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USER FEEDBACK ON PROCEDURES AND OUTCOMES

The use of universal products – whether solitary or combined – offers practical benefits, which are experienced differently depending on the clinical context, techniques selected and each user’s individual preferences. Key advantages include reduced treatment time, lower costs, fewer components and steps, fewer potential errors and ultimately more satisfied patients. The following compilation of statements from experienced dental practitioners on the universal concept and the products offered by Kuraray Noritake Dental Inc. in general will help you assess in what way they might allow you to elevate your workflows.

RATIONALIZING CLINICAL WORKFLOWS

Streamlining or rationalizing clinical workflows in restorative dentistry is always worth striving for. Procedures are often complex and materials demand strict adherence to recommended protocols, so that using universal solutions with standardized protocols for a wide range of indications is a promising approach. Dr José Ignacio Zorzin, Associate Professor at the Department of Operative Dentistry and Periodontology at the Friedrich-Alexander-University of Erlangen-Nürnberg in Erlangen, Germany, stated in an article: “Rationalizing clinical workflows: This is the main reason for the use of universal products in adhesive dentistry. They are suitable for a wide range of indications and different application techniques, fulfil their tasks with fewer components than conventional systems and often involve fewer steps in the clinical procedure.”

INCREASING PREDICTABILITY AND EFFICIENCY

Predictability and efficiency in direct posterior restoration procedures are the main reasons for Dr Koray Kendir, the co-founder of a private dental clinic in İzmir, Turkey to choose universal adhesives and composites. In a case report, he stated that “the combination of CLEARFIL™ Universal Bond Quick 2 and CLEARFIL MAJESTY™ ES Flow Universal allows clinicians to perform predictable, efficient posterior restorations. Their universal applicability and handling properties align with the “Universal Excellence” concept, supporting simplified, yet reliable daily practice.”

Fig. 1. Clinical image from the case report of Dr Koray Kendir: Cavities ready for the restorative procedure.

Fig. 2. Clinical image from the case report of Dr Koray Kendir: Occlusal view of the teeth restored with a universalshade flowable composite with super-low flowability.

GETTING A GRIP ON COSTS

Dr Alessandro Devigus, the owner of a private practice in Bülach, Switzerland, shared in an interview that the cost factor is most important for him: “In the first place, using fewer products and components that are easy and quick in their application allows me to get a grip on costs. With fewer steps and fewer bottles, shortened application times and standardized workflows, the time a patient needs to sit in the chair is reduced, which allows me to save the most valuable factor in the office: my time.” And there is even more to it: “At the same time, material storage and order management are streamlined, so that it is much easier to keep track of dates of expiry, hence saving material costs as well. And the best thing about it is that all these savings are possible without compromising treatment quality,” he continued.

If you would like to benefit from the described workflow enhancements, it is probably worth giving universal excellence products from Kuraray Noritake Dental Inc. a try. For those who prefer to start with a single universal solution instead of transforming whole procedures immediately, the following feedback from clinicians may be enlightening.

UNIVERSAL CLEANER: SUITABLE EVEN FOR USE IN THE PATIENT’S MOUTH

The probably most special feature of KATANA™ Cleaner is its universal applicability. It cleans not only virtually every restorative material very well, but also works intra-orally to clean enamel and dentin after tooth preparation. Dr Richard Young from San Bernadino, CA, USA, uses it intra- and extra-orally, stressing that it “contains MDP based surfactant that breaks down blood and saliva – removing contamination.”

Fig. 3. Extra-oral application of KATANA Cleaner to remove contamination from a lithium disilicate crown by Dr Richard Young.

Fig. 4. Intra-oral application of KATANA Cleaner to remove contamination from the prepared tooth by Dr Richard Young.

UNIVERSAL ADHESIVE: SKIPPING THE WAITING TIME

Zero waiting time is probably the most striking feature of CLEARFIL Universal Bond Quick 2. While other universal adhesives need to be rubbed into any surface extensively, the product is applied within a few seconds. This reduces the risk of contamination and saves time. Based on his clinical experience, Dr Kendir confirmed that it works well: “In this case, CLEARFIL Universal Bond Quick 2 provided strong adhesion with minimal application time.”

Talking about universal adhesives in general, Dr Zorzin stressed that adhering to the protocols described in a material manufacturer’s instructions for use is particularly important: “Universal adhesives contain lots of different technologies in a single bottle. While this fact indeed allows users to rationalize their clinical procedures, it also requires some special attention. As every highly developed material, universal adhesives need to be used according to the protocols recommended by the manufacturer.” For CLEARFIL Universal Bond Quick 2, this protocol is particularly easy.

UNIVERSAL COMPOSITES: GREAT SHADE-MATCHING PROPERTIES

Lately, an experienced user of CLEARFIL MAJESTY™ ES Flow, Dr Michał Jaczewski from Legnica in Poland, tested the universal-shade option CLEARFIL MAJESTY ES Flow Universal – also in the low flowability variant. He confirmed that the reduced number of shades works well: The product “offers properties which are – from a personal perspective – ideal for the flowable injection technique. The shadematching properties are astonishing; the translucency is quite high when placed in thin layers (so that enamel is very well imitated), and the polishability is as good as that of CLEARFIL MAJESTY ES Flow. For virtually effortless, bubble-free injection, the product comes in a nicely designed syringe. And last but not least, the product’s mechanical properties provide peace of mind even in the posterior region.”

Fig. 5. Clinical image from the report of Dr Michał Jaczewski: Flowable composite injected into the transparent index.

Fig. 6. Clinical image from the report of Dr Michał Jaczewski: Central incisors beautifully restored.

According to Dr Jusuf Lukarcanin, MEDICANA International Hospital Izmir, Turkey, the same is true for the universal paste-type composite CLEARFIL MAJESTY™ ES-2 Universal. He states: “My first reaction to this material was: This is a Game-Changer. The results are magical. Smoother and easy handling properties, high-gloss, more natural light distribution and the process is simple. Aside from being able to skip the shade selection step, your workflow remains the same as with traditional composites. At first, I might have been a little sceptical about replacing all the different colours of composites we use in office every day. But after a couple of tries I found out that it indeed works every time, in some cases even without the use of a blocker. Simply ingenious!”

Fig. 7. Clinical image from Dr Jusuf Lukarcanin: Diastema closure in a 28-year-old female patient - initial clinical situation.

Fig. 8. Clinical image from Dr Jusuf Lukarcanin: Diastema closure in a 28-year-old female patient - upper anteriors treated with CLEARFIL MAJESTY ES-2 Universal in the shade UW.

UNIVERSAL RESIN CEMENT: NO PRIMER NEEDED

Primer for tooth structure, cement paste, ceramic primer and silane: PANAVIA™ SA Cement Universal has it all in a single syringe. With no extra bottles needed, it provides for streamlined cementation procedures. That is why Dr Devigus uses it as his standard solution for definitive placement of CEREC overlays and crowns: “It bonds to virtually every surface including lithium disilicate without a separate primer and offers a good flowability that facilitates restoration placement. An additional feature contributing to a quick and stress-free clinical procedure is its easy and gingiva-friendly excess removal after tack curing.”

Watch the video to hear what exactly Dr Alessandro Devigus says about PANAVIA SA Cement Universal:

CONCLUSION

Experience shared by clinicians from different clinical environments demonstrates that universal solutions can make restorative dentistry more efficient, predictable and economical. By reducing the number of materials, steps and technique sensitivities, universal products help streamline workflows while maintaining high clinical performance.

Smooth and efficient procedures, easy shade matching, and great clinical outcomes are key expectations in modern restorative dentistry. Kuraray Noritake Dental Inc. continues to support these needs through ongoing innovation in advanced dental materials. Building on the success of CLEARFIL MAJESTY™ ES Flow, with its multiple flowabilities and extensive shade range, a flowable composite with a simplified universal shade concept was developed.

Launched in Europe in 2025, CLEARFIL MAJESTY™ ES Flow Universal is available in two flowabilities – Super Low and Low. It is a highly filled flowable composite featuring submicron fillers (Super Low: 78% and Low: 75% by weight, respectively) and light diffusion technology.

Its universal shade system allows one shade (U) to cover the VITA classical A1-D4 system shades. For cavities in darker teeth (B3 and darker shades) with limited surrounding tooth structure – such as Class III and IV cavities – a second darker shade (UD) is available.

While the material is available in two flowabilities in Europe, Super Low is the variant offered in the United States and tested by the Dental Advisor.

CLEARFIL MAJESTY ES Flow Universal is gaining increasing clinical acceptance thanks to:

• A simplified two-shade concept
• Excellent handling properties
• High mechanical strength – comparable to paste-type composites
• Easy polishing and long-lasting gloss
• A well-designed syringe and tip system that helps minimise voids and dripping

DENTAL ADVISOR RESEARCH AWARD

Laboratory tests confirm strength, stability, and efficient placement

Independent in-vitro testing conducted at the Dental Advisor Biomaterials Research Center demonstrated that CLEARFIL MAJESTY ES Flow Universal (Super Low) delivers some of the highest physical property values within its class, including flexural strength, fracture toughness, and compressive strength.

The material also showed excellent shade matching across a broad range of tooth shades when compared with other universal-shade composites. Radiographic analyses further confirmed that the syringe and tip design contribute to minimal void formation, supporting reliable and efficient placement. Viscosity testing revealed a low-flow, no-slump consistency, allowing precise anatomical sculpting and controlled cusp build-up.

These results were key factors in earning the Dental Advisor Research Award, which recognizes outstanding physical property testing and a strong commitment to research-driven product development.

Dental Advisor Top Product Award

Clinicians praise handling, translucency, and blend-in ability

Beyond laboratory performance, CLEARFIL MAJESTY ES Flow Universal (Super Low) also excelled in clinical practice, which was a key factor in earning a Dental Advisor Top Product Award. Evaluators highlighted its ideal viscosity and impressive blend-in ability achieved through optimised translucency, light diffusion technology and fine-tuning of the chroma.

The simplified shade system and delivery design translated into confident, predictable results in daily practice, as reflected in evaluator feedback such as: "Excellent shade matching and no air bubbles." These attributes make the material well suited for a wide range of restorative applications in both anterior and posterior regions.

Scientific excellence and clinical practicality smartly combined

By receiving both the Dental Advisor Research Award and the Top Product Award, CLEARFIL MAJESTY ES Flow Universal (Super Low) demonstrates a strong balance of scientific excellence and clinical practicality. Its combination of simplified shade matching, high mechanical performance, and convenient handling makes it a versatile solution for clinicians seeking efficiency without sacrificing aesthetics or strength.

Part of Expanding Universal Excellence 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 streamlines your workflows, offering you high-quality materials and tools that work seamlessly with your expertise.

CLEARFIL MAJESTY ES Flow Universal is the latest resin-based addition to our universal portfolio. Being suitable for a wide range of applications within direct and indirect restorative workflows, it is a valuable complement to existing universal paste-type composite CLEARFIL MAJESTY™ ES-2 Universal and universal resin cement PANAVIA™ SA Cement Universal.

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

Interviu su Takehiro Kameya, „Kuraray Noritake Dental Inc.“ technologijų skyriaus vadovu.

Kaip nustatėte, kad reikia universalios skystos kompozicinės medžiagos?

Kompozicinės medžiagos su universaliu atspalvių pasirinkimu visame pasaulyje tampa vis populiaresnės. Tai leido mums padaryti prielaidą, kad yra paklausa ir skystos kompozicinės medžiagos. Vartotojai taip pat gaus naudos iš supaprastintų procedūrų ir sumažinto atspalvių skaičiaus, kurį reikia laikyti sandėlyje, o tai turės teigiamą poveikį atsargų valdymui. Atitinkamai, mes pristatėme universalų skystą kompozitą Japonijoje, kur jis jau užima didelę rinkos dalį. Vartotojai jį naudoja įvairiais atvejais ir gauna puikius atsiliepimus. Kadangi jis buvo labai gerai priimtas Japonijoje, mes kreipėmės į Europos komandą, kad išplėstume jo platinimo teritoriją į Europą, ir buvo priimtas sprendimas jį pristatyti. Mes pasistūmėjome į priekį su komercializavimu per labai trumpą laikotarpį – apie vienerius metus.

Ar tikrai yra pridėtinė vertė naudoti universalią tekantį kompozitą kartu su universaliu pastiniu variantu?

Taip, papildomas modernių tekančių kompozitų naudojimas duoda keletą privalumų. Tai yra todėl, kad, skirtingai nuo ankstesnių produktų, naujausios kartos tekantys kompozitai pasižymi pakankamu mechaniniu stiprumu, kad juos būtų galima naudoti įprastiniams restauravimams. Skysto kompozito naudojimo privalumai apima gebėjimą įtekėti net į siauriausias (kartais sudėtingas) ertmės dalis, o tai užtikrina lengvas ir greitas plombavimo procedūras bei tvirtą prisitaikymą prie adhezijos sąsajos, dėl ko susidaro sandarus užsandarinimas.

Kuo skiriasi CLEARFIL MAJESTY™ ES Flow ir CLEARFIL MAJESTY™ ES Flow Universal?

CLEARFIL MAJESTY™ ES Flow Universal išlaiko CLEARFIL MAJESTY™ ES Flow išskirtines savybes, tokias kaip patogus dozavimas, naudojimas ir formavimas, itin lengvas ir greitas poliravimas, ilgalaikis blizgesys ir puikios mechaninės savybės. Dėl didelio stiprumo abu produktai gali būti naudojami ne tik kaip pamušalas, bet ir įprastoms tiesioginėms restauracijoms. Skirtumas yra atspalvių koncepcijoje. CLEARFIL MAJESTY™ ES Flow Universal pristato universalią atspalvių sistemą, leidžiančią prisitaikyti prie plačios spalvų gamybos su mažesniais atspalvių skirtumais.

Apibūdinkite „CLEARFIL MAJESTY™ ES Flow Universal“ atspalvių koncepciją. Kiek atspalvių yra ir kaip jie parenkami?

„CLEARFIL MAJESTY™ ES Flow Universal“ serija CLEARFIL MAJESTY™ ES Flow Universal asortimentą sudaro dvi spalvos: Universal (U) ir Universal Dark (UD). U yra puikus pasirinkimas visoms užpakalinėms restauracijoms, nepriklausomai nuo norimos spalvos. Priekinėje srityje ir kaklelio srityje (III, IV ir V klasės ertmės) U yra geriausiai tinkama dantų restauracijai, kurių spalvos yra nuo A1 iki A3 (įskaitant B1, B2, C1, C2, D2, D2, D3 ir D4), o UD yra spalva, tinkama tikslinėms spalvoms nuo A3,5 iki A4 (įskaitant B3, B4, C3 ir C4).

Spalvų suderinimas su priekinių ir užpakalinių dantų restauracijomis

Kodėl siūlote papildomą atspalvį priekinės srities dantims?

Universalūs kompozitai turi prisiimti aplinkinių dantų struktūros spalvą, kad būtų pasiektas tobulas atitikimas daugeliui tikslinės spalvos atspalvių. Šoninių dantų srityje paprastai yra didelis kiekis aplinkinių dantų struktūros, kurioje vis dar yra keletas ertmės sienelių. Tai palengvina danties spalvos pritaikymą, palyginti su ertmėmis priekinėje srityje. Čia šviesa lengvai prasiskverbia, todėl kompozito spalva yra labiau linkusi atsispindėti. Tai gali riboti spalvų suderinimą. CLEARFIL MAJESTY™ ES Flow Universal atveju, U atspalvis, kuris pasirodė esąs idealus šoninių dantų srityje, parodė tam tikrus spalvų suderinimo apribojimus priekinėse tamsesnių dantų restauracijose. Todėl nusprendėme pasiūlyti antrą spalvų variantą, specialiai sukurtą šioms situacijoms. Su U ir UD, CLEARFIL MAJESTY™ ES Flow Universal siūlo puikų spalvų pritaikomumą nuo šviesių iki tamsių atspalvių ir todėl tenkina tikslaus spalvų suderinimo poreikį, ypač priekinėje srityje.

Sukurti tik du kompozito atspalvius, kurie padengtų tiek daug tikslinės dantų spalvų, atrodo sudėtinga užduotis. Kaip įvertinote, ar turimi atspalviai tinka klinikinėje aplinkoje?

Iš tiesų, buvo gana sudėtinga sukurti U atspalvį, kuris galėtų atitikti platesnį dantų spalvų spektrą tiek priekinėms, tiek užpakalinėms dantims nei U atspalvis CLEARFIL MAJESTY™ ES-2 Universal. Siekdami įvertinti ir patobulinti sukurtus atspalvius, mes kartą po karto atlikome plombavimo bandymus, naudodami platų spektrą eksperimentiniai atspalviai dirbtiniuose dantyse ir išrautuose dantyse įvairių dantų spalvų. Be to, galutinis atspalvių pasirinkimas buvo vizualiai įvertintas konsultuojantis su odontologais,  kurie naudojo kompozitą klinikinėje aplinkoje.

Kokie yra didžiausi iššūkiai, susiję su tinkamos spalvos nustatymu ir pasirinkimu klinikinėje aplinkoje?

yra tai, kad jis tiesiog padidina procedūros trukmę. Tačiau tiek stomatologui, tiek pacientui svarbiausias tikslas yra kuo labiau sutrumpinti laiką kėdėje, nes tai sumažina išlaidas ir padidina paciento komfortą. Tikrasis trūkumas, susijęs su laiku ir komfortu, yra spalvų neatitikimas, atsirandantis dėl klaidos nustatant atspalvį: dėl to gali prireikti intraoralinių koregavimų arba, blogiausiu atveju, naujo restauravimo.

CLEARFIL MAJESTY™ ES Flow Universal yra prieinamas dviejų klampumo – žemo ir super žemo. Kodėl taip yra ir kuo skiriasi jų naudojimas?

Mes nusprendėme pasiūlyti dviejų tipų klampumą su skirtingomis tikotropinėmis savybėmis, kad patenkintume vartotojų pageidavimus dėl naudojimo. Iš esmės nėra jokio skirtumo tarp žemo ir super žemo klampumo. Tačiau vartotojams rekomenduojama naudoti kompozitus su skirtingomis tiksotropinėmis savybėmis pagal savo pageidavimus ir konkretų atvejį. Pavyzdžiui, super žemas klampumas yra naudingas formuojant šoninių dantų dantų okliuzinę paviršių. Žemas klampumas gali būti plačiai naudojamas tokiems taikymams kaip dantų kaklelių ir artimų paviršių padengimas ir plombavimas.

CLEARFIL MAJESTY™ ES Flow Universal – puikios mechaninės savybės

Kokios technologijos, naudojamos CLEARFIL MAJESTY™ ES Flow Universal, užtikrina puikų susiliejimą?

Turbūt populiariausia šioje produktoje naudojama technologija yra mūsų patentuota šviesos sklaidos technologija. Mes nustatėme optimalų šviesos difuzijos lygį, remdamiesi pastebėjimu, kad stiprus difuzinis atspindys šviesos, krintančios ant paviršiaus, sukelia balinimą, o silpnas šviesos difuzijos lygis palengvina tamsių spalvų perėmimą burnos ertmėje, tamsiinant plombavimo vietą. Be to, mes sutelkėme dėmesį į spalvos intensyvumo reguliavimą: universalios spalvos koncepcija pagrįsta gebėjimu perimti aplinkinių dantų struktūros spalvą ir susilieti su ja. Todėl nustatėme spalvų sodrumą taip, kad jis lengvai derėtų su įvairiais dantų atspalviais. Galiausiai medžiagos permatomumas buvo reguliuojamas naudojant submikroninius užpildus ir silicio dioksido grupes. Pagrindinių nuomonės formuotojų vertinimas padėjo mums nustatyti tinkamą permatomumo lygį.

Kaip elgtis, jei danties struktūra po danga yra pakitusi spalvos – ar reikia ją užmaskuoti blokatoriumi ar opakuojančia medžiaga?

Tai priklauso nuo spalvos pakitimo laipsnio. Dėl CLEARFIL MAJESTY™ ES Flow Universal, šviesos sklaidos savybių, paprastai manoma, kad blokatorius nėra reikalingas, o spalvą galima pasiekti. Tačiau esant stipriam spalvos pakitimui, gali būti Tačiau esant stipriam spalvos pakitimui, gali būti naudinga užpildyti ertmės dugną A2D arba A3D atspalviais CLEARFIL MAJESTY™ ES Flow, arba naudoti CLEARFIL™ ST Opaquer.

Ką padarėte, kad išvengtumėte tuštumų susidarymo taikymo metu?

Mes pritaikėme tą patį pakuotės dizainą, kuris naudojamas CLEARFIL MAJESTY™ ES Flow, kad išvengtume tuštumų susidarymo ir šiame produkte. Novatoriškas konteinerio dizainas sumažina tarpą tarp adatos galiuko ir švirkšto, kai galiukas yra pritvirtintas.

Ar yra rekomendacijų, kada naudoti CLEARFIL MAJESTY™ ES Flow, o kada rinktis CLEARFIL MAJESTY™ ES Flow Universal?

Nors universalus variantas gali būti naudojamas bendriems dantų plombavimams ir užpildymams, kaip aprašyta naudojimo instrukcijoje, CLEARFIL MAJESTY™ ES Flow rekomenduojamas tais atvejais, kai danties struktūra yra padengta ir reikia pakeisti viso danties spalvą. Puikus pavyzdys – tiesioginiai veneriai. Tokiose situacijose akivaizdžiai naudinga naudoti įvairius atspalvius ir opacitetą.

Kokia yra tekančių kompozitų ateitis?

Kadangi informacija apie klinikinį veiksmingumą ir fizines savybes vis plačiau skleidžiama, tikimasi, kad pasitikėjimas tekančiais kompozitais Europoje didės, o tai lems jų plačiau naudojimą. Be to, numatoma paklausos didėjimas dėl plombavimo metodų, kuriuose naudojami tekančių kompozitų ir formų arba matricų deriniai, plėtros.

TAKEHIRO KAMEYA

Today's dental practitioners are expected to deliver highly aesthetic, minimally invasive treatments that last – often within tighter schedules, with fewer assistants and under increasing financial and operational pressure. These factors can lead to elevated stress levels. With high patient expectations and a multitude of treatment options available, clinicians must make numerous decisions while the complexity of clinical procedures continues to increase.

Being aware of these dynamics and the associated challenges, Kuraray Noritake Dental Inc. has developed materials designed to make the clinician's work easier in many respects.

ADHESIVE DENTISTRY: OPPORTUNITIES AND CHALLENGES

To better understand this approach, let us take adhesive dentistry as an example. Being the driving force behind less invasive tooth preparations and the use of highly aesthetic tooth-coloured materials such as composites and ceramics, adhesive dentistry has significantly improved restorative dental care.

At the same time, the need to establish a strong and durable chemical bond between tooth structure and restorative material has made clinical procedures more complex than ever. Daily challenges include selecting the appropriate material and technique, preparing tooth structure correctly, controlling moisture and contamination, managing etching and pre-treatment protocols for each restorative material, and layering restorations predictably.

Intelligent simplification: Reducing complexity without compromising quality

The solutions Kuraray Noritake Dental Inc. has developed in recent years are materials that adapt to multiple indications, techniques and substrates – without adding procedural burden. The focus is not simply on innovation, but on meaningful innovation, leading to materials that genuinely streamline and simplify workflows.

While individual universal materials already offer flexibility, the thoughtful combination of compatible products can truly transform clinical procedures. When materials are designed to work together seamlessly, efficiency increases and variability decreases.

Universal product combinations from Kuraray Noritake Dental Inc. are designed to:

• Reduce the number of clinical steps
• Decrease technique sensitivity
• Improve workflow efficiency
• Simplify inventory management
• Reduce overall costs
• Support consistently high-quality treatment outcomes

The goal is not simplification for its own sake. Instead, the aim is to reduce complexity while maintaining the high performance required for predictable and durable clinical outcomes.

By aligning product features with proven clinical protocols, Kuraray Noritake Dental Inc. enables practices to work smarter, not harder.

Universal Excellence: product portfolio for simplified restorative procedures

The universal product portfolio of Kuraray Noritake Dental Inc. consists of five core products: The universal bond CLEARFIL™ Universal Bond Quick 2, the paste type composite CLEARFIL MAJESTY™ ES-2 Universal, the flowable alternative CLEARFIL MAJESTY™ ES Flow Universal, the universal resin cement PANAVIA™ SA Cement Universal and KATANA™ Cleaner as a universal cleaning solution designed for intra- and extra-oral use.

DENTAL ADVISOR HIGHLIGHTS THE SUITABILITY OF KATANA Cleaner FOR INTRA-ORAL USE

Clean surfaces – whether tooth structure or restorative materials – are essential for reliable and long-lasting adhesion in restorative dentistry. To achieve this, clinicians require a cleaning agent that removes contaminants such as blood or saliva efficiently and thoroughly, without adding complexity to the workflow. KATANA™ Cleaner was developed by Kuraray Noritake Dental Inc. to meet these clinical demands.

 
Recognized with a 2026 Research Award in the category Research – Restoration Cleaner, KATANA Cleaner is a truly universal cleaning solution for both restorations and tooth structure. Designed for intra-oral and extra-oral use, it contains MDP salt, which effectively removes contamination from a wide range of surfaces, supporting bond integrity during adhesive procedures.

 
Key benefits of KATANA Cleaner include:

• High cleaning efficacy based on the surface-active characteristics of MDP salt
• Mild pH value (4.5), allowing effective intra-oral application
• Simple, time-efficient application requiring just ten seconds of surface rubbing 

DENTAL ADVISOR RESEARCH AWARD: RECOGNITION FOR CLEAN SURFACES THAT SUPPORT OPTIMAL BOND STRENGTH

The Dental Advisor Research Team conducted in-vitro testing to evaluate the cleaning performance of KATANA Cleaner and its impact on bond strength with indirect restorative substrates. In these studies, zirconia and lithium disilicate surfaces were contaminated with saliva and subsequently treated with KATANA Cleaner. SEM analysis revealed virtually perfect surface cleanliness, which contributed to optimal bond strength levels. The Research Team also noted that KATANA Cleaner is “one of the few products commercially available that can be used intra-orally...”

SUITABLE SOLUTION FOR MANAGING CONTAMINATION

With its universal applicability, gentle yet highly effective cleaning effect and proven ability to restore optimal bond strength, KATANA Cleaner offers clinicians an excellent solution for managing contamination in adhesive dentistry. Its recognition with a 2026 Dental Advisor Research Award underscores its relevance and highlights its suitability for a wide range of indications.

PART OF EXPANDING UNIVERSAL EXCELLENCE PORTFOLIO

At Kuraray Noritake Dental Inc., we understand the demands of modern adhesive dentistry. Reliable adhesion depends not only on high-performing bonding materials, but also on proper surface preparation and contamination management throughout the workflow.

That is why KATANA Cleaner is part of our expanding Universal Excellence portfolio. Designed for both intra-oral and extra-oral use, it helps clinicians optimize adhesive procedures by efficiently removing contamination from tooth structure and restorative materials.

Supporting clean bonding surfaces in a simple and time-efficient manner, KATANA Cleaner complements restorative workflows involving products such as CLEARFIL™ Universal Bond Quick 2 and PANAVIA™ SA Cement Universal — contributing to predictable and durable adhesion across a wide range of clinical indications.

For more information, visit Dental Advisor at dentaladvisor.com.

Clinical case by Dr Luca Alibrandi

In the field of aesthetic dentistry, achieving natural, durable and predictable results requires the use of advanced materials, precise instruments and clinical expertise. Thanks to its versatility and the included innovative technology, CLEARFIL MAJESTY™ ES Flow Universal (Kuraray Noritake Dental Inc.) supports clinicians in standardising aesthetic rehabilitation even in complex cases (Figs 1–3).

Fig. 1. Initial situation with multiple diastemas in the maxillary anterior region. The patient does not wish to undergo indirect veneer therapy.

Fig. 2. Patient with a deep bite and atypical swallowing, which has caused flaring, particularly in the maxillary left anterior region. The patient refuses orthodontic treatment.

Fig. 3. Detail of the maxillary anterior region.

CLEARFIL MAJESTY™ ES Flow Universal is a monochromatic flowable composite that simplifies colour management thanks to its guided shade system, supporting aesthetic harmony without the complexity of multiple shades. Available in two levels of viscosity (Low and Super Low), it offers excellent handling for different restorative areas.

The Low version (75 wt%, 59 vol%) has a flexural strength of 151 MPa and a compressive strength of 373 MPa. It is ideally suited for anterior areas and for injection into IVENEER matrices, thanks to its easy handling and long-lasting gloss. Radiopacity (140% Al) provides for visibility on follow-up radiographs.

The Super Low version, with a filler content of 78 wt% (60 vol%) and radiopacity of 150% Al, has a flexural strength of 152 MPa and compressive strength of 374 MPa. Ideal for posterior sectors, it offers durability and resistance even under high functional loads.

The optimised syringe design supports precise dispensing, reducing waste and facilitating application. Both formulations allow easy polishing and long-lasting shine.

Combined use with IVENEER matrices (Fig. 4) makes it possible to precisely shape incisal morphology, creating an ideal contour and a protected environment that improves surface polymerisation (Fig. 5). The result is a stronger, glossier and more durable restoration. Flowable composites facilitate adaptation of shape and correction of natural proportions, contributing to a harmonious outcome.

The composite veneers can subsequently be refined using subtractive or additive techniques (Figs. 6 to 8), adapting to situations such as wide and irregular diastemata, simplifying the workflow and improving the final result.

Fig. 4. IVENEER in position under rubber dam: these innovative matrices, used with conventional isolation, provide a highly effective seal to prevent contamination during the injection phase.

Fig. 5. Polymerisation is always started on the palatal side to allow resin contraction towards the enamel and to increase adhesion of direct restorations.

Fig. 6. The polishing phase is facilitated by the creation of an environment that helps limit the oxygen-inhibited layer via the matrices. In this case, however, subtractive modelling of the elements is required to recreate overall harmony.

Fig. 7. Post-injection situation.

Fig. 8. Surface texturing with longitudinal morphological characterisations to improve coronal proportions.

Fig. 9. Detailed view of the central incisors after polishing.

FINAL CONSIDERATIONS

The combined use of CLEARFIL MAJESTY™ ES Flow Universal and IVENEER matrices represents a significant advancement in aesthetic incisor restoration. The composite’s properties (strength, handling and gloss), together with the preformed matrices, allow natural, high-quality results to be achieved in reduced treatment times. Thanks to the new technique, even patients with financial limitations can access effective treatments and regain their smile (Fig. 9).

Dentist:

LUCA ALIBRANDI

Luca Alibrandi graduated in Dentistry and Dental Prosthetics from Universidad Europea de Madrid in 2014. From 2015 to 2017, he specialised in Periodontology and Implantology with a full-time, two-year Master’s degree at the same university, completing a thesis entitled “Evaluation of Different Peri-Implant Treatments”, while actively attending the practice of Professor Ricardo Fernandez.

A member of SIPRO, AIOP, SIDP, SEPA, SEPES and ITI, since 2014 he has further developed his professional training by attending the practice of Dr Agostino Scipioni and collaborating at the private practice of Professor Dario De Leonardis.

He attended the annual AIOP Advanced Training Course in Analogue and Digital Prosthetics in 2018/19.

He currently works at the Alibrandi Dental Practice as a specialist in periodontology, implantology and prosthodontics.

Since 2023, he has collaborated as a lecturer for the intraoral scanner company 3Shape, producing educational materials and delivering training events in the field of prosthodontics.

“Adding new value to dental care”

Few manufacturers can claim one century of innovation. However, as Kuraray celebrates its 100^th anniversary, its subsidiary, Kuraray Noritake Dental—shaped by this legacy—remains humble and focused on its holistic vision for improving the delivery of oral care.

Reflecting on this centenary, Satoshi Yamaguchi, president of Kuraray Noritake Dental, shares his perspective on how the company’s long-standing ethos continues to shape its direction. In this exclusive interview, he discusses Kuraray Noritake Dental’s latest solutions and the way the company combines scientific expertise with consistent quality, clear and evidence-based information, support grounded in everyday clinical needs, and a stable supply chain. The ultimate aim, Yamaguchi says, is to bring new value to dental care and contribute to more reliable and efficient clinical practice.

Mr Yamaguchi, could you tell us about your professional background and how you first joined Kuraray?

My Kuraray journey began with a strong aspiration to contribute to public health. I was drawn to the company’s extensive expertise in chemical manufacturing and the potential to apply its technologies in the medical field. I started in the medical development division, where I was involved in research and development activities. Later, I transitioned to a marketing role at Kuraray America and, upon returning to Japan, resumed my position in development. This allowed me to engage with the dental healthcare business from both a technical and a commercial perspective. Subsequently, I served as head of the dental business at Kuraray Europe in Germany, where I oversaw sales operations across the European region. These international experiences have profoundly shaped my professional approach, enabling me to lead with a global mindset and remain attuned to the specific needs of local markets.

How has this international experience shaped your approach as president of Kuraray Noritake Dental?

Through my international assignments, I came to recognise the importance of addressing the diverse values held across different countries and regions. In the field of dental materials, preferences often differ. In many parts of Europe and Asia, natural aesthetics are widely valued; in the US, treatment efficiency is often prioritised; and in South America, there is often an emphasis on balancing aesthetics with cost-effectiveness. Although these are general tendencies and can vary, they provide a useful guide in meeting the specific needs of each market.

Satoshi Yamaguchi, president of Kuraray Noritake Dental, previously served as head of Kuraray Europe’s dental business, based in Germany.

My goal is to establish a robust framework for delivering reliable, evidence-based information to dental professionals. We are striving to strengthen the foundation of trust by facilitating the collection of credible data and case studies from both internal and external sources, ensuring that the information we provide contributes to greater confidence in clinical practice. In addition, we place strong emphasis on how this information is communicated. By leveraging multiple channels—presentations at academic conferences and seminars, contributions to journals and communication through digital platforms, for example—we are creating an integrated system that ensures our messages reach dental professionals effectively.

How does Japan’s role as a dental innovation hub influence the company’s global operations?

In Japan, there is a focus on creating scientifically proven technologies and transforming them into trusted dental solutions. At Kuraray, a prime example is our original adhesive monomer, MDP. This solution exhibits exceptional bond strength, even when using traditionally difficult substrates such as metals and zirconia. Today, MDP is recognised as a proven global standard in adhesive monomers and is widely used by dental material manufacturers around the world.

Scientifically valid technologies developed in Japan are being utilised in clinical settings worldwide, supported by reliable, evidence-based information. This tradition is a driving force behind Kuraray Noritake Dental. We honour it by prioritising materials that can function like natural tooth substances over the long term in the oral environment—ensuring clinical reliability through durability, defined as the preservation of strength and aesthetics. Building on this foundation, we continuously enhance the value of our products by expanding indications and improving usability.

How important is the European market in your overall strategy?

The European market plays a vital role in advancing our efforts in quality assurance and information dissemination. Given the strictly enforced medical device regulations and environmental laws, we proactively work to enhance quality and reliability in our operations in the region, including in the areas of product design, packaging and product information. In turn, these initiatives help to improve the accuracy of product development and information dissemination for all markets.

At the same time, we are strategically expanding our global business operations, focusing on the US, Asia and South America. To ensure the consistent delivery of high-quality products and services, we are working in close collaboration with local dental professionals, educational institutions and partner companies. By leveraging the expertise gained through our operations in Europe and adapting this to the unique needs and cultures of other regions, we continue to provide reliable solutions for dental professionals worldwide.

Kuraray Noritake Dental introduced several new materials last year. What can you tell us about these materials and the clinical needs they were designed to meet?

At the 2025 International Dental Show, we introduced CLEARFIL MAJESTY ES Flow Universal, CLEARFIL Universal Bond Quick 2 and CERABIEN MiLai. These products are based on our concept of Universal Excellence, a philosophy that emphasises scientifically grounded performance and outcomes.

Dental practitioners in clinical settings seek materials that they can use with confidence. To meet these needs, we ensured that these materials embody the principles of Universal Excellence. This means versatile, high-performance solutions that streamline clinical workflows by minimising the number of required components and procedural steps. In this way, the products support decision-making in daily dental practice and laboratory work.

KATANA Zirconia is recognised for aesthetics and strength. What sets your proprietary zirconia powder and multilayer technology apart in today’s competitive CAD/CAM market?

We consistently develop and manage raw material powders in-house. By focusing on proprietary material development, we have created high-quality dental zirconia that combines aesthetics and mechanical strength. In addition, our advanced manufacturing technologies and strict quality control standards ensure stable and reliable product quality. Furthermore, by utilising our proprietary zirconia powder and working closely with manufacturers of milling machines and sintering furnaces, we have significantly reduced both processing and sintering times in the fabrication of zirconia restorations.

One notable example is KATANA Zirconia ONE SPEED CROWN, which supports a streamlined chairside workflow. We have developed a new zirconia powder that can reach a highly activated state with little energy. This accelerates the sintering process, thereby achieving an ultra-short sintering time of just 9 minutes. Furthermore, our zirconia and multilayer technology enable natural gradation by varying both shade and translucency across the layers of the zirconia disc—closely replicating the appearance of natural teeth. In KATANA Zirconia YML, each layer contains a different concentration of yttria: the upper layers offer natural colouration and high translucency, and the lower layers deliver superior strength. Owing to this advanced material design and multilayer technology, the KATANA Zirconia series combines outstanding aesthetics and mechanical performance and contributes to greater efficiency in clinical workflows.

Kuraray has regional offices in China and Brazil. How do you adapt product development and clinical education to the diverse needs of these fast-growing markets?

China and Brazil are two of the world’s fastest-growing dental care markets, characterised not only by their large populations but also by a growing interest in quality dental care, rapidly advancing adoption of CAD/CAM technologies and ongoing development of clinical dental education. We address these evolving needs by delivering products and clinical support tailored to the specific dental requirements and educational styles of each country.

For example, we continue to meet the demand for our adhesive dental materials—such as the CLEARFIL and PANAVIA series—by offering hands-on seminars and webinars in local languages. By sharing clinically relevant information backed by scientific evidence, we contribute to improving the quality of local dental care.

In addition, user feedback gathered through our local offices serves as a valuable source of insight for product development. By incorporating market-specific trends, preferences in product handling and differences in clinical education styles into the development of new products, we can deliver locally optimised quality solutions.

Kuraray Noritake Dental is expanding production at its new plant in Miyoshi in Japan. How will this affect supply chain resilience and product innovation?

Leading up to this year, we significantly strengthened our global supply system for dental materials. At the heart of this initiative was the strategic expansion of production capacity at our Miyoshi plant, where we ultimately aim to roughly double production capacity. This facility specialises in the manufacturing of inorganic dental materials such as zirconia and porcelain and plays a critical role in our business strategy through technological expertise, rigorous quality control and product development capabilities.

Additionally, by strengthening collaboration between our manufacturing site and our research and development, we are working to establish a system that enables rapid incorporation of feedback from clinical settings into product improvements. These efforts also contribute to enhancing our product development capabilities, allowing us to deliver dental material products that meet market needs in a timely manner. We view this as a vital step towards better meeting the expectations of dental professionals worldwide and elevating our market presence.

As the Kuraray Group marks its 100^th anniversary, what vision is Kuraray Noritake Dental pursuing for the future of dental care?

Our anniversary presents an opportunity to reflect on the spirit that has shaped the company over the last 100 years. At the heart of our company lies a philosophy of embracing challenges: “For people and the planet—to achieve what no one else can”. Long before the term “corporate social responsibility” became widespread, we were addressing social issues through the power of technology and developing materials that improve lives. That ethos continues to underpin our business today.

Since entering the dental industry as a chemical products manufacturer, we have remained committed to craftsmanship and quality. As noted earlier, because dental materials are used inside patients’ mouths over extended periods, we consider durability to be a particularly critical factor. This durability encompasses strength and aesthetics, which together form the foundation of reliable clinical performance.

However, even products backed by advanced technology may not fully convey their intrinsic value to users. That is why we strive to provide reliable, evidence-based information and deliver trusted products to clinical settings.

What can you tell us about future initiatives at the company?

Through collaborative product development with dental clinicians, we aim to incorporate more insights from the front lines of dental care. By actively listening to dental professionals and technicians, we aim to further address the real-world challenges that they face and deliver products that more effectively meet daily clinical demands. We also aim to build greater trust with dental clinicians by sharing reliable, evidence-based information and clearly communicating the scientific evidence and development background behind our products. Additionally, in support of our commitment to sustainability, we aim to offer responsible choices to users through designing products with environmental considerations in mind and reducing our overall environmental impact.

Through these initiatives, we will continue adding new value to dental care by leveraging our material design expertise, which is rooted in the founding spirit of our company. We aspire to remain a trusted partner for dental professionals around the world—one that they can rely on with confidence.

Originally published on Dental Tribune website on March 4^th, 2026.

Šiuolaikinėje odontologijoje pastebimas medžiagų, kurios suteiktų galimybę derinti patogų naudojimą ir procedūrų efektyvumą su estetiškais, ilgalaikiais rezultatais, poreikis. Šios medžiagos leidžia odontologams efektyviau pasiekti norimų rezultatų, taigi jie daugiau laiko gali skirti bendravimui su pacientais.

Tiesioginio restauravimo atveju pasirinktas dervinis kompozitas yra labai svarbus procedūrų paprastumo ir rezultatų kokybės aspektais. Būtent todėl vis populiaresni tampa universalūs pastos konsistencijos kompozitai, tokie kaip „CLEARFIL™ MAJESTY ES-2 Universal“ („Kuraray Noritake Dental Inc.“). Pristačiusi „CLEARFIL™ MAJESTY ES Flow Universal“, „Kuraray Noritake Dental Inc.“ pasiūlė panašiais privalumais pasižymintį takųjį kompozitą. Apibendrinome šiuos privalumus atsakydami į jūsų pagrindinius klausimus.

Kaip sukurti estetiškas, patvarias restauracijas naudojant takųjį kompozitą?

„CLEARFIL MAJESTY™ ES Flow Universal“ yra takiojo kompozito sprendimas su dviem papildomais atspalviais, sukurtas intuityvaus atspalvių derinimo tikslais ir tinkantis įvairioms restauravimo procedūroms. Jame suderintos praktikoje naudingos takumo charakteristikos, pažangi atspalvių maišymo galimybė ir puikios mechaninės savybės.

Mažo takumo („Low“) 

• Lenkiamasis stipris 151 MPa
• Gniuždomasis stipris 373 MPa
• Užpildo kiekis 75 % pagal masę arba 59 % pagal tūrį
• Rentgenokontrastiškumas 140 % Al

Itin mažo takumo („Super Low“)

• Lenkiamasis stipris 152 MPa
• Gniuždomasis stipris 374 MPa
• Užpildo kiekis 78 % pagal masę arba 60 % pagal tūrį
• Rentgenokontrastiškumas 150 % Al

Kas yra „CLEARFIL MAJESTY™ ES Flow Universal“? 

„CLEARFIL™ MAJESTY ES Flow Universal“ yra šviesoje kietinamas, rentgenokontrastiškas, dviejų klampumo variantų ir 2 atspalvių dervinis kompozitas, skirtas įvairioms klinikinėms situacijoms. Jame panaudota nanodalelių užpildo technologija, kuri leidžia kontroliuoti tėkmę, išlaikyti blizgesį ir sukurti natūraliai atrodančias restauracijas. Dėl išmanios emalio skaidrumo, dentino sodrumo ir šviesos difuzijos technologijos (LDT) dermės šis kompozitas tolygiai susilieja. Dėl emalio skaidrumo šviesa gali prasiskverbti per medžiagą, taigi pagerinama spalvos integracija su aplinkine danties struktūra. LDT leidžia restauracijoms išsklaidyti šviesą panašiai kaip emalis ir dentinas. Kartu su tiksliai suderintu spalvos sodrumu šios savybės padeda medžiagai sklandžiai optiškai integruotis į aplinkinę danties struktūrą.

Kada galima naudoti „CLEARFIL MAJESTY™ ES Flow Universal“?

Šis takusis kompozitas skirtas įvairiems restauravimo poreikiams. Jis sukurtas naudoti tiek pagal konservatyvius, tiek pagal kompleksinius gydymo planus – nuo I–V klasės restauracijų iki įdubių ir įtrūkių užpildymo bei taisymo.

„CLEARFIL MAJESTY™ ES Flow Universal“ galima naudoti šiais tikslais:

• tiesioginėms visų tipų ertmių, cervikalinių pažeidimų (pavyzdžiui, šaknies paviršiaus ėduonies, V formos defektų), dantų nusidėvėjimo ir erozijos restauracijoms;
• dantų ertmės pagrindui ir (arba) įklotui;
• dantų padėčiai ir formai koreguoti (pavyzdžiui, dantų tarpui šalinti, netaisyklingai išdygusiems dantims);
• lūžusioms restauracijoms taisyti intraoraliniu būdu.

Kaip parenkamas atspalvis?

Naudojant „CLEARFIL MAJESTY™ ES Flow Universal“ atspalvių parinkimas yra menkniekis. Du vienas kitą papildantys atspalviai – universalus (U) ir universalus tamsus (UD) – parenkami intuityviai, todėl nereikia atspalvių gido. U atspalvis tinka daugumai užpakalinių ir priekinių dantų restauracijų. UD tinkamiausias tamsesnio atspalvio dantims (B3 ir aukštesnio lygio), kai aplinkinių dantų struktūra yra menka, įskaitant III ir IV klasių ertmes. Tinkamiausią atspalvį galima parinkti atsižvelgiant į ertmės klasę ir paciento amžių.

Spalvų derinimas restauruojant priekinius ir užpakalinius dantis

Kas padeda užtikrinti „CLEARFIL MAJESTY™ ES Flow Universal“ veiksmingumą?

Šio produkto sudėtis lemia kelias klinikinį veiksmingumą užtikrinančias savybes:

• nanodalelių užpildo technologija – palaiko optimalų užpildo kiekį, siekiant mažesnio susitraukimo, didesnio atsparumo dilimui ir ilgalaikio blizgesio išlaikymo;
• universalaus atspalvio adaptavimas – užtikrina gerą vizualią integraciją su aplinkine danties struktūra ir supaprastintą atspalvio parinkimo procedūrą; 
• tiksotropinės charakteristikos – aplikuojama medžiaga teka esant slėgiui, bet aplikavus išlieka stabili, taigi aplikavimas yra labai tikslus

Kodėl verta rinktis „CLEARFIL MAJESTY™ ES Flow Universal“? 

Gydytojai pastebės, kad „CLEARFIL™ MAJESTY ES Flow Universal“ yra naudingas dėl šių savybių:

• nuspėjamas naudojimas ir dozavimas;
• estetiški tiek priekinių, tiek užpakalinių dantų restauracijų rezultatai;
• atsparumas dilimui ir paviršiaus degradacijai;
• rentgenokontrastiškumas, palengvinantis rentgenologinį vertinimą;
• pritaikomumas įvairiems restauravimo poreikiams.

Kaip aplikuoti „CLEARFIL MAJESTY™ ES Flow Universal“?

Aplikavimas yra paprastas ir atitinka standartinius klinikinius darbo eigos metodus:

1. Atitinkamai paruoškite ir izoliuokite sritį.
2. Aplikuokite suderinamą adhezyvą (pvz., „CLEARFIL™ Universal Bond Quick 2).
3. Dozuokite medžiagą švirkštu ir aplikatoriumi su plonu antgaliu.
4. Kietinkite šviesa pagal gamintojo nurodymus (paprastai 20 sekundžių, atsižvelgiant į atspalvį ir naudojamą kietinimo lempą). 
5. Užbaikite restauravimo procesą apdailindami ir nupoliruodami.

Dozuojant švirkštu užtikrinamas kontroliuojamas aplikavimas ir patogumas.

Tiesioginis restauravimas naudojant „CLEARFIL MAJESTY™ ES Flow Universal“

Ar „CLEARFIL MAJESTY™ ES Flow Universal“ įvertintas nepriklausomų šaltinių?

Taip. „CLEARFIL™ MAJESTY ES Flow Universal“ (itin mažo takumo) įvertintas odontologijos specialistų per trečiųjų šalių vykdytus bandymus ir remiantis kolegų atsiliepimais. Neseniai šis gaminys pelnė 2025 m. „Dental Advisor“ mokslo apdovanojimą. Savo išvadoje šio JAV leidinio vertintojai teigė:

“Bandymų duomenimis, šis kompozitas pasižymi vienomis geriausių fizinių savybių tarp takiųjų kompozitų, lenkiamojo ir gniuždomojo stiprio vertėmis prilygsta tvirčiausiems kondensuojamiems kompozitams, be to, jam būdingas idealus rentgenokontrastiškumas.“

Universalus takusis pasirinkimas – „CLEARFIL MAJESTY™ ES Flow Universal“

„CLEARFIL MAJESTY™ ES Flow Universal“ skirtas restauravimo procedūroms palengvinti, derinant kontroliuojamą naudojimą, estetinį integravimą ir mechaninį patvarumą. Tai gali būti praktiškas pasirinkimas specialistams, ieškantiems patikimos takios dervos įvairioms klinikinėms situacijoms.

Sužinokite daugiau >

„Universal Excellence“ – išmanūs supaprastinti sprendimai

„Kuraray Noritake Dental Inc.“ supranta šiuolaikinės odontologijos praktikos reikalavimus. Derinti sudėtingas procedūras, įtemptą grafiką ir pacientų poreikius nėra lengva užduotis. Todėl jau dešimtmečius nenuilstamai dirbame, kad supaprastintume ir patobulintume kiekvieną jūsų darbo etapą. Mūsų vizija aiški: pasaulis, kuriame medžiagos ir instrumentai sklandžiai veikia jūsų rankose, kuriame sudėtingumas sumažintas iki minimumo ir kuriame turite pakankamai laiko sutelkti dėmesį į tai, kas svarbiausia, – individualius kiekvieno paciento norus ir poreikius. Būtent tai ir yra odontologijos ateitis, ir mes kuriame ją kartu.

Sužinokite >

Case by Dr. Onur Alp Yünük

Beautiful teeth, a bright, flawless smile: Meeting the aesthetic demands of patients asking for veneer treatment can be challenging. While some patients share concrete ideas on how their new teeth should look, it is more difficult for others to express their expectations. In this case, it is important to select a treatment approach that allows for modifications – be it in the form of an extended planning phase including digital smile design or by placing composite restorations that can be easily modified intraorally.

The latter approach was selected for a young female patient who presented to our clinic as she was dissatisfied with her composite veneers that had been placed on the upper incisors (Figs. 1 to 4). During intraoral examination, it became evident that the existing restorations on her maxillary incisors and canines had irregular, rough surfaces, discoloured margins and compromised structural integrity of the composite material. In accordance with these findings, removing the existing restorations at the maxillary anterior teeth and re-establishing optimal aesthetic and functional integrity with new direct composite restorations were planned (teeth between #13 - #23 according to the FDI notation). The patient stated that she would like us to add more individuality and character to her teeth and have a brighter smile than with her existing restorations.

Fig. 1. Composite veneers on the maxillary incisors showing aesthetic and functional integrity issues.

Fig. 2. Occlusal view of the maxillary anterior teeth with visible defects in the composite veneers.

Fig. 3. Lateral view from the right revealing surface irregularities.

Fig. 4. Lateral view from the left revealing a large debonded and chipped area.

REPLACEMENT OF THE COMPOSITE VENEERS

To reproduce the translucency characteristics of the patient’s natural teeth and fulfil her aesthetic demands, the use of a polychromatic layering system and a dual-layer technique was planned. This would allow for a nice play of translucencies in the anterior area.

During the shade selection phase, the Bilaminar Shade Assessment Technique (BSAT) was employed, which is based on the color combination of dentin and enamel composites. In this technique, the intended enamel shade was stratified over the target dentin chroma to evaluate the resultant shade created by the two composite color layers. The materials were polymerized on the tooth surface without bonding agents; thus, the cumulative color perception resulting from stratification, rather than the individual shades of the materials, was verified for harmony with the natural tooth structure at the onset of treatment. Photos were taken with a camera equipped with a cross-polarized filter (Fig. 5). Subsequently, the fixed retainer was removed, as were the existing composite veneers. To save as much of the underlying healthy tooth structure as possible, the procedure was performed under magnification and blue-light illumination. The selected instruments were red- and yellow-band diamond burs as well as tungsten carbide burs. Figure 6 shows the result of the procedure.

Fig. 5. Shade determination – image taken with the aid of a cross-polarizing filter that eliminates reflections.

Fig. 6. Teeth after the removal of the deficient composite veneers.

The teeth were isolated using rubber dam, which was secured with floss in the cervical area. Then, restoration procedures were initiated on the teeth. After etching of the enamel and application of a self-etching bonding agent (CLEARFIL™ SE Bond 2, Kuraray Noritake Dental Inc.), CLEARFIL MAJESTY™ ES-2 Premium (Kuraray Noritake Dental Inc.) was applied: The dentin core with its pronounced mamelons was modelled using the shade A1D. The incisal edges and mamelons were highlighted with spots of white tint. To create an opalescent effect, a thin layer of the translucent shade Blue was placed on top, while the enamel parts were built up with the enamel shade WE. Since the retainer had been removed, a clear aligner was fabricated and delivered to the patient at the end of the session for use until the subsequent appointment.

Fig. 7. Isolation with rubber dam for restoration of the lateral incisors and canines.

Fig. 8. Vestibular enamel layer applied to the teeth.

Fig. 9. Shape and shade of the restorations created according to the patient’s expectations.

After finishing and polishing with Twist DIA for composite, the patient was sent home and a new appointment was made for re-evaluation and final adjustments.

In the control appointment, the patient asked us to slightly reduce the incisal translucencies and brightness in her maxillary incisors and alter the shape of all restored teeth: She requested longer maxillary central incisors with softer, more rounded line angles and a smoother incisal contour. Rubber dam was placed again. Then, the vestibular surfaces of the composite restorations on the maxillary incisors were reduced slightly using red- and yellow-band diamond burs. To roughen the surface and enhance the topography for optimal micromechanical interlocking, the composite surface was sandblasted with 50-μm aluminium oxide particles. Phosphoric acid etchant, silane and CLEARFIL™ SE Bond 2 were applied sequentially as part of the adhesive protocol. The restorations were then modified by lengthening, shade correction using CLEARFIL MAJESTY™ ES-2 Premium in the shades A1D and A1E and refining of the anatomical contours (Figs. 10 and 11).

Fig. 10. Modification of the central incisor restorations.

Fig. 11. Modified smile with more regular tooth forms and contours as well as a more natural tooth shade.

During this final appointment, the patient expressed that she was very happy with her new smile. The restoration surfaces were re-polished, a new retainer was bonded and final photographs were taken (Figs. 12 to 16).

Fig. 12. Final treatment outcome – frontal view.

Fig. 13. Final treatment outcome – occlusal view.

Fig. 14. Final treatment outcome – lateral view.

Fig. 15. Final treatment outcome – the patient’s smile.

Fig. 16. Detailed view of the inner colour structure – made visible with the aid of a polarized filter.

CONCLUSION

Talking to patients about every detail of the treatment and listening attentively to their ideas, expectations and demands does not always protect us from adjustments – simply because they need to see what they get to be able to judge if they like it. Luckily, selecting appropriate materials and techniques enables dental practitioners to create new smiles that can be modified without harming healthy tooth structure, so that making even the most demanding patients happy is no longer a challenge.

Dentist:

ONUR ALP YÜNÜK

Dr. Onur Alp Yünük completed both his undergraduate and doctoral education at Istanbul University. He currently serves as an Assistant Professor in the Department of Restorative Dentistry at the Istinye University Faculty of Dentistry. His work primarily focuses on direct composite restorations of anterior teeth and on polychromatic layering systems.

Clinical case by Dr. Giuseppe Iacona

The Flowable Injection Technique represents an innovative and predictable approach for the direct aesthetic restoration of one or more teeth in a single appointment (Fig. 1). This methodology, resulting from close collaboration between clinician and technician, allows reproducible results from the very first intervention, offering patient comfort and long-term durability.

In the case presented, the patient wished to close a diastema between the mandibular central incisors (teeth #31 and 41 according to the FDI notation; Fig. 1). Following clinical, radiographic and periodontal assessment, the injection technique was selected, ruling out orthodontic treatment and veneer solutions.

Fig. 1. Extraoral photographs of the patient: initial situation.

The technique involves the injection of flowable composite through a transparent index (made of silicone or 3D-printed resin), produced from a digital or conventional mock-up (Figs. 1 to 2). It represents a viable treatment option thanks to the combination of advanced composite materials and digital technology.

Intraoral and facial scans were taken to create digital models of the patient’s maxilla and mandible (Fig. 2). Matching the scans made it possible to virtually simulate the initial situation. Based on this dataset, a wax-up was generated and converted into a 3D-printed model and a putty index for wax-up transfer into an intra-oral mock-up.

Transferred into the patient’s mouth through injection of the material into the index, the mock-up (Fig. 3) allowed aesthetic and functional evaluation by providing a preview of the final outcome.

Fig. 3. Mock-up in the patient’s mouth.

Subsequently, the two direct veneers were fabricated using the Flowable Injection Technique in a single appointment (Fig. 4). After placing gingival retraction cords with astringent gel (Fig. 5), isolation with PTFE tape was performed and the surfaces were etched (Figs. 6 and 7), followed by application of the adhesive CLEARFIL™ Universal Bond Quick 2 (Kuraray Noritake Dental Inc., Fig. 8).

Fig. 4. Baseline.

Fig. 5. Application of retraction cords soaked in astringent gel.

Fig. 6. Isolation of adjacent teeth with dental PTFE tape.

Fig. 7. Etching with phosphoric acid etchant.

Fig. 8. Application of CLEARFIL™ Universal Bond Quick 2.

Fig. 9. Injection indices.

Fig. 10. Placement of the injection index.

Fig. 11. Final treatment outcome.

FINAL CONSIDERATIONS

CLEARFIL MAJESTY™ ES Flow Universal (Kuraray Noritake Dental Inc.) stands out for its excellent aesthetic properties, high compressive and flexural strength, and outstanding blend-in ability. Its translucency characteristics, which vary according to thickness, allow for a polychromatic effect using a single material, particularly in the universal variant. The material’s chameleon effect supports seamless colour integration with adjacent teeth, making the restoration indistinguishable from natural tooth structure. This provides for long-term durability, a low incidence of fractures and highly satisfactory results, making it ideal for addressing a wide range of aesthetic and functional requirements.

Dentist:

GIUSEPPE IACONA