry. Conversely, two-step mild, self- etch adhesives have been well-tested in clinical trials and represent the current state-of-the-art for bonding to dentin, with reduced incidence of postoperative sensitivity when compared to etch-and rinse adhesives.

DEVELOPMENT OF CONTEMPORARY ADHESIVES FROM A RESEARCHER’S PERSPECTIVE

The current thinking by researchers is that dentin bonding is not as durable as it was originally perceived. This lack of durability is attributed partially to secondary caries around restorative margins that are devoid of enamel and partially to the degradation of the adhesive joint. The latter may be caused by the hydrolysis of ester bonds in the adhesive component by salivary esterases, or by degradation of water-rich, resin-sparse regions of the hybrid layers by endogenous collagen-bound proteases such as matrix metalloproteinases (MMP) and cathepsin K, that are activated from their dormant preforms to active forms by the acidity of contemporary adhesives. These activated enzymes slowly degrade the denuded collagen matrix within hybrid layers, resulting in gradual loss of adhesion.

Much work has been done in developing therapeutic dental adhesives that are able to resist secondary caries and degradation of the adhesive joint. One of the most thoroughly studied antimicrobial resin monomers is the quaternary ammonium methacrylate developed by Kuraray known as methacryloyloxydodec ylpyridinium bromide (MDPB). This polymerizable resin monomer is incorporated in the two-step self-etch adhesive CLEARFIL™ SE Protect. Recent research has demonstrated that MDPB resin is also an effective inhibitor of both MMP and cysteine cathepsins, thereby providing a mechanism to increase the longevity of resin–dentin bonds by preventing collagen degradation. Indeed, an in-vitro and in-vivo study (Donmez, et al. J Dent Res. 2005;84:355-359) showed that resin-dentin bonds created with CLEARFIL™ SE Protect (aka, CLEARFIL™ Protect Bond) did not degrade after 1 year when compared with a similar self-etch adhesive that did not incorporate the MDPB resin monomer.

MOST COMMON CLINICAL APPLICATIONS OF CLEARFIL™ SE PROTECT

As a board-certified endodontist, the author uses CLEARFIL™ SE Protect as an antimicrobial adhesive to establish coronal seal after finishing root canal treatment to prevent reinfection of the peri-radicular tissues via coronal leakage through the filled root canals (Figure 1 and Figure 2). Another common use of CLEARFIL™ SE Protect is the restoration of the access cavity prepared through a zirconia-based full-coverage restoration. By taking advantage of the MDP component, the author feels more confident that he can bond to the zirconia with a resin composite without causing leakage along the composite-zirconia interface.

Disclaimer: This article was provided by Dr. Tay.

Fig 1. Preoperative radiograph of tooth No. 18. Diagnosis: pulpal necrosis with symptomatic api-cal periodontitis.

Fig 2. Postoperative radiograph of tooth No. 18. Coronal seal was created with radiolucent antimicrobial self-etching adhesive (CLEARFIL™ SE Protect, arrow) and a radiopaque flowable composite, followed by placement of a cotton pellet and a temporary restoration.

ADVANCED NEW FEATURES FOR MORE CONFIDENCE

Studies show that the risk of bacteria remaining in cavities tends to increase with smaller minimal intervention cavities (S. Imazato; Dent. Mater. J. 2009).

CLEARFIL™ SE Protect contains a new functional monomer MDPB, which exhibits an “Antibacterial Cavity Cleansing Effect” (Fig 3).

Fig 3. The bactericidal mechanism of MDPB is presumed to be similar to the well-known antibacterial agent CPC**, which is in many toothpastes and mouth rinses. **Cetyl pyridinium chloride

EXCEPTIONAL RESEARCH RESULTS

Increased durability of resin-dentin bonds

Recent research has demonstrated that MDPB is also an effective inhibitor of matrix metaloprotinases (MMP) that may deplete collagen.

The advantage of MDPB over chlorhexidine (CHX) is that it polymerizes with adhesive resins and cannot leach from the hybrid layer.

(Pashley et al. Compend Contin Educ Dent. 2011)

Fluoride-release

CLEARFIL™ SE Protect contains a patented, specially treated sodium fluoride (NaF); the NaF in CLEARFIL™ SE Protect is coated with a unique polymer capsule that allows release of NaF while the bonding layer physical properties, including strength, are maintained.

Simple proven procedure - avoid technique sensitivity

CLEARFIL™ SE Protect is a two bottle primer and adhesive bonding system.

• No scrubbing needed to achieve good bond strength to tooth structure
• No shaking required Bond itself maintains homogeneity and creates no worries in the quality of the first and last drop of adhesive.

DIRECT RESTORATION

Follow the standard procedures for isolation, moisture control, cavity preparation and pulp protection.

Dentist:

FRANKLIN TAY, BDSC (HONS), PHD

Franklin Tay is Professor and Chair in the Department of Endodontics, College of Dental Medicine, Georgia Regents University, Augusta, Georgia, and a Fellow of the Academy of Dental Materials, as well as a Diplomate of the American Board of Endodontics. With more than 400 papers published in peer reviewed journals, his research interests include biomineralization of collagen scaffolds with apatite and/or silica, remineralization of resin-dentin bonds, antimicrobial sol-gel chemistry, mesoporous silica, and endodontic materials.

First published in COMPENDIUM, April 2014, Volume 35, Number 4.

For the placement of veneers, a resin cement must be selected that supports long-lasting aesthetics, is easily applied, offers a working time sufficient for simultaneous cementation of multiple restorations and provides excellent bond strength. The new “PANAVIA™ Veneer LC” is precisely what you need.

For the pretreatment of the tooth you can use PANAVIA V5 Tooth Primer as shown in our previous workflow video.

BUT did you know that CLEARFIL Universal Bond Quick is also an option? Today’s video demonstrates exactly how. Check it out!

Hypersensitivities make patients suffer, no matter what their cause is. Kuraray Noritake Dental Inc.’s TEETHMATE™ DESENSITIZER is the solution for all of them. Designed to crystallize hydroxyapatite (HAp) from the ground up, the material effectively and durably occludes exposed dentinal tubules and enamel cracks. The tubules may be exposed due to gingival recession, dental erosion or excessive toothbrushing, professional tooth cleaning, scaling and root planning, tooth whitening or restorative procedures. TEETHMATE™ DESENSITIZER provides lasting hypersensitivity relief in all those cases – a fact that is surely one of the reasons for its winning of a Dental Advisor award for the eighth consecutive year.

Consisting of natural calcium and phosphate, the product may even be applied to freshly prepared tooth structure without negatively affecting the bond strength of subsequently utilized dental adhesives or cements.

The consultants of the Dental Advisor conducted a six-month clinical study to be able to evaluate the performance of TEETHMATE™ DESENSITIZER. They selected 27 patients with hypersensitivity issues in their dental practices. Thermal testing with cold air was used to identify the affected teeth, 54 of which were included in the evaluation. For the initial assessment, patients were asked to evaluate their level and frequency of hypersensitivity per tooth on a five-point scale (1 = severe, persistent sensitivity to 5 = no sensitivity). Subsequently, TEETHMATE™ DESENSITIZER was applied according to the instructions for use. Sensitivity was evaluated again immediately after the treatment and six months later. At baseline, 91 percent of the patients stated that they had no or only mild, sporadic sensitivity, which was still the case for 85 percent after six months. This indicates that the product is very effective in providing immediate and even long-term hypersensitivity relief.

Hence, it is not surprising that TEETHMATE™ DESENSITIZER has been among the winners of the Dental Advisor’s Top Product Award every year between 2015 and 2022.

Study results that confirm the material’s effectiveness in reducing pre- and post-operative sensitivity in the context of tooth whitening¹ and indirect restoration procedures² are also available, so that users can count on a reliable performance in a wide range of indications.

1 Mehta D, Jyothi S, Moogi P, Finger WJ, Sasaki K. Novel treatment of in-office tooth bleaching sensitivity: A randomized, placebo-controlled clinical study. J Esthet Restor Dent. 2018 May;30(3):254-258.

2 Shetty R, Bhat AN, Mehta D, Finger WJ. Effect of a Calcium Phosphate Desensitizer on Pre- and Postcementation Sensitivity of Teeth Prepared for Full-Coverage Restorations: A Randomized, Placebo-Controlled Clinical Study. Int J Prosthodont. 2017 Jan/Feb;30(1):38-42.

It is difficult to cover every flowable composite indication with a single viscosity: Sometimes, you need it to stay put where applied or malleable to create a specific shape. In other situations, you need it runny so that it flows into every corner or undercut. In order to meet all those needs, Kuraray Noritake Dental Inc. offers CLEARFIL MAJESTY™ ES Flow with three different levels of flowability: High, Low, and Super Low. The level of flowability is selected depending on the indication, the geometry and size of the cavity. For example, the high-flowability option is best suited as a cavity liner, while the super low flowability variant is preferable in the context of composite veneering.

However, the material has much more to offer, as confirmed by the consultants of the Dental Advisor who have honored the product with an Editors’ Choice and a Top Product Award for the seventh time in a row (Volume 39, Number 01, January-February 2022).

The 29 Dental Advisor consultants tested the medium flowability variant (Low) of CLEARFIL MAJESTY™ ES Flow in their dental practices. They assessed the product’s performance regarding placement/handling, aesthetics, viscosity and polishability. All four properties received an “excellent” rating. CLEARFIL MAJESTY™ ES Flow Low shows no running during placement, while it offers a good adaptation to the cavity walls and even flows into narrow areas. Equipped with Kuraray Noritake Dental Inc.’s Light Diffusion Technology, the material integrates seamlessly with the surrounding tooth structure and a glossy surface is obtained simply by wiping with a cotton roll soaked in alcohol.

Due to these properties and a convincing overall performance, the product received a 98 percent rating, and all 29 consultants stated that they would recommend CLEARFIL MAJESTY™ ES Flow to a colleague. Since 2015, the product has won the Top Product Award time and again, and with its three viscosities, it is likely to become your favourite product for an even broader range of indications.