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Interview with Dr. Ludivine Facon

Individual prophylaxis, early defect detection and treatment, minimally invasive restorative techniques: In her joint dental practice in Anstaing, France, Dr. Ludivine Facon does everything in  her power to keep her patients’ teeth healthy for their lifetime. When we met her at the International Dental Show in Cologne, where she was a speaker for Kuraray Noritake Dental Inc., we asked her to share information about her treatment philosophy and how flowable injection fits into her overall approach.

Your treatment philosophy seems to be minimally invasive. Would you please tell us a bit more about it?

Ever since I started treating patients, my priority has always been to preserve the dental tissues and to be as minimally invasive as possible when restoration is required. My interest in prevention started with my thesis in 2000, which focused on oral health prevention in Quebec, Canada, a country where prophylactic care is an integral part of dental treatment. I have always been highly interested in individual prophylaxis, which naturally led me to focus on minimally invasive treatments. My goal is to stay as low as possible on the therapeutic gradient, always thinking about the long-term benefits for the patient.

What are the benefits of this approach for your practice?

Integrating prophylaxis for every patient into my practice allows me to work with excellent surface conditions for bonding. The oral environment is sanitized before applying conservative restorations, and carious lesion removal is kept to a minimum.

When defects – be it a carious lesion or severe tooth wear – are present, I use the following instruments and materials that allow for truly minimally invasive interventions:

• Rondoflex 50-micron sandblaster to roughen the surface,
• Micro diamond burs to remove what is necessary,
• Layered composites for single-tooth restorations,
• Injected composites when multiple teeth are involved.

Case predestined for composite injection, as multiple teeth in the maxilla need to be treated (smile makeover).

What dental materials do you use for your restorative procedures?

I am a hands-on dentist, and in my daily practice, I strictly follow surface preparation and bonding protocols recommended for CLEARFIL™ Universal Bond Quick 2 (Kuraray Noritake Dental Inc.). In addition, I use high-quality composites from Kuraray Noritake Dental Inc. For layering, CLEARFIL MAJESTY™ ES-2 Premium Enamel and Dentin are my got-to solution, while I use CLEARFIL MAJESTY™ ES Flow Low for injection.

What are the benefits of a conservative approach for your patients?

Patients appreciate the fact that my treatment approach is as conservative as possible while still allowing for easy reintervention if necessary, preserving as much healthy dental tissue as possible. Another significant advantage is the moderate cost, which makes the treatment more accessible.

How does composite injection fit into this philosophy?

This technique allows for an easy reconstruction of multiple teeth by transferring a wax-up designed in the lab into the mouth via an injection of modern flowable composite into a transparent silicone index. Patients like this technique because it is aesthetic, reliable, reproducible and minimally invasive. A major advantage is that it allows for touch-ups and repairs, making it a reassuring solution. In some cases, no tooth preparation is needed at all—we simply add material, making the whole treatment truly non-invasive.

Why do you think this technique is promising?

It is a trendy and promising technique because:

• It is non-invasive --> preserves tissues --> aligns with minimally invasive dentistry.
• It is predictable --> due to the index, the technique is reproducible.
• It is easier than traditional layering --> saves chair time and improves patient comfort.
• It is cost-effective --> a cheaper alternative to ceramic veneers.
• It allows for repairs at any time, making it a reassuring option.

How did you proceed before knowing this technique?

In the anterior region, I used traditional composite layering with a wax-up and a palatal silicone index. It allowed me to rebuild the palatal wall and provide for precise incisal edge placement. In the posterior region, I used inlays, onlays, or overlays made of lab-processed reinforced composite or lithium disilicate.

Transparent silicone index with injection hole used to inject the flowable composite and restore the tooth to its planned shape.

What made you start using the new technique?

There has been an explosion in demand for smile enhancements, especially among young adults. The composite injection technique is an appealing alternative for reshaping smiles in young patients with intact teeth but unsatisfactory size or shape. It is less invasive than veneers, which have gained popularity due to social media trends, but often require significant tooth preparation.

How did you proceed in the beginning?

I first discovered the technique in a specialized journal in 2019, then trained myself using online tutorials. Of course, there were some trial-and-error moments, but it is a very accessible technique—even for beginners. To achieve optimal results, I believe that proper case selection and treatment planning are key. One of the most important preconditions for aesthetic outcomes is that the patient’s teeth have a simple shade structure. If the shade structure of the teeth is complex or the required restoration is large, it is better to layer the dentin before injecting the enamel. Moreover, it is essential to produce two models in the wax-up phase, not just one: An “intermediate wax-up model” with every other tooth featuring the wax-up, while the remaining teeth remain unmodified. The second is a “full wax-up model” with all teeth reshaped.

Considering these aspects, it is possible to obtain great outcomes quite quickly. The learning curve is steep, however – as with every new technique to be implemented – you need to step out of your comfort zone.

Apart from CLEARFIL™ Universal Bond Quick 2 and CLEARFIL MAJESTY™ ES Flow Low you already mentioned, what instruments and materials do you use?

For treatment planning including the wax-up, I use digital technology via Smilecloud, but a traditional wax-up works just as well. The production of the silicone index is the most delicate part when doing it in-house. I recommend using EXACLEAR (GC), the only truly effective transparent silicone currently available. Adjacent teeth are isolated with PTFE tape. Finishing instruments that have proven their worth are:

• Scalpel Blade No. 12,
• 3M™ Sof-Lex™ Contouring and Polishing Discs (Solventum),
• Red-ring fine diamond burs,
• TWIST™ DIA for Composite polishers (Kuraray Noritake Dental Inc.).

Intermediate wax-up model: One tooth with wax-up followed by one tooth without.

Full wax-up model.

Do you believe that the quality of the outcome is affected by the composite material you use?

Absolutely! New high-filled flowable composites, like CLEARFIL MAJESTY™ ES Flow Low, offer excellent mechanical properties and polishability, making them very promising.

Highly aesthetic treatment outcome after injection of CLEARFIL MAJESTY™ ES Flow Low.

What material characteristics impact overall quality?

First of all, the optical properties or shade matching ability of the material are crucial. I like the fact that I can select from a variety of shades when using CLEARFIL MAJESTY™ ES Flow. Once the right shade is selected and the thickness of the injected layer does not exceed 1 mm, the optical properties of the restorations may be expected to be exceptional.

Moreover, we need a material with great flow properties (fluid, but not too runny), which is virtually void-free. I prefer using low viscosity flowable composites like CLEARFIL MAJESTY™ ES Flow Low (two other flowabilities – HIGH and SUPER LOW – are also available). The physical properties (mechanical strength) and polishability plus polish retention are also important. They are usually excellent with premium flowable composites.

What are your most important clinical tips and tricks?

For beginners:

• Press firmly on the cervical area of the silicone index to reduce excess material upon removal.
• Finish the proximal area thoroughly before moving to the next injection step. This way, you provide for perfect key positioning for the following teeth.

If you follow the protocol, the technique is very beginner friendly!

What is your opinion about the emerging hybrid "layering & injection" technique?

This hybrid technique complicates the original injection technique, which is meant to simplify composite restorations. However, it is very useful in cases where aesthetic complexity requires layering. For maximum mimicry with this technique, I would love to have injectable composites in an enamel shade at my disposal.

Would you please share your final thoughts with us?

Take your time planning! Observe, document, take photos, use digital tools! Less is more.

Dr. Facon, thank you very much!

Dentist:

LUDIVINE FACON

Dr. Ludivine Facon graduated from the University of Lille, where she developed a solid foundation in dentistry. Passionate about periodontology and dental aesthetics, Dr. Facon pursued specialized training to refine her skills in these fields. In 2007, she completed clinical periodontology training at the Charon Clinic, followed by individual dental prophylaxis training with Michel Blique in 2008. From 2013 to 2014, she attended the long cycle program at the Académie du Sourire in Aix-en-Provence, enhancing her expertise in dental aesthetics. Dr. Facon continued to build on her knowledge with international training, including at the International Institute of Periodontology in Montreal in 2015, and a veneer training course at the GAD Center in Bordeaux the same year. In 2016, she further advanced in mucogingival surgery at the Académie de Parodontologie in Aix-en-Provence. Always keeping up with the latest developments, she participated in the CIDAE training in Brussels in 2022. More recently, in 2024, Dr. Facon completed a course in composite layering and injection, led by Guillaume Piskorski, the French specialist in injected composite technique, in Lille. With extensive expertise, Dr. Facon is also an educator in direct aesthetic composites, having taught at the University of Lille in 2020, 2022, 2023, and 2024.

In part two of this veneer workflow, Roberto Rossi completes the restoration by applying CERABIEN™ MiLai lusters to the pre-stained and sintered KATANA™ Zirconia YML. Watch as he enhances surface texture, gloss, and lifelike detail through precise finishing techniques.

With just a few simple steps, Roberto creates depth, dynamic light effects, and natural contours that rival real enamel. The process is intuitive and efficient, delivering a high-end finish—culminating in a final self-glazing fire for a polished, natural result.

An intelligent solution for dental technicians seeking efficiency without compromising on aesthetics.

In the first part of this aesthetic veneer workflow, dental technician Roberto Rossi demonstrates how to apply internal stains to KATANA™ Zirconia YML. This crucial step enhances the restoration by adding depth, translucency, and natural character from within.

After refining the anatomy and surface texture, Roberto skillfully blends and applies selected shades such as A+, Fluoro, and Incisal Blue. These shades create depth, opalescence, and inner vitality that radiate through the final restoration.

A must-watch for dental technicians looking to elevate their zirconia restorations with advanced, yet straightforward, internal staining techniques.

EUROPEAN KOLS EXPERIENCE INNOVATION AND CRAFTSMANSHIP IN JAPAN

This September, seventeen of Kuraray Noritake Dental’s Key Opinion Leaders (KOLs) from across Europe—representing nine countries—embarked on a remarkable journey to Japan. The program offered a rare opportunity to experience the heart of Kuraray Noritake Dental’s culture of innovation, craftsmanship, and collaboration.

A JOURNEY OF INSIGHT AND INSPIRATION

The tour began in Tokyo, where the group traveled by bullet train to Nagoya to explore some of Japan’s cultural and professional landmarks. Visits to Nagoya Castle and the historic Noritake Garden provided glimpses into the artistry and heritage that continue to inspire our company’s ceramic technologies today.

Nagoya castle.

That evening, an official dinner in Nagoya brought together the European guests and key members of the Kuraray Noritake Dental team, including Ms. Kiyoko Ban, Mr. Yoshihisa Yamada, and Mr. Kazuhiro Yamada. It was an evening filled with rich conversations, meaningful connections, and a shared vision for the future of dental excellence.

FROM CONCEPT TO CREATION: VISITING THE MIYOSHI AND NIIGATA FACTORIES

The following day, the KOLs visited the Miyoshi Factory, where the company’s ceramic products such as KATANA™ Zirconia are manufactured, and  attended insightful presentations by their European peers — including Jorgen Gad, Sophie Dallem, Dumitru Leahu, Marios Georgoulis, Stratos Chatzichristos, and Kamila Krzepkowska — followed by a comprehensive factory tour and in-depth discussions  with R&D experts on zirconia and dental lab materials, providing unique professional insights.

Discussion with Kuraray Noritake Dental team at Miyoshi Factory.

Presentation given by DT Sophie Dallem and DT Dumitru Leahu at Miyoshi Factory.

Presentation given by DT Marios Georgoulis at Miyoshi Factory.

The tour also brought our KOLs to Niigata, where participants experienced firsthand the research and development process behind Kuraray Noritake Dental’s renowned products. A highlight was the hands-on demonstration of CLEARFIL MAJESTY™ ES Flow Universal, allowing each participant to engage directly with the materials and processes that define the company’s quality.

Hands-on course at Niigata plant.

CONNECTING THROUGH COLLABORATION

Between technical sessions, the group visited the Tokyo office and showroom, sharing open discussions with our Japanese colleagues at the headquarters, followed by a sightseeing tour through Tokyo’s landmarks — from the Imperial Palace to Tokyo Tower. These shared experiences strengthened the sense of partnership and mutual respect not only between the European and Japanese teams but also between the KOLs themselves and the company.

“It was an incredible experience meeting exceptional people worldwide, among them top specialists.” 
—    DT Kamila Krezpkowska, Poland

Discussion with Kuraray Noritake Dental team at the Tokyo headquarters.

WORDS FROM OUR KOLS

The feedback from participants was overwhelmingly positive:

“It was truly a lifetime experience — both inspiring and invaluable for me as a dental technician. Witnessing how the materials we use every day are created gave me an even deeper appreciation for the craft behind them.”
— DT Marios Georgoulis, Greece

“I’m so impressed by the organization, the endless friendliness, the openness, and the willingness to answer all my questions. It was a wonderful time, filled with so many experiences.” 
— Dr. Bernhild Stamnitz, Germany

“It was a life experience I will never forget and I am very grateful I got this opportunity to be there.[…] The drive and compassion of all the workers in office, but also at the factory were very impressive to see. The view I had about the quality of your product improved more than it already was.” 
—  Dr. Mark Laske, Netherlands

A SHARED COMMITMENT TO EXCELLENCE

The KOL Japan Tour 2025 was more than a professional visit—it was a bridge between continents, uniting people through shared values of precision, innovation, and artistry. Kuraray Noritake Dental extends heartfelt thanks to all participants and to the teams in Japan who made this unforgettable experience possible.

Group picture at the Kuraray Noritake Dental office in Tokyo.

Arigato!

CLEARFIL MAJESTY™ES Flow Universal“ LAIMI MOKSLO APDOVANOJIMĄ

„Kuraray Noritake Dental Inc.“ ką tik pristatė takųjį kompozitą, pasižymintį supaprastinta atspalvių koncepcija: „CLEARFIL MAJESTY™ ES Flow Universal“. Kaip buvo paskelbta 2025 m. sausio–vasario mėn. JAV leidžiamo žurnalo „Dental Advisor“ numeryje, naujasis produktas pelnė prestižinį mokslo apdovanojimą už įtikinamus in vitro rezultatus.

SAVYBĖS TRUMPAI

Europoje „CLEARFIL MAJESTY™ ES Flow Universal“ buvo pradėtas gaminti dviejų klampumo variantų – mažo ir labai mažo, o Jungtinėse Amerikos Valstijose siūlomas tik labai mažo klampumo variantas. Tam, kad būtų galima nesunkiai parinkti atspalvį, medžiagoje sumaniai derinamas emalio skaidrumas, dentino spalva ir unikali šviesos difuzijos technologija (LDT). Taip pasiekiamas išskirtinis atspalvių suderinamumas, leidžiantis sukurti minimalią atspalvių gamą, kurią sudaro tik du vienas kitą papildantys atspalviai – universalus (U) ir universalus tamsus (UT). Sukietėjusi medžiaga natūraliai susilieja su aplinkinių dantų struktūra.

 
Be intuityvaus atspalvio pasirinkimo, takusis kompozitas turi dar vieną svarbų privalumą – jis itin tvirtas. „CLEARFIL MAJESTY™ ES Flow Universal“ (labai mažo klampumo) lenkiamasis stipris yra 152 MPa, o gniuždomasis stipris – 374 MPa, taigi „CLEARFIL MAJESTY™ ES Flow Universal“ (itin mažo klampumo) stiprumu nenusileidžia daugeliui pastos konsistencijos kompozitų. Todėl jį galima naudoti net ir streso veikiamose vietose. Jis skirtas:

• 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;
• mažesniems nei 2 mm storio keraminiams ir kompozitiniams įklotams, užklotams ir laminatėms cementuoti.

STULBINANTYS IN VITRO REZULTATAI

Jungtinėse Amerikos Valstijose pasiūlytas itin mažo takumo variantas buvo išbandytas „Dental Advisor Biomaterials“ biologinių medžiagų tyrimų centre ir palygintas su dviem kitais takiaisiais kompozitais. Buvo įvertintos šios medžiagų savybės: lenkiamasis stipris, tamprumo modulis, atsparumas lūžiams, gniuždomasis stipris ir rentgenokontrastiškumas. Be to, tyrėjai įvertino medžiagų atspalvių suderinamumą atkuriant V klasės ertmes A1, B2, C3 ir D4 atspalvio dantų protezuose. Galiausiai jie išbandė rentgenokontrastiškumo ir takumo savybes.

 
„CLEARFIL MAJESTY™ ES Flow Universal“ visais aspektais parodė labai gerus rezultatus. Paaiškėjo, kad produkto fizikinės savybės yra vienos geriausių tarp takiųjų kompozitų ir panašios į alternatyvių pastos tipo kompozitų savybes. Nustatyta, kad rentgenokontrastiškumas yra idealus, kaip ir klampumas, nes užtepta medžiaga išlaiko pradinę formą. Nors siūlomi tik du atspalviai, tyrėjai patvirtino, kad „CLEARFIL MAJESTY™ ES Flow Universal“ atitinka platų natūralių dantų atspalvių spektrą.

APIE „DENTAL ADVISOR“

JAV įsikūrusi organizacija „Dental Advisor“ organizuoja geriausio gaminio ir pageidaujamo gaminio apdovanojimus, kad padėtų itin neturintiems laiko odontologams orientuotis naujų odontologinių sprendimų įvairovėje, visų pirma mažiau invazinių metodų ir standartizuotų procedūrų srityje. Šiais apdovanojimais siekiama nustatyti gaminius, kurie nuolat gerina rezultatus. „Dental Advisor“ atlieka klinikinius vertinimus ir gaminių veiksmingumo bandymus netrukus po gaminio išleidimo į rinką ir skelbia metinius rezultatus internete, kad padėtų odontologams išsirinkti aukštos kokybės odontologines medžiagas, atitinkančias konkrečius jų poreikius. Mokslo apdovanojimai buvo įsteigti siekiant pagerbti tuos odontologinių gaminių gamintojus, kurie nuolat vykdo mokslinius tyrimus, kuria ir tobulina odontologines medžiagas, siekdami pagerinti gydymo kokybę.

Daugiau informacijos žr. „Dental Advisor“ interneto svetainėje www.dentaladvisor.com

Šiuolaikinėje odontologijoje akivaizdus 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.

Tiesioginiam restauravimui 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.characteristics with advanced shade-blending ability and outstanding mechanical properties.

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 pasirinkimas 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 pasirinkti atsižvelgiant į ertmės klasę ir paciento amžių.

Spalvų derinimas su priekinėmis ir užpakalinėmis restauracijomis

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 vizualinę integraciją su aplinkine danties struktūra ir supaprastintą atspalvio pasirinkimo procedūrą;
• dėl tiksotropinių charakteristikų, 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. Paruoškite ir izoliuokite sritį taip, kaip reikia..
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, priklausomai nuo atspalvio ir naudojamos kietinimo lempos).
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 2025 m. pelnė „Dental Advisor“ mokslo apdovanojimą. Savo išvadoje šio JAV leidinio vertintojai teigė:

“Bandymų duomenimis, šis kompozitas pasižymi vienomis geriausių fizikinių 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.

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Universal Excellence – išmanūs supaprastinti sprendimai

„Kuraray Noritake Dental Inc.“ žino 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.

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PANAVIA™ Veneer LC WINS PREFERRED PRODUCT AND RESEARCH AWARDS

PANAVIA™ Veneer LC has been singled out for a Research Award in the category Research – Veneer Cement by Dental Advisor and for a Preferred Product Award in the category Cement: Esthetic Resin. Published in the January/February 2025 issue of the US-based organisation, the annual Top Product, Preferred Product or Research Awards are given to those materials and devices deemed by the publication’s consultants to deliver the best practice-based or lab-based performance in their categories.

BENEFITS IN A NUTSHELL

PANAVIA™ Veneer LC is a specialized veneer cement designed to provide exceptional bond strength to various substrates, along with outstanding gloss retention and wear resistance. The resin cement utilizes smaller-diameter spherical filler particles, facilitating easy dispensing from the syringe and excellent flowability for minimal film thickness. All of these attributes contribute to virtually no change in gloss or surface appearance of veneer margins over time.

EXCELLENT PROPERTIES IN VITRO

To assess the scientific performance of PANAVIA™ Veneer LC, its features and physical properties, specifically its bond strength to various substrates after artificial aging and its wear resistance, were tested in the Dental Advisor Biomaterials Research Center. The investigators’ testing of these attributes reflects the challenges such products must meet – “Ideally, esthetic veneer cements should have a long working time, curing on demand, excellent color stability, and high strength”.

To assess bond strength to dentin, enamel, IPS e.max CAD, and zirconia, the cements were subjected to six months of artificial aging using thermocycling. To test wear resistance after toothbrush abrasion, the testing method involved measuring depth of wear, change in surface roughness, and change in gloss based on a simulation of about 5.5 years of regular toothbrush use.

The investigators reported that PANAVIA™ Veneer LC “had the best gloss retention of the three cements tested and a very even wear pattern,” noting further that “having limited surface roughness after toothbrush abrasion can help lower staining and bacterial adhesion.” Overall, they said, “The PANAVIA™ Veneer LC cement system showed excellent adhesion properties and exceptional gloss retention and wear resistance,” concluding:

OUTSTANDING RATING OF 96 PERCENT

In addition, the product was tested in the clinical setting. 25 clinical evaluators used PANAVIA™ Veneer LC cement system in their dental offices. After a total of 166 uses, the light-curing resin cement received “excellent” to “very good” ratings with regard to completeness of the kit, the shade of the try-in pastes, ease of clean-up of the try-in pastes and excess cement, viscosity, working time and lack of shade shift after curing.

The evaluator’s clinical tips included:

• „Use a micro brush or rubber tip to clean up excess cement before curing.”
• „Apply glycerin gel to the margins after placing the veneer with the cement to eliminate the oxygen inhibition layer and ensure a complete cure before light curing through the gel.”

In their comments, they praised the ease of use of the system, the design of the syringes, the shade options and shade match between try-in and cement shades, e.g.:

• “The white shade of the cement was opaque enough for efficient masking of discolored tooth structure.”
• “Great esthetics, very easy to use, complete system.”

This resulted in an overall clinical rating of 96 percent and an equally high recommendation rate.

ABOUT DENTAL ADVISOR

The Top Product and Preferred Product Awards from Dental Advisor, a US-based organization, were initiated to help busy practitioners navigate the variety of new dental solutions available, particularly for less invasive techniques and standardized procedures. These awards aim to identify products that improve outcomes consistently. Dental Advisor conducts clinical evaluations and product performance tests shortly after a product’s launch and publishes annual results online to help practitioners identify high-quality dental materials suited to their specific needs. Research Awards were initiated to honour those manufacturers of dental products with an ongoing commitment to research, development and advancement of dental materials to enhance treatment quality.

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

Interview with the team at Kuraray Noritake Dental Inc., who developed and brought to life this new universal adhesive.

Streamlining, enhancing and refining adhesive procedures – these are the aims of an 5-person team at Kuraray Noritake Dental Inc. in Japan. Recently, the team has developed a next-generation universal adhesive CLEARFIL™ Universal Bond Quick 2 that offers quick and easy application combined with an optimised bonding performance. To learn more about the goals and achievements of the development project, and the benefits of the product, we had a conversation with them.

From left to right: Ryo Matsuura and Ryota Murayama (R&D Department), Kazutoshi Ikeda (Production Department), Marina Okada and Yamato Nojiri (Planning & Development Department).

Why did you decide to improve CLEARFIL™ Universal Bond Quick?

Universal adhesives like CLEARFIL™ Universal Bond Quick are very well received by dental practitioners all over the world mainly due to their versatility and procedural simplicity. In the clinical setting, however, we have identified room for improvement. For example, it can be difficult to establish thin, uniform and strong bonding layers with the currently available products. Water and solvents in universal adhesives often limit the formation of a strong bond layer. A thin bonding layer and the relatively thick oxygen inhibition layer make this type of bonding agent susceptible to degradation by water sorption from dentinal moisture. Highly viscous bonding agents also complicate the ease of application in small cavities and can easily lead to pooling of the adhesive in critical parts of the cavity. Adhesives with a relatively high viscosity may pool or accumulate along margins, and may form a layer that is too thick and may change the morphology of the abutment tooth, a critical factor potentially affecting the fit of an indirect restoration. Generally, bonding agents with a low film thickness and/or are low-filled or unfilled, in turn have a potentially negative effect on the strength of the bonding layer. At Kuraray Noritake Dental Inc., we wanted to address the aforementioned issues and have developed a universal adhesive that is easy to apply and facilitates the establishing of thin, uniform bonding layers exhibiting high strength.

What are the indications of CLEARFIL™ Universal Bond Quick 2?

The new universal adhesive is indicated for bonding procedures in the context of creating direct restorations with light-cured composite, sealing of a prepared cavity or abutment tooth as a pretreatment for indirect restorations, treatment of exposed root surfaces and hypersensitive teeth, and also the intraoral repair of fractured restorations. Furthermore, the product is a suitable adhesive in post-cementation and core build-up procedures as well as in adhesive cementing of indirect restorations. When used in the context of the cementing of indirect restorations, the bonding to tooth structure of PANAVIA™ SA Cement Universal and of other manufacturers’ self-adhesive resin cements improves, leading to higher bond strengths.

What are the corresponding general benefits of CLEARFIL™ Universal Bond Quick AND CLEARFIL™ Universal Bond Quick 2?

The general benefits of both products are that they may be used with any etching procedure, plus the fact that there is no need to wait for the adhesive to penetrate the tooth structure after application. In addition, both products contain the original MDP monomer and the amide monomer, responsible for the formation of a thin and strong surface coating. Both products exhibit low technique sensitivity and are suitable for a wide range of indications. Finally, the adhesive monomers and fluoride offer extra protection to the underlying dentin.

Monomer image from the brochure

You mentioned the original MDP monomer as one of the essential components of the new adhesive and its predecessor. Is there a difference between this original MDP monomer and other MDP monomers available on the market?

Our MDP monomer is the only MDP monomer that is manufactured using the originally developed synthesis and purification process. Research has shown that the way MDP is manufactured has indeed an impact on the performance of the monomer itself1. While impurities and dimers detected in MDP monomers synthesized elsewhere negatively affected the immediate and aged micro-tensile bond strength in the in-vitro study, our MDP monomer shows high purity and more favourable test results.

Most universal adhesives need to be rubbed into the tooth structure extensively for 10 to 20 seconds. What did you do to eliminate the waiting time independent of the etching procedure, which led to an ultra-quick application procedure?

It is the amide monomer which is mainly responsible for an improved penetration speed into the tooth structure. The hydrophilicity of this monomer is much higher than the hydrophilicity of the HEMA monomer that is typically used. This provides for a better penetration into the moist dentin. The amide monomer’s polymerisation characteristics are better, and, following polymerisation, leads to higher stability in a wet environment due to the formation of a highly cross-linked polymer network. In combination with MDP, an efficient long-term performance will likely be achieved. For optimal outcomes, the adhesive is simply rubbed into the tooth structure as described in the IFU: “Apply BOND with a rubbing motion to the entire cavity wall with the applicator brush. No waiting time is required.”

What are the additional benefits that CLEARFIL™ Universal Bond Quick 2 has to offer?

First of all, we improved the viscosity and film thickness by optimizing the manufacturing method. The thin adhesive layer prevents pooling in the cavity, around abutments and along margins, creating a uniform bonding layer. Simply put, the new adhesive is applied thinly and spreads evenly. At the same time, the product offers high mechanical strength and excellent resistance to water sorption. Its bond strength is high in all etching modes and the new formulation allows for the product to be stored at room temperature.

Please explain the clinical benefit of an improved mechanical strength.

The risk of decreasing the film thickness lies in a possible decrease in the strength of the bonding layer which can lead to reduced bond durability. By introducing a new multifunctional urethane methacrylate monomer, we have been able to increase the strength. The effective advantage of the new bonding agent is that it can easily be used in small, difficult-to-access cavities or in cavities with complex morphology. The result is a thin yet strong adhesive layer that also allows for easy placement of any type of restoration.

How did you manage to improve the storage conditions?

Component stability was not an issue with CLEARFIL™ Universal Bond Quick. However, for a stable viscosity, it needed low-temperature storage. By optimizing the manufacturing method and decreasing the viscosity of CLEARFIL™ Universal Bond Quick 2, storage at room temperature became possible.

Was it difficult to integrate the new components and keep the existing benefits? How did you manage?

Integrating new components and removing others always means that the whole formulation needs to be rebalanced properly. This was particularly challenging for the multifunctional urethane methacrylate monomer we wanted to add. It improves the strength and hardness of the universal adhesive, but may affect adhesion depending on the amount of the compound in the formulation. Consequently, we needed to carefully find optimal balance, which took some time and required thorough testing, but in the end, we succeeded.

At the moment, the immediate dentin sealing technique is popular in indirect restoration procedures. What makes CLEARFIL™ Universal Bond Quick 2 suited for this technique?

Immediate dentin sealing is indeed a popular and useful technique that can result in significantly increased retention, reduced marginal leakage, improved bond strength, and less postoperative sensitivity. Using CLEARFIL™ Universal Bond Quick 2 in this context is beneficial as the procedure is quick, the resulting bonding layer is thin and strong, and the dentin is effectively protected.

Why should a dental practitioner switch to CLEARFIL™ Universal Bond Quick 2?

For users of CLEARFIL™ Universal Bond Quick, switching to CLEARFIL™ Universal Bond Quick 2 is worthwhile, as it offers additional advantages and improved performance while retaining the benefits of its predecessor. For users of other universal adhesives, the major benefit lies in the shortened application time: CLEARFIL™ Universal Bond Quick 2 is the only universal adhesive that can achieve a high bond strength and a high-strength bonding layer without any waiting time. In addition, it is suitable for a wide range of indications including core build-up procedures and cementation.

Thank you very much for these insights!

References
1. Yoshihara K, Nagaoka N, Okihara T, Kuroboshi M, Hayakawa S, Maruo Y, Nishigawa G, De Munck J, Yoshida Y, Van Meerbeek B. Functional monomer impurity affects adhesive performance. Dent Mater. 2015 Dec;31(12):1493-501.

CERABIEN™ MiLai in Daily Use

A tooth with crack lines, a characteristic round shape, age-related changes, or medication-induced discoloration — there’s no one-size-fits-all solution when it comes to all-ceramic anterior restorations, even when the porcelain system and production technique are defined.

To support technicians who wish to simplify their layering workflow using the micro-layering technique and CERABIEN™ MiLai — whether just getting started or looking to refine their process — we’ve collaborated with DT Dumitru Leahu to create a Chroma Map Catalogue featuring seven typical anterior restoration scenarios.

Each case example includes a detailed screenshot of the framework design, chroma maps outlining the planned steps, images of internal staining and micro-layering procedures, and the final restoration on the model. You’ll also find essential information about the selected framework material, target shade, and other relevant details.

We invite you to use the CERABIEN™ MiLai Catalogue as a step-by-step guide to success or simply as inspiration for individual cases. It offers a fast track to understanding the material’s optical properties and will make planning your next micro-layering case more intuitive. No need to start from scratch — instead, adapt what’s already there and gradually develop your own maps and techniques.

Interested in the CERABIEN™ MiLai Chroma Map Catalogue?

Download it here!

Interview with Takehiro Kameya
Manager of the Technology Division of Kuraray Noritake Dental Inc.

How did you identify the need for a universal flowable restorative?

Packable composites with a universal shade concept are becoming increasingly popular worldwide. This fact made us assume that there is a demand for the flowable type as well. Users will also benefit from simplified procedures and a reduced number of shades to be stocked, with a positive impact on inventory management. Accordingly, we introduced the universal flowable composite in Japan, where it already holds a significant market share. Users have been utilizing it for various cases with excellent feedback. As it turned out to be very well received in Japan, we approached the European team to extend the release area to Europe, and the decision was made to launch it. We pushed forward with commercialization in an ultra-short period of about one year.

Does it really create added value to use a universal flowable composite in addition to the universal packable variant?

Yes, several benefits arise from the additional use of a modern flowable composite. This is because – unlike earlier products – the latest generation of flowable composites offers sufficient mechanical strength to be used for regular restorations. The advantages of using a flowable composite include the ability to flow into even the narrowest parts of a (sometimes complex) cavity, which provides for easy and quick filling procedures, and to an intimate adaptation at the adhesive interface leading to a tight seal.

What are the differences between CLEARFIL MAJESTY™ ES Flow and CLEARFIL MAJESTY™ ES Flow Universal?

CLEARFIL MAJESTY™ ES Flow Universal maintains the distinctive features of CLEARFIL MAJESTY™ ES Flow, such as convenient dispensing, handling and sculpting, extremely easy and quick polishing, long-lasting gloss and great mechanical properties. Due to their high strength, both products can be used not only as liners, but also for regular direct restoration procedures. The difference lies in the shade concept. CLEARFIL MAJESTY™ ES Flow Universal introduces a universal shade system, allowing it to adapt to a wide range of colour tones with fewer shade variations.

Please describe the shade concept behind CLEARFIL MAJESTY™ ES Flow Universal. How many shades are available and how are they selected?

The CLEARFIL MAJESTY™ ES Flow Universal line-up consists of two shades: Universal (U) and Universal Dark (UD). U is an excellent choice for all posterior restorations, independent of the target shade. In the anterior region and cervical area (Class III, IV and V cavities), U is best suited for restoring teeth of the shades A1 to A3 (including B1, B2, C1, C2, D2, D2, D3 and D4), while UD is the shade of choice to match the target shades A3.5 to A4 (including B3, B4, C3 and C4).

Color matching with anterior and posterior restorations.

Why do you offer an additional shade for the anterior region?

Universal-shade composites need to take on the colour of the surrounding tooth structure to deliver a perfect match for a great number of target shades. In the posterior area, large amounts of surrounding tooth structure are usually available with several cavity walls still present. This facilitates the taking on of the tooth colour compared to cavities in the anterior region. Here, light easily passes through, so that the colour of the composite itself is more likely to be reflected. This can lead to limitations in colour matching. In the case of CLEARFIL MAJESTY™ ES Flow Universal, the U shade that turned to be ideal for the posterior area showed some colour-matching limitations in anterior restorations of darker teeth. Hence, we decided to offer a second colour option specifically designed for these situations. With U and UD, CLEARFIL MAJESTY™ ES Flow Universal offers great colour adaptability from light to dark shades and hence addresses the need for precise colour matching especially in the anterior region.

Developing just two shades of composite to cover so many target tooth shades sounds challenging. How did you evaluate whether the available shades are appropriate in the clinical environment?

Indeed, it has been quite challenging to develop the U shade, which is able to match a wider range of tooth colours for both anterior and posterior teeth than the U shade of CLEARFIL MAJESTY™ ES-2 Universal. In order to evaluate and fine-tune the shades we developed, we repeatedly conducted filling tests using a wide range of experimental shades in artificial teeth and extracted teeth of various tooth colours. Additionally, the final selection of shades was visually evaluated by consulting dental practitioners who used the composite in the clinical setting.

What are the greatest challenges in the context of determining and selecting the right shade in the clinical environment?

The major drawback of classical shade determination is that it simply increases the chair time. For both, the dental practitioner and the patient, however, minimizing chair time is the ultimate goal, as it reduces costs and increases patient comfort. A true drawback in terms of time and comfort is a colour mismatch produced due to an error during shade determination: it may necessitate intra-oral adjustments or, in the worst case, the creating of a new restoration.

CLEARFIL MAJESTY™ ES Flow Universal is available in two viscosities – Low and Super Low. Why is this the case and what is the difference in use?

We decided to offer two types of flowability with different thixotropic properties to cater to users’ preferences in terms of handling. Basically, there is no difference in usage between Low and Super Low. However, users are encouraged to use composites with different thixotropic properties according to their preferences and the specific case. For example, Super Low is useful for shaping the occlusal surface of posterior teeth. Low can be widely used for applications such as lining and filling in the cervical area and on proximal surfaces.

CLEARFIL MAJESTY™ ES Flow Universal – Great mechanical properties.

What are the technologies behind CLEARFIL MAJESTY™ ES Flow Universal that provide for a great blend-in?

The probably most popular technology used in this product is our proprietary Light Diffusion Technology. We determined the optimal light diffusion based on the observation that a strong diffuse reflection of incident light results in whitening, and weak light diffusion makes it easier to take on dark colours in the oral cavity, darkening the filling site. In addition, we focused on chroma adjustment: The universal shade concept is based on the ability to take on the colour of the surrounding tooth structure and blend with it. Therefore, we have set the chroma to be easily harmonized with a wide range of tooth shades. Finally, the translucency of the material was adjusted via its submicron fillers and silica clusters. Evaluation by key opinion leaders supported us in determining an appropriate level of translucency.

How to proceed in cases with discoloured tooth structure underneath – is there a need for masking with a blocker or opaquer?

The necessity depends on the degree of discolouration. Due to the light diffusion properties of CLEARFIL MAJESTY™ ES Flow Universal, it is generally believed that blocking is not required, and shading can be achieved. However, in cases of severe discolouration, it may be beneficial to fill the bottom of the cavity with A2D or A3D shades of CLEARFIL MAJESTY™ ES Flow, or to use CLEARFIL™ ST Opaquer.

What did you do to avoid void formation during application?

We have adopted the same packaging design used in CLEARFIL MAJESTY™ ES Flow to avoid void formation in this product as well. The innovative container design minimizes the gap between the needle tip and the syringe when the tip is attached.

Are there any recommendations of when to use CLEARFIL MAJESTY™ ES Flow and when to opt for CLEARFIL MAJESTY™ ES Flow Universal?

While the universal variant can be used for general lining and filling applications as described in the instruction for use, CLEARFIL MAJESTY™ ES Flow is recommended for those cases in which the tooth structure is covered and the colour of the entire tooth needs to be changed. Direct veneers are a perfect example. In those situations, the use of different shades and opacities is clearly beneficial.

What is the future of flowable composites?

As information on clinical performance and physical properties data continues to spread, the trust in flowable composites is expected to increase in Europe, leading to its expanded usage. Furthermore, an increased demand is anticipated due to the development of filling methods using flowable composites in conjunction with moulds or matrices.

TAKEHIRO KAMEYA