429 Too Many Requests

Case by CDT Daniele Rondoni and MDT Roberto Rossi

Working with high-translucency, multi layered zirconia (KATANA™ Zirconia Multi-Layered series from Kuraray Noritake Dental Inc.) paves the way toward indirect restorations that are closely adapted to our patients’ needs. Reduced wall thicknesses allow for minimally invasive tooth preparations, while polished zirconia in the occlusal contact areas provides for an antagonist-friendly behaviour. All this is possible due to the high aesthetic potential and homogeneous structure of the materials, which work well with a full-contour design or slight vestibular cutback. For individualization or characterization, different options are available. The portfolio of finishing solutions from Kuraray Noritake Dental has just been complemented by Esthetic Colorant for KATANA™ Zirconia, a set of twelve dyeing liquids for the company’s multilayered zirconia. They are applied to the milled restoration surface prior to sintering.

Some readers may wonder why there is a need for effect liquids applied to pre-shaded zirconia with a multi-layered colour structure. Being aware of natural teeth’s unique play of colours stemming from the shape and shade of the dentin core, however, the reason is quite obvious: Esthetic Colorant diffuses into the zirconia structure, hence allowing us to create depth effects even in monolithic restorations. Moreover, it enables the user to pre-treat tissue areas, and even by using the liquids on cutback designs, we are able to reproduce case-specific internal optical characteristics quite easily. Our standard approach for the use of Esthetic Colorant on KATANA™ Zirconia HTML Plus is described by means of the following case example: An implant- and tooth-based twelve-unit bridge with a slight vestibular cutback design, finished with Esthetic Colorant and CERABIEN™ ZR Porcelain.

Fig. 1. Restoration with sintering support removed from the blank.

Fig. 2. Esthetic Colorant for KATANA™ Zirconia: Available shades.

Fig. 3. Frontal view of the milled restoration after the application of Esthetic Colorant. A chromatic map is not needed since the colours of the applied liquids are clearly visible.

Fig. 4. Occlusal view of the milled restoration after the application of Esthetic Colorant. The liquids were applied with the Liquid Brush Pen for Esthetic Colorant.

Fig. 5. Frontal view: Appearance of the restoration after sintering.

Fig. 6. Occlusal view: Appearance of the restoration after sintering.

Fig. 7. Beautiful translucency and mamelon structures in the incisal area.

Fig. 8. Situation after the application of a thin layer of CERABIEN™ ZR Porcelain, which creates an enamellike window effect and reveals the play of colours found underneath.

Fig. 9. Restoration after firing and glazing.

FINAL SITUATION

Fig. 10. Beauty shots…

Fig. 11. … of the final restoration.

Easy handling and application, impressive colour effects: Esthetic Colorant perfectly fits into our micro-layering approach with a cutback design adjusted to the age and needs of every patient. Being applied on the pre-sintered zirconia surface, the liquids do not require any extra heat treatment – the restoration is simply dried and then sintered as usual. Esthetic Colorant may be used instead of or in combination with internal stains, luster porcelains and liquid ceramics – whatever complements a laboratory’s existing approach to highly aesthetic zirconia restorations.

Dentists:

Case by Kokla Thalia, Postgraduate student in Restorative Dentistry program, Faculty of Dentistry, National and Kapodistrian University of Athens, Greece

Restoring Class II cavities can be challenging due to limited access to the posterior area, where the interproximal contact needs to re-established in a proper way. Inadequate contacts tend to result in increased plaque accumulation, food impaction and, as a consequence, the development of caries and irritation of the interproximal gingiva. Therefore, it is essential that the interproximal contact is restored based on the model of nature. A suitable matrix system and a proper clinical protocol can help us succeed in this context. The following clinical case is used to illustrate a possible strategy.

Fig. 1. Initial clinical situation. 23-year-old female patient with caries on the mandibular left second premolar.

Fig. 2. Situation after cavity preparation, isolation of the working field with rubber dam and the placement of a sectional matrix fixed with a ring. It is essential that the matrix imitates the natural shape of the contact area, which is usually rather flat or concave cervically and convex in the middle and occlusal parts.

Fig. 3. Etching of the tooth structure with phosphoric acid etchant. Afterwards, the adhesive needs to be applied (in this case, Universal Bond Quick was used according to the manufacturer’s instructions).

Fig. 4. CLEARFIL MAJESTY™ ES-2 Premium in the shade A3E is applied in the distal box to build up the wall first. In this way, the available space is used to model the most critical part of the restoration before simply filling the cavity in increments with the dentin shade A3D.

FINAL SITUATION

Fig. 5. Final restoration after finishing and polishing. In accordance with the concept behind CLEARFIL MAJESTY™ ES-2 Premium with its pre-defined shade combinations, the final enamel layer was build-up using the shade A3E. However, the use of a single opacity is also possible in the posterior region depending on the aesthetic demands.

CONCLUSION

By elevating deep interproximal margins, it is possible to focus on the critical designing of the contact point when there is still sufficient space available to do so. This simplifies the procedure, while all that is left to do can be managed in a straightforward way like a Class I restoration.

JUST COLOR: ESTHETIC COLORANT FOR KATANA ZIRCONIA

The natural tooth impresses with wonderful light-optical effects - characteristic features that result from the inner structure of the tooth. Imitating these specific effects in zirconia restorations with the staining technique or micro-layering has shown limitations so far. Kuraray Noritake has addressed this problem. Based on solid research and development work, an amazingly simple solution was created - Esthetic Colorant for KATANA Zirconia.

Mr. Stratos Chatzichristos CDT will present Esthetic Colorant in detail in this online webinar. He will show how the aesthetically individual effect of a zirconia restoration can be intensified with the new effect liquids and will showcase practical application and material science basics. Learn how to achieve a zirconia restoration with truly impressive aesthetics.

Topics:

•    basics about Esthetic Colorant for KATANA Zirconia
•    differences to traditional staining and infiltration solutions
•    areas of application of Esthetic Colorant
•    achieving a true color effect
•    masking effect for the zirconia framework (discolored stumps or metallic abutments)
•    economic advantages of using Esthetic Colorant
•    material basics of zirconia

“Very nice handling properties”

PAVANIA™ Veneer LC receives 4.6 rating in REALITY’s Five Star Award

After a FirstLook evaluation published in May 2022, a team of evaluators from REALITY RATINGS & REVIEWS has thoroughly tested PANAVIA™ Veneer LC in the clinical practice environment – with great outcomes. The purely light-cured resin cement received 4.6 out of 5 stars in the Five Star Award, the most convincing features being its handling and viscosity.

While most of the evaluators used PANAVIA™ Veneer LC for the permanent cementation of veneers, some also tested the onlay indication (restricted to high-translucency materials of a material-specific maximum thickness). Those who decided to polish the margins (43 %) found that the resin cement is very well polishable with little effort. Among the handling properties highlighted were easy seating with virtually no drifting, non-stickiness and easy excess removal – both after tack curing and in the cement’s uncured state. In addition, the evaluators praised the minimal film thickness and favourable viscosity, which has a considerable impact on the ease of seating. The working time was sufficient for all evaluators, independent of their way of working (filtering/blocking dental unit light or not, placing multiple veneers simultaneously or one veneer at a time).

The shade offering – PANAVIA™ Veneer LC is available in the four shades Clear, Universal/A2, Brown/A4 and White – was regarded adequate by most evaluators (79 %), the most popular shade being Clear. One evaluator stated that “I think the “clear” shade is my new favorite. It seems to have a brightness to it compared to other clear or translucent cements.”. Being the only shade with a high opacity, White was found to have a decisive impact on the appearance of the final restoration. The try-in pastes were well-received for their handling and easy rinse-off ability.

The PANAVIA™ Veneer LC kit available in Europe consists of PANAVIA™ Veneer LC Paste, PANAVIA™ V5 Tooth Primer and CLEARFIL™ CERAMIC PRIMER PLUS. Hence, it builds confidence by sharing primers with the proven PANAVIA™ V5, while its long working time and specific handling properties add extra benefits that are extremely valuable during veneer cementation. Click here to read the full evaluation!

HOW MANY SHADES DO WE NEED?

Case by Gasparatos Spyros, Postgraduate student in Restorative Dentistry program, Faculty of Dentistry, National and Kapodistrian University of Athens, Greece

Restoring anterior teeth with large defects using composite seems to be quite challenging. With high-performance materials at hand and a systematic layering concept in mind, however, it is possible to produce highly aesthetic results in a reproducible way. The clinical case below is used to illustrate a dual-shade layering technique with CLEARFIL MAJESTY™ ES-2 Premium, a composite system with pre-defined colour combinations.

CASE EXAMPLE

The patient, a young male, was unhappy with the appearance of his maxillary anterior teeth. Several years ago, his central incisors had been restored with composite. These existing restorations had defective and heavily discoloured margins, while their shade did not match the adjacent natural tooth structure. The maxillary lateral incisors were peg-shaped (microdontia). Economic considerations and the desire to save as much natural tooth structure as possible made the team decide to restore all four maxillary incisors with composite. CLEARFIL MAJESTY™ ES-2 Premium became the material of choice as it eliminates the need for complicated shade combination formulas and supports predictable outcomes.

Fig. 1. The patient’s initial smile.

Fig. 2. Intraoral image of the initial situation with defective composite restorations and microdonts. Two composite buttons on the right lateral incisor are used to verify the determined shade combination.

RESTORING THE CENTRAL INCISORS

We decided to restore the central incisors first and then focus on the lateral incisors. The tooth shade was determined using the VITA™ classical A1-D4 shade guide, while composite buttons were applied to the teeth to verify the determined shade combination. In order to simplify the restoration procedure, a palatal silicon index was produced before removing the existing restorations. During minimally invasive tooth preparation, bevels were created at the margins to provide for a smooth optical transition from the natural tooth structure to the composite.

An adhesive (CLEARFIL™ Universal Bond Quick) was applied after selective etching of the enamel to achieve a strong bond. With the aid of the silicon index, it was easy to create the palatal shells of the restorations with CLEARFIL MAJESTY™ ES-2 Premium in the shade A3E (enamel), which matches the determined tooth shade A3. The dentin core was built up with the same composite in the recommended shade A3D (dentin), mamelons were modelled and some CLEARFIL MAJESTY™ ES-2 Premium in the shade WD added for the incisal halo, while some individual effects (like enamel cracks) were imitated with brown stain. The build-up was finalized in the interproximal and labial areas with composite in the shade A3E. Between the central incisors, a wedge was used to retract the papilla and facilitate the designing of the interproximal contact area. The finished and pre-polished restorations already had a natural appearance.

Fig. 3. Central incisors after removal of the old restorations and the beveling of the enamel.

Fig. 4. Light-cured palatal shells made of CLEARFIL MAJESTY™ ES-2 Premium in the shade A3E.

Fig. 5. Build-up of the dentin core with mamelons individualized with the shade WD and brown stain.

Fig. 6. Situation after finalization of the central incisor restorations with composite in the enamel opacity.

Fig. 7. Central incisor restorations after finishing and initial polishing.

RESTORING THE LATERAL INCISORS

Tooth preparation was not required on the lateral incisors. Instead, they were merely cleaned after a slight roughening of the enamel surfaces. The build-up procedure was similar to the one used for the central incisors. The adjacent tooth was protected with PTFE tape, and the palatal shell was created with the aid of a finger instead of a silicone index. Afterwards, we focused on the build-up of the interproximal walls before a small amount of dentin was placed and the shape was finalized by applying the labial enamel layer.

Fig. 8. Build-up of the left lateral incisor.

Fig. 9. Situation after finishing and polishing.

FINAL SITUATION

Fig. 10. Final smile of the patient's demands.

CONCLUSION

Two different opacities, a single shade combination and some bleached shade plus stain for special effects – in the present patient case, a simple formula allowed us to create lifelike anterior restorations. With one enamel and one dentin paste used, it is possible to simply rebuild the natural anatomy without the risk of ending up with a bulky core that – once reduced – will lose its special optical structure. It is also easy to control the thickness of the final enamel layer with its huge impact on the light-optical properties of the whole restoration. For most patients and teeth with a simple or medium-to-complex internal colour structure, the selected concept is very well suited and will lead to pleasing outcomes.

According to Koelnmesse, 120,000 visitors from 162 countries attended the 40th International Dental Show between March 14 and 18, 2023. Being one of the 1,788 companies from 60 countries exhibiting at the show, the Kuraray Noritake Dental Inc. team enjoyed being back on-site, and seized every opportunity to connect with end-users of their products in person again. About 60 percent of the visitors and 75 percent of the exhibitors came from abroad. A highly international, euphoric atmosphere and lots of positive feedback on innovations confirmed that the team is on the right track in developing solutions that support users in improving the lives of their patients. However, the visiting dental professionals were not only interested in products for the dental office and laboratory, but also in smart techniques and approaches for their productive use – presented by renowned experts in lectures and hands-on demonstrations.

Laboratory solutions: The professionals were particularly interested in the brand-new Esthetic Colorant and the whole KATANA™ Zirconia Multi-Layered Series.

Hands-on demonstration of MDT Giuliano Moustakis: Zero Bake Technique with Esthetic Colorant and CERABIEN™ ZR FC Paste Stain.

MDT Nondas Vlachopoulos revealing how to obtain aesthetic outcomes with the One-Bake Technique.

Micro-layering with MDT Daniele Rondoni.

A roadmap to white-pink aesthetics shared by MDT Andreas Chatzimpatzakis.

MDT Alek Aronin describing a handcraft approach to highly aesthetic outcomes.

Indirect workflow solutions: PANAVIA™ Cements meeting every need.

Universal Excellence: CLEARFIL MAJESTY™ ES-2 Universal put to a test.

Handling test with direct restorative materials.

Demonstration of the flowable injection technique by Dr Michał Jaczewski.

Dr José Ignacio Zorzin shedding light on how to achieve reliable adhesion with universal products.

CEREC tips and tricks from MUDr Josef Kunkela, PhD.

Looking forward to seeing you at the next International Dental Show in Cologne in 2025 or elsewhere: The Kuraray Noritake Dental team!

Stratos Chatzichristos just tested the brand-new Esthetic Colorant on restorations made of KATANA™ Zirconia. This is his verdict:

“For me, KATANA™ Zirconia plus Esthetic Colorant is a true killer combination that leaves nothing to be desired. I love to apply the dyeing liquids to my monolithic zirconia restorations to intensify characteristic features and create natural shade effects. Usually, those restorations just need a final layer of glaze to look amazing!”

Every tooth has its unique internal shade structure. With its unique raw materials and colour structure, and specifically developed for the “KATANA ™ Zirconia” Multi-Layered series, Esthetic Colorant enables you to easily and efficiently imitate a variety of these unique characteristics.

The liquids are simply applied to the monolithic or anatomical restoration after milling using ametal-free brush or brush pen, preferably with a Liquid Brush Pen. The Esthetic Colorant diffuses into the pre-sintered structure and is fixed during sintering with no additional baking, resulting in lifelike shade effects shining from the inside of the restoration.

Would you like to know more about how to use our Esthetic Colorant, watch the video now:

World’s largest dental trade show is coming to a close

Have you been one of the dental professionals who have visited the world’s largest dental trade show this year? We have all had a fantastic time and would like to thank you for your huge interest in our products and solutions. From our conversations with you, the whole team has gained new insights into what you like, value and desire. We will use this information to keep on innovating – to develop more groundbreaking new technologies and products for patient-centered dentistry.

For example, products like KATANA™ Zirconia YML which feature second-generation multi-layered technology. It enables dental technicians to solve all their zirconia cases with a single material thanks to its flexural strength, translucency and colour gradation in a single disc.

Experts like MDT Daniele Rondoni and MDT Nondas Vlachopoulous value the well-balanced properties that enable them to position the restoration quite flexibly in the blank. They are also enthusiastic about the aesthetic potential of this and other materials of the KATANA™ Zirconia Multi-Layered Series that allows for beautiful outcomes with no or just a small layer of porcelain.

In their presentations, both professionals revealed how to leverage the benefits of multi-layered zirconia. For MDT Daniele Rondoni, for example, multi-layered KATANA™ Zirconia is the perfect base for his 4.4.1 micro-layering technique demonstrated at the booth. Thanks to the extraordinarily well-balanced optical properties of the materials, he usually opts for a full-contour design or a slight vestibular cutback – depending on the region in the mouth and the aesthetic demands of the patient. Then, he combines different materials of the CERABIEN™ ZR portfolio in a micro-layer to create natural outcomes.

MDT Nondas Vlachopoulos uses the KATANA™ Zirconia Multi-Layered Series as a basis for his restorations finishing with the one-bake technique he demonstrated in his presentations – or for the incredible imitations of nature that only a few dental technicians are able to create.

Have you missed some of the presentations that were of interest you? All the lectures and hands-on demonstrations will be available OnDemand soon!

See you all in Cologne in 2025!

IDS and Kuraray Noritake Dental Inc. celebrating anniversaries

Did you know that not only the IDS is celebrating a double anniversary this year, but Kuraray Noritake Dental Inc. is, too? The PANAVIA™ brand was established 40 years ago, while the first ever zirconia disc with a multi-layered colour structure – KATANA Zirconia ML – was introduced ten years ago at the IDS 2013.

The success story of the brand PANAVIA began with the introduction of PANAVIA™ EX, the first resin cement containing the original MDP Monomer. Since then, the company never stopped innovating: new technologies were developed and combined with existing ones to create a portfolio of resin cements precisely geared to the era-specific needs of end users. All of this has resulted in the current portfolio of easy-to-use and highly aesthetic resin cements that provide top-level bond strength.

The latest member of the PANAVIA™ family is PANAVIA™ Veneer LC, a light-curing resin cement system from Kuraray Noritake Dental Inc. available in four shades. It consists of PANAVIA™ Veneer LC Paste, PANAVIA™ V5 Tooth Primer and CLEARFIL™ CERAMIC PRIMER PLUS. With its extended working time of 200 seconds* on the primer, PANAVIA™ Veneer LC is designed for a simultaneous veneer placement technique. Other beneficial features include a well-aligned paste consistency, a high colour stability, easy excess removal after tack-curing and an excellent bond strength over time.

Many visitors interested in this as well as the other two products of the current PANAVIA™ family – PANAVIA™ V5 and PANAVIA™ SA Cement Universal – had the chance to talk to Yui Otsuka, marketing specialist, from the Information Marketing Group of Kuraray Noritake Dental Inc. in Japan. “Many visitors know and trust the PANAVIA™ brand. As users of PANAVIA™ V5, they were either looking for a light-curing version – which they found in PANAVIA™ Veneer LC – or for a solution that would simplify their workflows in many situations. The desired simplification is easily achieved with PANAVIA™ SA Cement Universal, the self-adhesive resin cement that even bonds to glass ceramics very well,” she reports. Please be sure to look out for her at our booth to learn more interesting facts about the PANAVIA™ family!

For dental technicians, it might be worth having a look at the last day’s presentation programme: At 09:30 am, and MDT Daniele Rondoni will shed light on the “4.4.1 Micro-Layering Technique”. At noon, MDT Giuliano Moustakis will demonstrate how to achieve beautiful outcomes simply by carving and the use of Esthetic Colorant on KATANA Zirconia. And finally, MDT Andreas Chatzimpatzakis will focus on ”White-Pink Aesthetics” (1:30 pm).

See you tomorrow in Hall 11.3 at our Booth # E010/F019!

Just two more days to satisfy your thirst for knowledge!

We cannot quite believe how quickly three days of the world’s largest dental trade fair have passed! We have had some fascinating conversations with visitors and truly appreciate the insights and information they have been able to give us. So, with just two more days to go, please do not miss the opportunity to talk with our team – we promise you will not be disappointed; you will find them more than happy to make time for you and share their profound knowledge.

Today in the early afternoon, many CEREC users interested in our chairside materials – KATANA™ AVENCIA and KATANA™ Zirconia Block for CEREC – attended the hands-on demonstration of MUDr Josef Kunkela, PhD titled “KATANA™ Properties and CEREC Tips & Tricks”. He revealed that CAD/CAM materials should be carefully selected not only for aesthetic reasons, but also to provide for an accurate fit, high marginal stability and surface quality of the restorations produced. His knowledge stems from studies conducted in his own research laboratory. In these tests, KATANA™ materials outperformed other materials (of the same material class) in terms of dimensional stability, size of the cement gap and margin and surface quality.

These facts were new to a part of the audience, and confirmed by experienced users. As Ricarda Köbler, Area Sales Representative at Kuraray Noritake Dental, says: “I talked to several users of KATANA™ Zirconia Block, who were not surprised by the findings just presented. They love the processing properties of the material just as its aesthetic potential, and value the precise fit and smooth surfaces they obtain every time.” Ricarda is part of the team at our booth’s Indirect Restorative counter showcasing CAD/CAM blocks, resin cement systems and more.

The next – and final – opportunity to attend the demonstration of MUDr Josef Kunkela, PhD is tomorrow morning at 09:30 am at the Kuraray Noritake Dental booth (Hall 11.3, Booth # E010/F019). Popular presentations focusing on laboratory solutions and approaches from today will be repeated on Friday, starting with MDT Daniele Rondoni’s “4.4.1 Micro-Layering Technique” at 12:00 pm and continuing with MDT Nondas Vlachopoulos’ “One Bake Technique at 03:15 pm. On Saturday, MDT Daniele Rondoni will be on stage again at 09:30 am.