429 Too Many Requests

During the strange and difficult times caused by the COVID-19 pandemic, the top priority for dentists across the world has been to keep themselves and their patients safe. To do so, not only have many dental practices been shut down, but also in-person dental congresses, symposia and other events have been postponed indefinitely.

As a result of these shutdowns, countless dentists have found it difficult to keep up to date with all of the latest scientific and product developments in the dental world. Our webinars highlight how Kuraray Noritake Dental’s emphasis on education allows you to stay informed and evolve professionally - all from the comfort of your own home.

A range of on-demand webinars

When the pandemic began, Kuraray Noritake Dental quickly set about establishing a state-of-the-art, self-hosted webinar platform. The master dental technician Daniele Rondoni hosted the debut webinar, in which he eloquently discussed the art of micro-layering with Kuraray’s new porcelains.

Since then, a number of adventurous and intelligent dental professionals have shared their knowledge and insight through further webinars. Dr Josef Kunkela, a key opinion leader in digital dentistry and the founder of the KUNKELA Campus, informed participants about the crucial factors that influence the gap between the margin of the prepared tooth and the restoration. Meanwhile, zirconia, oral scanners and feather edge preparation - the winning triad of today’s prosthetic therapy - were the focal points of Dr Davide Cortellini’s engaging presentation.

These free webinars, along with others presented by such figures as Dr Michael Braian and Dr Piero Simeone, are all available for on-demand viewing through Kuraray Noritake Dental’s webinar library.

“At Kuraray Noritake, we’re focused on creating more universal and streamlined dental workflows,” says Maurice Bonn, marketing manager for Europe. “This naturally extends to our series of educational webinars, which have featured such industry-leading products as PANAVIA™ V5 and the KATANA™ Zirconia series.”

“Dental professionals can look forward to more webinars hosted by some of the industry’s best and brightest in the coming months,” adds Bonn.

Clinical cases to broaden your knowledge

Kuraray Noritake Dental’s investment in research and development is just part of the reason for the company’s continued success. Now, clinical cases involving KATANA™ Zirconia HTML and CLEARFIL MAJESTY™ ES-2 and even a full-mouth rehabilitation using three different types of KATANA™ Zirconia are all available for easy access through the company’s website.

A newsroom packed with new information

Webinars, clinical cases, interviews, product news and more - there is only one place where all of these can be found in abundance, and that is the Kuraray Noritake Dental newsroom.

By Aleksandra Łyżwińska, DMD

This patient required the replacement of an insufficient composite restoration of the mandibular right second premolar. It was planned to restore the tooth using a combination of CLEARFIL MAJESTY™ ES Flow – Super Low A3 and CLEARFIL MAJESTY™ ES-2 Classic A3 with some tints. CLEARFIL™ SE BOND 2 was the adhesive of choice. It produces a reliable chemical adhesion to dentin and enamel as it contains 10-MDP. The best results are obtained after selective enamel etching.

Fig. 1 Initial clinical situation.

Fig. 2 Removal of the existing restoration reveals carious tissue underneath.

Fig. 3 Appearance of the cavity after caries excavation and preparation.

Fig. 4 Dried tooth structure after selective enamel etching with a sectional matrix in place.

Fig. 5 Build-up of the interproximal wall with CLEARFIL MAJESTY™ ES-2 Classic (shade A3) after the use of CLEARFIL™ SE BOND 2.

Fig. 6 Successful transformation of a Class II cavity to Class I.

Fig. 7 Cavity filled with CLEARFIL MAJESTY™ ES Flow (Super Low A3).

Fig. 8 Appearance of the tooth after the application of a final layer of CLEARFIL MAJESTY™ ES-2 Classic (shade A3) and some tints.

Fig. 9 Polished restoration on the mandibular right second premolar.

FINAL SITUATION

Fig. 10 Treatment result ...

Fig. 11 ... after rubber dam removal.

Dentist:

ALEKSANDRA ŁYŻWIŃSKA
Warsaw, Poland

Aleksandra Łyżwińska, DMD, is a passionate aesthetic and adhesive dentist. Driven by Evidence Based Dentistry, her goal includes using modern composite materials and bonding agents in her clinical practise. In addition to her primary job, she worked as a lecturer and an assistant professor at the Department of Conservative Dentistry and Endodontics of Medical University of Warsaw, her alma mater.

By Aleksandra Łyżwińska, DMD

INITIAL SITUATION

Fig. 1 MOD filling with marginal leakage, secondary caries, and significant mechanical weakening.

Fig. 2 Cavity preparation extending over the buccal and palatal cusps.

Fig. 3 Direct restoration created with CLEARFIL MAJESTY™ ES-2 Classic, shade A2, and stains.

Fig. 4 Appearance of the restoration after polishing with CLEARFIL™ TWIST DIA.

FINAL SITUATION

Fig. 5 Repolishing during check-up one week later. The restoration shows an excellent color integration and natural gloss.

Dentist:

ALEKSANDRA ŁYŻWIŃSKA
Warsaw, Poland

Aleksandra Łyżwińska, DMD, is a passionate aesthetic and adhesive dentist. Driven by Evidence Based Dentistry, her goal includes using modern composite materials and bonding agents in her clinical practise. In addition to her primary job, she worked as a lecturer and an assistant professor at the Department of Conservative Dentistry and Endodontics of Medical University of Warsaw, her alma mater.

By D.T. Pier Francesco Golfarelli

Digital workflow and CAD/CAM shaping have now become a daily practice that helps to manage most cases, including the most extensive re-adaptations (rehabilitations).

KATANA™ HTML zirconia was selected, in consultation with the specialist, for the case presented here. It was principally chosen for its aesthetic and mechanical properties. One of our selection criteria was the advantageous lower abrasiveness level of zirconia. Because of its density, this material is less abrasive than the more traditional ceramics in combination with adequate mechanical polishing. Based on the initial situation, once the assembly in the articulator was completed, we designed a structure with anterior cutbacks for maximum aesthetics, while for the posterior teeth a monolithic solution was chosen for maximum strength and quality of the functional surfaces.

With the CORE & SHELL technique developed by the Noritake Italian Study Club, I can now fully exploit the optical properties of KATANA™ zirconia by integrating it, in the anterior area, with Noritake CERABIEN™ ZR ceramics. In the images here you can see the aesthetic results of the anterior and side areas, the mechanically polished monolithic surfaces and the special Noritake glaze.

Fig. 1 CAD Shaping - 3Shape Dental Designer

Fig. 2 Structure design with cutbacks

Fig. 3 KATANA™ HTML structure

Fig. 4 Occlusal surface – details

Fig. 5 Shade stain

Fig. 6 Shade Stain (SS)

Fig. 7 Core

Fig. 8 Internal Live Stain (ILS)

Fig. 9 Shell

Fig. 10 Shell Tissue

FINAL SITUATION

Fig. 11 Layering Details

Dentist:

D.T. Pier Francesco Golfarelli
Noritake Italian Study Club Teacher, Forlì

By Dr Adham Elsayed

This video explains the concept of doing class I restorations in less than 10 minutes.

Dr. Elsayed uses Clearfil Majesty ES Flow, Clearfil Universal Bond Quick and Clearfil Twist Dia and shows one of the advantages of flows over conventional composites. Using stamp technique (optional), fast and easy restorations can be done using Clearfil Universal Bond Quick (no waiting time) and different viscosities of flows. This is very practical for composite restorations in the molar area.

This case was conducted by Dr Davide Cortellini, owner of Studio Cortellini in Riccione in Italy, and dental technician Angelo Canale, owner of Canale dental laboratory in Rimini in Italy.

This patient came to the clinic to improve her chewing ability and aesthetic level. The physical examination revealed the presence of several endogenous erosive lesions that made chewing difficult, in addition to partly affecting the esthetics due to decrease in enamel thickness and the presence of dyschromic composite restorations. The possibility of using the new types of both tetragonal and cubic multilayer zirconia made it possible for us to plan the complete covering of all the elements with extremely conservative crowns with thicknesses between 0.5 and 1 mm in the axial and occlusal areas and up to 0.2 mm at the margin.

VERTICAL PREPARATIONS

Very conservative vertical preparations were carried out in the enamel without anesthesia. In the upper arch, the front group was prepared for full-veneer crowns, while the lower front group was treated with conventional lithium disilicate veneers without interproximal separation. In this case too, vertical preparations were carried out without finishing line. The impression was made using a 3Shape TRIOS intraoral scanner. The technician modeled the zirconia restorations that were then completed by the ceramist.

Knife Edge Preparation

SCANNING SEQUENCE

Digital DV models of temporary teeth

The three different materials were selected on the basis of the specific positions inside the mouth:

• UTML for the anterior teeth
• STML for the premolars
• HTML for the molars

The final result shows excellent integration between the 3 different types of zirconia and a good natural feeling.

MINIMAL PREP KATANA™ (KATANA™ MICRO LAYER)

HARMONIC OPTICAL INTEGRATION

The full-mouth rehabilitation procedure using three different types of zirconia led to a functional and beautiful treatment outcome. The optical integration between the materials is excellent and the high translucency especially in the anterior region creates a true-to-life appearance.

APPROACH WITH MINIMAL INVASIVE PREPARATIONS - REPORT ON THE SELECTION OF MULTI-LAYERED ZIRCONIA

Dental zirconia is no longer just the opaque framework material introduced two decades ago. Nowadays, it offers the high strength needed for long-span bridges, dentin-like translucency and strength perfect for thin-walled posterior crowns, or enamel-like optical properties for beautiful anterior restorations - depending on its composition and structure. Kuraray Noritake offers three types of dental zirconia - three with a multilayered structure created using patented powder coloring technology. They differ with regard to their optical and mechanical properties, which makes it possible to choose an ideal material for every clinical situation.

Dentists:

DR. DAVIDE CORTELLINI

Dr. Cortellini graduated with honours in Dentistry and Dental Prosthetics from the University of Siena in 1992. He won the scholarship of the Italian Society of Periodontology for the year 1994-95. He then received the opportunity to attend the Department of Periodontology and Fixed Prosthetics of Prof. NP. Lang at the University of Bern in Switzerland, carrying out clinical and research activities. He obtained the title of „Doctor Medicinae Dentium“ (D.M.D.) at the same university in 2000. Dr. Cortellini is the author of scientific publications in international journals of aesthetic dentistry. He is an active member and advisor to the Italian Academy of Prosthetic Dentistry, and a member of the International Academy for Digital Dental Medicine. He holds conferences in Italy and abroad and is dedicated to clinical activity in his own practice in Riccione, where he primarily focuses on aesthetic and digital prosthetics and complex prosthetic rehabilitation.

CDT. ANGELO CANALE

Mr. Canale is a dental technician graduated high school in 1981. He’s the owner of a dental laboratory in Rimini since 1986. He is specialized in fixed prosthesis on natural teeth and on implants with a metal free approach using different kind of materials. He is always interested about digital technique using CAD-CAM systems (in his laboratory the 80% of the work comes from digital impressions). He is co-author of international publications on PPAD, QDT, EJED and THE JOURNAL OF ADHESIVE DENTISTRY concerning the use of metal free in prosthesis. He is a speaker in national and international congress.

By Daniele Rondoni, RDT

Hybrid designing meets the functional needs in term of lower abrasiveness and higher toughness.

Step 1
Zirconia Frame (KATANA Zirconia HTML A2) cut-back designed to minic anatomical dentin structure and incisal frame.

Step 2
Application of Internal Stain.

Step 3
Completion of Internal Stain firing.

Step 4
Application of Luster, Clear Cervical and Opacious Body.

Step 5
Completion of firing.

Step 6
Completion of glaze (self-glaze) firing.

Step 7
Polishing of lingual side.

Step 8
Post-operative view.

4-Years Post-operative.

To achieve excellence it is crucial to know the properties of modern materials and their correct clinical procedure. With this premise, surprising clinical results can also be achieved by combining different materials in the same clinical case.

This clinical case follows the aesthetic request of the patient who wanted to solve the pathology concerning the incisors with a direct composite restoration on 2.1 and a KATANA^TM STML crown on 1.1.

Following the mock-up the patient wanted larger incisor shapes with a strong character. The 2.1 was restored only with the MAJESTY^TM ES-2 Classic A2 mass exploiting the extraordinary ability of mimicry that comes from the Kuraray Noritake Dental light diffusion technology - LDT. The restoration on the 2.5 was performed with a CAD/CAM hybrid ceramic block - KATANA^TM AVENCIA^TM.

KATANA^TM AVENCIA^TM Block was characterized with a staining resin before cementation with the new PANAVIA^TM SA Cement Universal. PANAVIA^TM SA Cement Universal includes in its formulation a new type of silane coupling agent – LCSi monomer and this ensures strong and durable chemical bond to glass ceramics and composite resins without pretreatment with silane.

By Irfan Abas
Dental implantologist & restorative dentist

Irfan Abas is a specialist in the field of oral implantology & restorative dentistry and an international speaker on the subject. He has given more than 20 presentations, workshops and live surgery courses throughout the world. TP - a dutch dental magazine, of which he is also editor, has published multiple articles under his name. Another highlight is a publication in the NTvT, in collaboration with Prof. Gert Meijer (Radboud UMC), under whose supervision Abas successfully completed the four-year postdoctoral training Reconstructive Dentistry in 2014. He is also an instructor and lecturer for the AAIE and chair of MINEC Netherlands. Irfan Abas has his own practice in Bussum, the Netherlands (tandartsabas.nl).

A healthy 42 year-old male patient requested reconstruction of his central incisors, which were badly worn.

Pre-Treatment

After producing the mock-up, grooves were prepared through the mock-up.

To fit two lithium disilicate veneers, a preparation of 1 mm was required. After removing the mock-up, the preparation was perfected.

Checking the space using a silicone mold.

Definitive preparation (frontal)

Temporary veneers made from temporary resin based material (Protemp)

Spot-etching before bonding the temporary veneers in place.

A small amount of flowable composite applied to the etched surfaces.

Light curing the entire surface of the temporary veneers.

Finished temporary veneers.

The veneers constructed by the dental technician.

Checking the fit of the veneers

Rubber dam fitted to enable controlled adhesive cementation.

Etching with 35% phosphoric acid K-Etchant Syringe for 10 seconds.

Treatment with selfetching primer PANAVIA™ V5 Tooth Primer (left on for 20 sec.)

Etching of the lithium disilicate veneers with hydrogen fluoride.

Clearfil Ceramic Primer Plus MDP-silane primer applied to the veneers.

Veneers secured to a placement instrument before definitive cementation

PANAVIA V5 Paste applied to the inner surface of the veneer.

PANAVIA V5 Paste spread over the veneer.

Veneer fitted and excess removed.

Light curing (minimum 10 sec.).

Immediately after the adhesive cementation with PANAVIA V5.

Immediately post-op.

Immediately post-op.

Two months post-op.

One year post-op.

One year post-op.