Prisistato pardavimo ir rinkodaros atstovas Matvejus Šuldiakovas

„Kuraray“, kaip ir aš, teikia pirmenybę kokybei ir klientui, o ne pelnui“

„Niekada nebuvau laimingesnis nei per pastarąjį mėnesį“, – apie savo pirmąjį mėnesį dirbant „Kuraray“ pardavimo ir rinkodaros atstovu Lietuvoje kalba Matvejus Šuldiakovas. Žmonės, kuriuos jis sutiko, įmonės vertybės (pirmiausia – klientas ir kokybė), gaminiai, kuriuos jis reklamuoja: visa tai yra susiję. „Noriu būti glaudžios odontologų bendruomenės dalis. Tai verčia mane tobulėti.“

Entuziastingas, aistringas, atsidavęs, smalsus. Šie žodžiai ateina į galvą kalbant su Matvejumi Šuldiakovu. Jo pirmasis darbo mėnesis „Kuraray“ Lietuvoje dar tik baigėsi, tačiau jis jau galvoja apie savo ateitį įmonėje. „Tai buvo ypatingas mėnuo“, – sako jis.

Matvejus yra pirmasis ir vienintelis „Kuraray“ prekybos atstovas Lietuvoje. Per pastaruosius penkerius metus „Kuraray“ gaminius reklamavo prekiautojai Lietuvoje. Kai reikia parduoti daugiau nei 20 000 gaminių, tai nėra tas pats, kas turėti tiesiogiai įmonėje dirbantį asmenį. Šiuo metu Matvejus važinėja po šalį ir lankosi pas odontologus, dantų technikus ir prekiautojus, reklamuodamas ir pasakodamas apie gaminius. „Pagrindinis mano tikslas yra supažindinti žmones su „Kuraray“ gaminiais.“

Didelė paklausa

Matvejus pastebi, kad odontologai noriai domisi „Kuraray“ gaminiais. „Daugybė odontologų ir dantų technikų girdėjo apie „Kuraray“ ir labai susidomėjo. Pardavimo atstovui labai malonu žinoti, kad gaminiai yra tokie paklausūs.“

Matvejui lengva suprasti, kodėl odontologai ir dantų technikai Lietuvoje taip domisi „Kuraray“. „Peržiūrėjus įmonės dokumentus, frazė, kuri tikrai atkreipė dėmesį buvo „įmonė visada teikia pirmenybę kokybei ir klientui, o ne pelnui“. Tai – nepakartojama. Kiekvieno verslo pagrindinis tikslas, kad ir kokias vertybes jis skelbtų, yra pinigai. Bet raštiškas patvirtinimas buvo toks: „mes, kaip įmonė, vertiname savo klientus ir ryšį.“

Be to, pirmomis darbo dienomis jam nebuvo pasakojama apie biudžetą ar tikslus. Vietoje to, sako Matvejus, jį supažindino su unikaliais ir itin ištobulintais produktais. „Tiesa tokia: klientai nepirks jūsų gaminių dėl gražių akių, bet pirks todėl, kad naudodamiesi jūsų teikiamais gaminiais, galės išspręsti problemą, su kuria susiduria. Nesvarbu, ar tai estetika, ar ekonominė perspektyva, ar kažkas kita – tai yra tai, ką jie vertina. Mano vertybės susijusios su įmonės vertybėmis, pirmiausia teikiant pirmenybę klientui ir žinioms.“

Bendravimas

Nors Matvejus kilęs iš medikų šeimos, pirmiausia jis tapo teisininku. Vis dėlto, pastaruosius porą metų jis dirbo odontologijos srityje. „Esu tikras, kad dabar esu daug laimingesnis nei būdamas gydytoju ar odontologu“, – juokiasi jis. „Dievinu bendravimą, susitikimus su naujais žmonėmis, naujas patirtis, galimybę kurti naujus verslus, visada veikti. Tai nėra darbas nuo 9 iki 17 valandos, tai – mano gyvenimo būdas. Noriu būti glaudžios odontologų bendruomenės dalis. Tai verčia mane tobulėti. Kad būčiau vienas iš jų, privalau įsipareigoti.“

Iš tiesų – darbo labai daug, tačiau Matvejus nesiskundžia. Netgi priešingai – jis jau galvoja apie tai, kas bus toliau. Kai visa Lietuva sužinos viską apie „Kuraray“ gaminius, Matvejaus planuose – plėtra į Estiją ir Latviją. „Mano tikslas yra tapti paklausiu lektoriumi apie „Kuraray“ produktus visame Baltijos regione.“

Kontaktai

Norėdami gauti informacijos apie visus „Kuraray“ produktus, odontologai, dantų technikai ir prekiautojai iš visos Lietuvos gali kreiptis į Matvejų Šuldiakovą. Norite išbandyti „Kuraray“ gaminius? Susisiekite su Matvejumi telefonu 8 687 55 111 arba el. paštu [email protected].

Apie „Kuraray“

„Kuraray“ įkurta 1926 m. Kurašikyje, Japonijoje. Šiandien įmonė yra pirmaujanti pasaulio medicinos produktų, medžiagų, tekstilės, chemikalų, dervų ir kitų medžiagų gamintoja. 2012 m. „Kuraray Medical“ ir „Noritake Dental Supply“ susijungė ir tapo „Kuraray Noritake Dental“. Įmonė tęsia dantų cementų, keramikos ir kitų patikimų gaminių pristatymą į daugiau nei 90 pasaulio šalių. Žinomi gaminiai: „KATANA Zirconia“ gaminių linija, „CLEARFIL Universal Bond Quick“ ir „PANAVIA“ dervos cementas.

Daktaras Adham Elsayed, atestuotas ortopedas, chirurgas bei klinikos ir mokslo vadovas "Kuraray Noritake Dental" įmonėje, šiame interviu įvardija įmonės naujojo kompozito "CLEARFIL MAJESTY™ ES-2 Universal" pranašumus ir paaiškina, kaip jį naudoti kasdieninėje odontologijos darbų eigoje.

Nors odontologų profesionalumas nuolat auga, plečiasi visoms indikacijoms naudojamų produktų paklausa. Kaip "CLEARFIL MAJESTY™ ES-2 Universal" atitinka ši modelį?

Pirmiausia reikėtų paaiškinti termino "universalus" reikšmę šiame kontekste. Anksčiau būdavo naudojami dviejų rūšių kompozitai, kurie skyrėsi pagal naudojimo sritį: priekinių dantų srities kompozitai, naudojami III, IV ir V klasės restauracijoms, kur pirmenybė teikiama estetiniam rezultatui, ir galinių dantų srities kompozitai, kai svarbesnės mechaninės savybės, tokios kaip tvirtumas ir susidėvėjimo greitis. O universalūs kompozitai yra tokie, kuriuos galima naudoti visų tipų restauracijoms tiek priekinių, tiek galinių dantų srityse.

Kitas žodžio "universalus" aiškinimas yra susijęs su atspalviu. Šiuo atveju terminas vartojamas apibūdinti atkuriamąją kompozito sistemą, turinčią mažiau atspalvių ir galinčią prisitaikyti prie danties struktūros, nepriklausomai nuo danties spalvos. Pagrindinis šio tipo kompozitų pranašumas yra tas, kad jie supaprastina darbo eigą.

"CLEARFIL MAJESTY™ ES-2 Universal" yra iš esmės universalus abiem prasmėmis – tai sistema, kurią galima naudoti priekinių ir galinių dantų sričių restauracijai, be to, ji turi tik tris atspalvius – vieną galiniams dantims, du – priekiniams.

Universalūs produktai – tvirtinimo cementai, rišamosios medžiagos ar kompozitai – odontologams yra patrauklūs, jei jais galima supaprastinti gydymo procedūrą, o kokybė ir patvarumas nuo to nenukenčia.

Kaip „CLEARFIL MAJESTY ES-2 Universal“ prisideda prie „CLEARFIL MAJESTY“ produktų asortimento sėkmės?

"CLEARFIL MAJESTY" produktų šeima šiuo metu yra labai gerai įsitvirtinusi. Jai priklauso tokie produktai, kaip "CLEARFIL MAJESTY Posterior" – vienas populiariausių galinių dantų kompozitų, pasižyminčių puikiomis mechaninėmis savybėmis ir minimaliu polimerizacijos susitraukimu. "CLEARFIL MAJESTY™ ES-2" – tai plati sistema, kuri ypač naudinga dėl išskirtinių optinių savybių ir gebėjimo sukurti aukštos kokybės estetiką priekinių dantų srityje, naudojant „Kuraray Noritake Dental“ daugiasluoksnę techniką. Trys takiųjų kompozitų "CLEARFIL MAJESTY ES Flow" skirtingų konsistencijų alternatyvos taip pat yra sėkmingi produktų šeimos nariai.

"Kuraray Noritake Dental" tęsia "CLEARFIL MAJESTY" sėkmės istoriją su naujausiu inovatyviu produktu, kuris gali pakeisti universalaus depozito apibrėžimą. "CLEARFIL MAJESTY ES-2 Universal" apima keletą gerai žinomų "ES-2" ir "ES Flow" atributų, įskaitant "Kuraray Noritake Dental" šviesos difuzijos technologiją (LDT).

Kalbant apie LDT – kuo ši technologija naudinga kompozitui?

LDT leidžia medžiagai išsisklaidyti ir atspindėti šviesos spindulius įvairiais kampais, o tai, savo ruožtu, leidžia kompozitinei restauracijai skleisti šviesą panašiai, kaip supanti dantų struktūra. Taip pašalinamos tokios estetinės problemos, kaip restauravimo ir gruntavimo kraštų matomumas. Dėl inovatyvios LDT technologijos, optimalių dalelių užpildų ir matiškumo "CLEARFIL MAJESTY ES-2 Universal" sklandžiai susilieja su supančia danties struktūra ir imituoja natūralius dantis, todėl nebereikia naudoti atspalvių.

Kaip minėjote, vienas "CLEARFIL MAJESTY ES-2 Universal" atspalvis yra skirtas galinių dantų restauracijoms, o kiti du – priekinių dantų restauracijoms. Ar tokio siauro atspalvių asortimento tikrai pakanka išties estetiškoms restauracijoms atlikti?

"CLEARFIL MAJESTY ES-2 Universal" nėra pirmasis kompozitas rinkoje, pasižymintis siauro atspalvių asortimento sistema. Tačiau galime drąsiai teigti, kad pirmiausia dėmesys skiriamas estetikai, o ne atspalvių asortimento susiaurinimui.

Iš patirties žinome, kad naudojant vieno atspalvio kompozitų sistemas priekinių dantų srityje dažniausiai gaunami nepatenkinami estetiniai rezultatai, netgi tais atvejais, kai atspalvių tarpusavio sąveikos trukdžiams sumažinti naudojamas matinis kompozitas. Taip yra dėl to, kad stengiantis suteikti vieną atspalvį visoms galinių ir priekinių dantų restauracijoms pagal visus dantų atspalvius labai nukenčia estetika. Kitaip tariant, itin gerai permatomos medžiagos naudojimas siekiant suderinti visų dantų restauracijas ir atspalvius sukels tarpusavio sąveiką su kitais burnos objektais, pavyzdžiui, liežuviu, dantenomis ir panašiai.

"Kuraray Noritake" puikiai suprato šį faktą ir išsprendė problemą, įvesdama tris atspalvius, kurie pasižymi tokiu permatomumu, kuris tiktų konkrečioms indikacijoms. Svarbu atkreipti dėmesį į darbo eigos paprastumą, nes kiekvienai restauracijai tereikia vieno švirkšto. Todėl "CLEARFIL MAJESTY ES-2 Universal" yra tikra žaidimo taisykles pakeisianti inovacija, suteikianti tobulą paprastumo ir estetikos derinį.

Kokie kiti šio naujojo kompozito pranašumai?

Kiti pranašumai – tai jau gerai žinomos "CLEARFIL MAJESTY" produktų šeimos puikios mechaninės savybės, pavyzdžiui, palankios nusidėvėjimo savybės, mažas susitraukimo krūvis ir geras tvirtumas. Jis lengvai poliruojamas ir išlieka blizgus. Be to, medžiagos apdorojimas yra didžiulis pranašumas: esant darbiniam apšvietimui produktą galima naudoti apie 270 sekundžių. Jis nelipnus ir lengvai formuojamas.

Kuriems odontologams šis produktas būtų naudingiausias?

Tobulas paprastumo ir estetikos derinys gydytojui suteikia keletą pranašumų. Tai labai paprasta, laiką taupanti procedūra, nedaranti neigiamos įtakos estetiniams rezultatams. Nereikia parinkti tikslaus atspalvio, tokiu būdu išvengiant atspalvių neatitikimo klaidų, be to, sunaudojama mažiau medžiagos. Todėl, mano nuomone, šį produktą reikėtų naudoti daugeliu atvejų kasdieninėje odontologijos veikloje.

Odontologinių medžiagų pažanga ir pokyčiai vyksta sparčiai, o gydytojai šias naujoves turėtų integruoti į kasdieninę veiklą, kad ji taptų efektyvesnė, su paprastesne darbo eiga, laiką taupančiomis procedūromis, naudojant mažiau medžiagų ir atitinkamai sumažėjusiu jautrumu technikoms bei mažesniu poreikiu odontologams susipažinti su medžiagų gausa.

Vien dėl estetinių priežasčių pacientas paprašė rekonstruoti kūgio formos viršutinį dešinįjį lateralinį kandį (12). Pacientui buvo pasiūlytas gydymas, apimantis pirmąją ortodontinės terapijos fazę, kuria siekiama atkurti erdvę, reikalingą lateraliniam kandžiui rekonstruoti iki idealaus dydžio. Pacientui atsisakius atlikti šią ortodontinę terapiją, buvo nuspręsta dantį rekonstruoti kompozicine derva ir pritaikyti jo dydį prie jau esamos vietos.

Naudota surišimo sistema – „CLEARFIL SE BOND 2“, o restauracija sukurta naudojant naująjį „CLEARFIL MAJESTY ES-2 Universal“ kompozitą. Nors ši medžiaga skirta vieno atspalvio technikai, ir vos du atspalviai atitinka priekinių dantų atspalvius, nusprendžiau sujungti abi pastas, kad pasiekčiau geriausią įmanomą rezultatą. Šoninio kandžio kakleliui ir centrinei daliai rekonstruoti buvo naudojamas atspalvis UD (universalus tamsus). Incizinio ploto dalis buvo rekonstruota naudojant UL (universalus šviesus).

Pirminė kūgio formos viršutinio dešiniojo lateralinio kandžio padėtis (12).

Pirminės situacijos vaizdas, nufotografuotas naudojant poliarizacinį filtrą, siekiant įvertinti atspalvį. 

Pasirinktas naujas „CLEARFIL MAJESTY™ ES-2 Universal“ kompozitas, turintis vos du priekinės dantų srities atspalvius. Siūloma gera optinė integracija „Kuraray Noritake Dental“ šviesos sklaidos technologijos dėka.

Atspalvio taikymas naudojant sukietėjusius „CLEARFIL MAJESTY ES-2 Universal“ UL (universalus šviesus) ir UD (universalus tamsus) mėginius ant dantų paviršių.

Izoliavimas koferdamu.

Naudojamas „CLEARFIL SE BOND 2“ tvirtam ryšiui tarp danties struktūros ir kompozicinės medžiagos sukurti

GALUTINĖ PADĖTIS
Universalus kompozitas puikiai prisitaiko prie gretimų dantų savo spalva ir paviršiaus apdaila.

No shade taking needed. Just one shade to cover all posterior cases. Even the larger Class I's and II's!

Anterior cases from B1 to C4 done with only two shades, without the need for shade taking. Can you imagine? No additional opake materials (light blockers) needed too.

Volume 7 of our "BOND" magazine is now published and ready to read!

Content Highlights:

• Composites versus hybrid ceramics
• Flowable composites a universal solution?
• Universal adhesives, is one bottle sufficient?

Start Reading: BOND | VOLUME 7 | 10/2020

At Kuraray Noritake Dental Inc. we are proud that our products are being developed using innovative technologies, paying attention to detail and keeping in mind the needs of our customers.

We are committed to offering outstanding products that provide dental professionals with the flexibility for self-expression and creativity, adding value and delivering superb aesthetic results to each and every procedure.

Usability, simplicity and, of course, quality always in mind - providing dental professionals with materials that will make their daily practice stress free.

As a prove that our products meet the needs of dentists and lab technicians alike, we are happy to share with you the EC Certificates of Full Quality Assurance System that we have received from The Notified Body.  Those can be downloaded below.

Chairside products

Labside products

Kuraray celebrates its 90th anniversary in 2016. We take the opportunity of this occasion to offer you a glimpse of the history of Kuraray from a new perspective. The name Kuraray represents more than 8,300 employees and an annual turnover of approximately 3.7 billion euros. Kuraray was founded in Kurashiki, Japan, in June 1926, by Magosaburo Ohara. Kuraray began with the domestic production of Rayon, a synthetically produced cellulose fibre referred to as artificial silk, a new and innovative product at the time. 

The name KURARAY is derived from the location: Kurashiki and the product manufactured: Rayon. The development of this branch of production developed very quickly in Japan, with many other major manufacturers establishing themselves during this period. Whereas others recruited their technicians and experts from elsewhere, Kuraray established the Kyoko Research Laboratory, which was managed by the University of Kyoto to generate expertise and support for the development of the required technologies. Ohara also committed himself to cultural and social projects. The building of an art gallery and the financing of an orphanage represent only two of his many projects in Kurashiki. The Ohara Museum of Art was the first private museum of Western art in Japan.

Ohara considered the dreadful conditions in which employees commonly worked and lived at the time to be unacceptable; he was not a profit-driven employer, and attempted to solve such issues. He ensured that decent accommodation, fitness facilities and nursery schools were built to provide young employees, or families who had left their homes to work for Kuraray, with everything they needed for education and a healthy and culturally rich lifestyle.
One of the largest general hospitals in the west of Japan, the Kurashiki Central Hospital, was originally founded by Kuraray to promote the well-being of employees and their families. It is still considered to be one of the most famous hospitals in Japan.

With the production of Kuralon in 1950, developed from the in-house manufactured products PVA and vinyl acetate, Kuraray expanded to become the specialist chemical company it is today. Always intent on making a contribution to the good of society, Kuraray addressed the subject of environmental protection very early on. The visionary Ohara was aware of the seriousness of environmental pollution, and made great efforts to prevent it.

Internationally too, Kuraray has remained aware of its social responsibilities. After the war, a production facility was opened in China which helped to improve the poor post-war living conditions of the Chinese population.
Today, Kuraray is a leading global manufacturer of the specialist chemicals used in many aspects of daily life. Kuraray has always viewed its employees as its most important asset, and continues to do so to this day.

In 1978, Kuraray shook up the dental market with the introduction of CLEARFIL BOND SYSTEM F, the world’s first total-etch adhesive system. Having inaugurated the era of adhesive dentistry, we steadily introduced new dental products over the following years. In 1983, Kuraray introduced the PANAVIA EX resin cement. By utilising our patented MDP monomer technology developed in-house, PANAVIA EX enabled Kuraray to set the industry standard for adhesion—a position we have held in the decades since. This year marks the 40th anniversary of Kuraray’s entry into the commercial dental products market, providing a perfect opportunity to reflect on how far we have come since.

Kuraray—Rooted from a true trailblazer 
Founded in June 1926 by Magosaburo Ohara in Kurashiki in Japan, Kuraray has transcended our humble origins as a producer of rayon to become a leading global manufacturer of medical products, materials, textiles, chemicals, resins and much more. Our commitment to research and development in the fields of chemistry and engineering has led to many market firsts and a reputation as a pioneer of new products and technologies. 

A history of innovation
From the very beginning, Kuraray has been focused on the manufacture of high value-added products. At the time of the business’s birth, rayon was a new type of synthetic material, and over the ensuing years, Kuraray was able to master its production. In 1950, we became the first company in the world to develop the technology to mass-produce POVAL (polyvinyl alcohol), paving the way for the production of the new synthetic fibre Vinylon in the same year. CLARINO, a water-resistant synthetic leather substitute for shoes, bags and other items, was released in 1964 after extensive research and testing, and quickly collected international awards for its technology.

Kuraray’s continued emphasis on independently developed proprietary technologies and techniques, rather than relying on imported alternatives, has enabled our company to provide original, high-quality products for a variety of different industries. High on this list is dentistry.

The Kuraray Noritake Dental era
In April 2012, Kuraray Medical and Noritake Dental Supply merged to form Kuraray Noritake Dental. By bringing together the materials and technologies developed by each of these market-leading companies, Kuraray Noritake Dental has continued to deliver dental bonding agents, ceramics and other reliable products to over 90 countries worldwide. The KATANA Zirconia range, for example, employs our unique multi-layered zirconia technology to provide a ceramic restorative material with superior translucency and perfect blending properties, while rapid bond technology ensures that CLEARFIL Universal Bond Quick delivers a lasting bond faster and easier than ever. 

Through a focus on research and production, Kuraray Noritake Dental is ideally positioned to continue providing leading-edge solutions to dental issues both now and in the future. 
 

Peter Schouten, Technical Manager at Kuraray Europe Benelux

Before universal adhesives were available, two major techniques were used: total-etching adhesives, which basically work with phosphoric acid etching on enamel and dentine; and self-etching adhesives, which can be used with or without the option of etching enamel selectively. Prior to the introduction of self-etching adhesives in the late 1990s, dentists used mostly total-etching techniques. While this procedure achieves strong enamel bonding, it can also be very technique-sensitive and involves several steps. As a consequence, dentists welcomed the development of simplified adhesives. In 2011, the new generation of universal adhesives was introduced, with the aim of replacing all previous generations.

The development of universal adhesives was firstly due to the success of self-etching adhesives, but total etching was still advocated. The result, a universal adhesive, must be considered a self-etching adhesive with a phosphoric acid conditioning option on enamel and/or dentine. Maximum flexibility resulting from the freedom of choice in etching technique and the preference of the practitioner was thus obtained.

CLEARFIL Universal Bond Quick, manufactured by Kuraray Noritake Dental, is a single-component light-curing bonding agent indicated for all direct and indirect restorations in combination with all etching techniques (total-etching, self-etching or selective-etching). The adhesive is also indicated for the surface treatment of zirconia- and silica-based ceramics. When compared with other one-bottle universal adhesives, CLEARFIL Universal Bond Quick exhibits RAPID BOND TECHNOLOGY. We asked Peter Schouten, Technical Manager at Kuraray Europe Benelux and a chemist with decades of experience in the dental industry, about his views on universal adhesives and CLEARFIL Universal Bond Quick.

Dental Tribune: Since the introduction of the first universal adhesive, a new generation of adhesives has been created that has enjoyed increasing popularity since then. What is your opinion about the system?

Peter Schouten: For me, the term “universal” remains debatable. There is no clear definition of a universal bonding system yet. When we look at what different manufacturers are saying about universal bonding systems, the term to me applies primarily to the etching technologies and the ability to adhere to all substrates currently used in dentistry, such as silica- or metal-based materials. In this case, we can really speak of “universal”.

What are the advantages and disadvantages of self-etching and total-etching technologies? How are universal adhesives positioned in relation to them?

In my home country of the Netherlands, there is a large group of self-etching users. In many other countries, most dentists still use the total-etching approach. And, of course, there are reliable three-step total-etching systems on the market. However, etching of dentine removes hydroxyapatite and creates a layer of collagen. Afterwards, the dentist tries his or her best to penetrate this layer again with a bonding system. Why not preserve the hydroxyapatite and create a reliable bonding to the hydroxyapatite itself? This is the basis of the gold standard two-step self-etching bonding, our CLEARFIL SE BOND. Now universal adhesives—at least CLEARFIL Universal Bond Quick—provide the advantage that dentists can use any etching technique without worrying about results that are less than optimal. It really is an open system.

How do universal adhesives perform on wet and dry dentine, as well as enamel, in combination with all etching technologies?

I am a strong believer in the self-etching technique as we have proven already. The wetness and dryness of dentine is always an issue in total-etching techniques. With CLEARFIL Universal Bond Quick, the instruction is to rinse and dry. Our universal adhesive has the capability of penetrating the dentine surface quickly and completely.

Kuraray is a pioneer in adhesive systems: the company introduced total-etching bonding in the 1970s and innovative self-etching technology in the 1990s. The secret to success of all universal adhesives seems to be the incorporation of the adhesive molecule MDP (10-methacryloyloxydecyl dihydrogen phosphate) developed in 1981 by Kuraray. What is the function of MDP?

Kuraray has over 40 years of experience in the development of phosphate monomers. In 1976, we had already developed Phenyl-P. By far the most important ingredient in our current bonding systems is the original MDP. We never would have reached the level at which we are today without this phosphate monomer. MDP is capable of creating a long-lasting bond to calcium in hydroxyapatite and to other metals. As MDP can chemically bond to Ca2+ ions, it forms stable, insoluble MDP–Ca salts present as nano-layers at the adhesive interface.

Kuraray Noritake Dental introduced CLEARFIL Universal Bond Quick at this year’s International Dental Show. According to the company, CLEARFIL Universal Bond is the best one-step adhesive ever developed. Briefly, what do you find noteworthy about the bonding agent?

The most remarkable thing is RAPID BOND TECHNOLOGY, enabling us to introduce the benefit of no waiting. This technology works in three steps: first, rapid penetration; second, fast polymerisation; and third, quick formation of a hydrophobic, hydrolytically stable bonding layer. It took our research and development lead Dr Yamato Nojiri many years to develop a cocktail of amide monomers that is superhydrophilic and turns after curing into a stable hydrophobic polymer. The addition of this amide monomer makes it possible to skip the waiting step. Fast polymerisation is achieved by a modified photoinitiator, releasing twice as many radicals in comparison with other initiators. The quickly formed stable bond derives from the combined action of MDP and the amide monomer. MDP bonds to calcium and amide monomer turns into a highly cross-linked hydrophobic polymer network.

The motto of CLEARFIL Universal Bond Quick is “Universal. Easy. Reliable.” Could you please explain that further?

I think that clinicians will be very satisfied with the bonding agent’s performance and wide indication range. It definitely will be used mainly for direct restorations with light-curing composite resins, but also for core build-ups, cavity sealing, treatment of exposed root surfaces and hypersensitive teeth. The pretreatment of the tooth can be done with any of the three etching procedures before applying this adhesive. For selective enamel etching and total-etching, phosphoric acid needs to be applied. I recommend K-ETCHANT Syringe etching gel. It is left in place for 10 seconds, followed by rinsing and drying. The product is very easy to use and not technique-sensitive. The result is a reliable bond because of the use of our proven MDP technology combined with the cross-linked hydrophobic polymer network.

Does CLEARFIL Universal Bond Quick adhere to any dental substrate (lithium disilicate, zirconia and metals)?

Yes, it does. CLEARFIL Universal Bond Quick is the ideal bonding agent in most situations. Bonding to tooth structure and to most direct and indirect filling materials can be performed with CLEARFIL Universal Bond Quick. For the pretreatment of silica-based ceramics (glass-ceramics); however, we advise the use of CLEARFIL CERAMIC PRIMER PLUS for the most optimal results.

What is known regarding combining universal adhesives with light-curing, dual-curing and self-curing composites without the use of primers? Can the dentist really combine them without any problems?

It can be used with all light-curing composites and compomers, with the exception of silorane-based composites. For use with self- and dual-cure composites, CLEARFIL DC Activator is needed. This catalyst activates the dual-curing mechanism of this adhesive. However, the addition of CLEARFIL DC Activator to the adhesive is not required when using it with CLEARFIL DC CORE PLUS or PANAVIA SA Cement Plus.

What do you see for the future of universal adhesives? 

As long as we still need adhesives to bond our composites to tooth structure, I'm almost certain that single-bottle universal adhesives will become the most used systems. In vitro tests have shown good results. A universal, easy-to-use adhesive with few treatment steps and a short working time reduces the risks of errors. Of course, relevant long-term clinical research results are needed to prove the quality. Kuraray Noritake Dental, with its leading adhesive technology, will surely remain the leader in this field.

Reliable adhesive cementation of zirconia

10-Methacryloyloxydecyl Dihydrogen Phosphate is a bit of a tongue-twister for anyone who is not a chemist by profession, so in everyday communication, this adhesive monomer is referred to by the three initial letters: MDP. MDP is indispensable in the dentistry business. For example, reliable adhesive cementation of zirconia restorations would not be possible without MDP. This adhesive monomer was developed by Kuraray Noritake Dental in 1981.

Requirements
Indirect restorations in modern dentistry must fulfil at least three requirements. First of all, they must be tissue-saving. This implies that a full crown is not the first choice, because approximately 70% of the tooth tissue has to be sacrificed for such a restoration. Nevertheless, full crowns are often still indicated by virtue of their mechanical retention. But given that the retention which can be achieved by adhesive cementation is now sufficiently reliable, a less invasive restoration than a crown should be chosen more often. And this choice may very well be for a zirconia restoration. Combined with the preliminary sandblasting of such an adhesive restoration, this choice is now an appropriate one thanks to MDP.

Durability is the second requirement for an indirect restoration. This quality of a restoration is largely associated with the flexural strength of the restoration material. While it has become clear that zirconia achieves the best durability scores, it should be pointed out that the cementation method also contributes significantly to the durability of a facing, inlay, onlay, etching bridge etc., which can nowadays all be realised in zirconia.

KATANA Zirconia UTML

KATANA Zirconia STML

KATANA Zirconia ML

AESTHETICS
Aesthetic acceptability is the third requirement for a modern indirect restoration. This means that porcelain baked on metal has become a thing of the past; full-ceramic materials are now the standard. Zirconia still has a relatively poor reputation in terms of aesthetics due to the extreme whiteness of the earliest examples from the turn of the century. Types of zirconia are now available with varying translucencies, and there are even so-called multi-layer varieties (KATANA Zirconia ML, STML and UTML by Kuraray Noritake), and these new zirconia no longer have to be porcelain-baked. Obviously, baking is still possible, and partial baking is a choice that is frequently made. One of the results of a multi-layer build-up is that the transparency is higher incisally than cervically, as it is in natural elements; the light falls through the incisal margin, but is blocked at the cingulum of the restoration. With a modern zirconia material such as KATANA Zirconia ML, this variable transparency goes hand in hand with a natural colour gradient from cervical to incisal. In a given colour, A1 for example, the cingulum has the corresponding dentine shade body and it passes to incisal in the appropriate enamel colour via two transition shades.

These veneers were made from KATANA Zirconia UTML and coloured using CERABIEN ZR External Stain

SURFACE
The new zirconia materials are changing the way dental technicians operate, as illustrated by the experience of Daniele Rondoni, a renowned dental technician. This professional, from Savona in Italy, has specialised in the use of Multi-Layering technology for ceramic materials (Tecnica della Multistratificazione in Ceramica). According to his philosophy, the choice of restoration materials should be so wide that customised solutions can be realised. Among other things, he believes that there will still be room for baked porcelain on a core of lithium disilicate or zirconia. Using baked porcelain, the dental technician can modify the surface texture of an aesthetic restoration to lend, as it were, a certain age to the restoration.

As for surface structure, the fact that the material allows for the smooth polishing of the occlusal plane is crucial to counteract abrasion by the antagonist and to maintain the occlusal balance. In this respect, the hardness of the material selected is not the main factor; the smoothness and resistance of the surface are far more important.

FLEXURAL STRENGTH
When selecting material for restorations, the dental technician also has the option to choose KATANA Zirconia Ultra Translucent Multi-Layered for veneers or anterior crowns; a zirconia with a translucence comparable to that of glass. This translucence is especially important with anterior restoration which is to be fitted between flawless natural elements, a situation that often occurs after anterior traumas. Such a restoration effected using KATANA Zirconia UTML harmonises with the neighbouring natural teeth, not least because this type of zirconia does not cause the frequently-occurring white appearance common in anterior crown. The modern aesthetic zirconia materials of the second generation are sintered at a temperature of 1,550°. This temperature is maintained for two hours. The dental technician needs to be aware that this temperature differs from the sintering temperature for KATANA Zirconia High Translucent Multi-Layered (1,500 °C). Wide-span bridges can be realised with the latter product, whereas the size of bridges made from KATANA Zirconia Super Translucent Multi-Layer remains limited to a maximum of four elements. KATANA Zirconia UTML can be used for small anterior bridges, but is more suitable for anterior crowns and veneers. The reason for this is that the flexural strength of these highly aesthetic zirconia materials is lower than the flexural strength of the standard zirconia, in which the flexural strength – 1,125 MPa – is sufficient for the production of durable widespan bridges. The flexural strength of the highly aesthetic zirconia varieties (approximately 750 MPa (STML) and 550 MPa (UTML)) is amply sufficient to ensure the durability of solitary aesthetic restorations and limited-span bridges.

Minimum wall thickness of KATANA*

* Maintain 0.8 mm thickness of pressed ceramic in all areas. When trimming of the zirconia framework the framework should be at least 0.4 mm.

PREPARATION
Flexural strength is not the only decisive factor for durability; the method of preparation is also crucial to properties of this material. Chamfer preparation is the required form of preparation,
with no knife-edge outline, no deep shoulder and, obviously, no undercuts. Since the restorations are fixed adhesively, parallel walls or grooves in the preparation are undesirable, and sharp
edges and transitions must be rounded off. If a preparation for a full crown has nevertheless been made, a substantial height difference between the vestibular and palatal/lingual outline is
contra-indicated.
 

Using the new zirconia materials means that a thickness of only 0.4 to 0.8mm need be removed for a veneer in the incisal and cervical area, and only 0.5mm is required in the labial plane,
which corresponds with the requirement to save tissue. For inlays, too, only 1mm is sufficient to achieve a durable result. If the inlay is extended to an onlay, 1mm is also sufficient for the
area where the cusps are capped. For a full crown in the lateral parts, a 1mm space must be kept as a minimum, which thickness must also be maintained for the upright walls of the preparation.

FIXATION
A wide range of possibilities have already been suggested for the durable fixation of zirconia-based restorations. All of these options have also been researched, but according to Prof. Matthias
Kern, there is no point in conducting further research into the best cementation procedure. This scientist and practitioner, who currently works at Kiel University, in Germany, has been involved
in the adhesive cementation of zirconia for nearly twenty years.Based on his wide experience, Kern is convinced that three requirements have to be met to achieve the reliable cementation
of zirconia. First of all, a rubber dam must be applied for the operation, which is obviously easier for partial restorations than for total restorations. It is not only from the perspective of tissuesaving that it is useful to keep the preparation limited for this reason. The second condition is that micro-mechanical adhesion needs to be achieved. For zirconia restorations, the necessary adhesion is obtained by sandblasting the surface. Obtaining chemical adhesion is the third condition. Based on extensive research, Kern is fully convinced that chemical adhesion can only be achieved by using MDP. His first publication on this subject dates back to 1998. It was the use of Kuraray Noritake’s PANAVIA, which did indeed contain MDP, which made it possible to achieve durable synthetic resin bonding to zirconia
after sandblasting.
 

SANDBLASTING
Dentists and dental technicians are apparently somewhat averse to sandblasting*, as evidenced by the extensive research conducted in an attempt to find an alternative. No such alternative has yet
been found. Efforts have been made to fuse a silica layer onto the zirconia to improve bonding, but according to Kern, the results of this procedure – the Rocatec method, for example – have been
disappointing. Nor is the silanisation of a zirconia restoration effective, because zirconia does not react to silan. Dentists who want to achieve the durable cementation of their zirconia restorations therefore have no other option than the purchase of a sandblasting device. Sandblasting can be carried out in a small cabin to prevent the surrounding area of the practice from being
affected. Soft air abrasion is carried out at 0.5 bar, while tight air abrasion is performed at 2.5 bar. The exact pressure is not all that crucial to the adhesion of the zirconia, providing that it is between
0.5 and 2.5 bar**. Kern advises sandblasting at a pressure of 1 bar, so that the surface to be bonded becomes somewhat rougher without this being visible to the naked eye. Obviously, the part of
the restoration that does not require bonding, such as the outside
of a veneer or the dummy of an etching bridge, has to be protected from the effect of the abrasive grains. It is also advisable to apply a colorant (waterproof marker pen) to the area to be sandblasted
prior to the operation. The colour disappears during sandblasting, making it easy to check that the entire adhesive surface has actually been abraded.

SANDBLASTING
Sandblasting of zirconia oxide at a lower pressure is a requirement for an effective adhesion. The
combination of sandblasting and MDP ensures both mechanical adhesion in the micro-roughness and
chemical adhesion between zirconia dioxide and MDP. There is extensive research material to corroborate the effectiveness of this method.

* It had long been assumed that the tetragonal and/or cubic structure would relapse into a
monoclinic state due to sandblasting, as a result of which fracturing would occur because
of the associated expansion. Sandblasting with aluminium oxide particles of 50 micron as a
maximum and a maximum air pressure of 2.5 bar does not, however, cause any damage.
** Airpressure is different from manufacturer‘s recommendation.

Adhesive monomer
The restoration surface can be cleaned using alcohol after the
sandblasting process. This step is optional. If the alcohol becomes
contaminated, for example, by saliva residues, the effect will be
negated, because the sandblasted surface would be contaminated
as well. The choice of the fixation procedure is relatively simple
provided MDP is used. This adhesive monomer was developed in
1981 by Kuraray Noritake Dental to improve the adhesive strength
to hydroxyapatite, and has proved its strength ever since. MDP is
not present in the glass ionomer cements (GIC’s), which, because
of their ease of use, are also sometimes used for the cementation
of zirconia restorations. ‘Don’t!’ warns Kern. It is clear from all the
studies that the composite cements containing MDP provide the
most durable results. The oldest known cement from this category
is PANAVIA EX, which was introduced in 1983. The optimised
PANAVIA V5 was presented recently as the single cement for
all cementation indications guaranteed to work according to a
predictable procedure. All the cements and bondings produced by
Kuraray Noritake contain MDP.

Possibly because Kern conducted his research in Maryland for
two years, he has recorded remarkable results with adhesively
cemented Maryland bridges (etching bridges). It has also become
apparent that, most of the time, an adhesion bridge functions best
with only one wing. For example, if a one-wing zirconia adhesion
bridge is cemented using a cement containing MDP instead of
a lateral upper incisive adhesive, such an adhesion bridge may
remain in place for up to 20 years, to the satisfaction of both
dentist and patient. This restoration, with its survival rate of 95.2%
after five years, therefore qualifies as a permanent restoration.

And the same goes for an onlay bridge made from zirconia.
Sandblasting and MDP; the formula for the durable bonding
of zirconia restorations.

So bear in mind: MDP also stands for a Mega Durable Product.

PANAVIA V5 for the adhesive fixation of zirconia
Achieving a reliable bonding to zirconia – it can be done! Read all about it in the preceding article.

PANAVIA V5 is the successful successor to both PANAVIA F2.0 and CLEARFIL ESTHETIC CEMENT. Thanks to its excellent adhesive bond with both dental tissue and all indirect materials, superior aesthetics, and unambiguous processing, PANAVIA V5 is a popular bonding cement. PANAVIA V5
provides a single cement for all cementation indications and features an unambiguous procedure.

CONCISE INSTRUCTIONS FOR USE
1. Sandblast the zirconia surface to be bonded with aluminium oxide powder (30-50 μm) at low pressure, then clean the restoration in an ultrasound bath and allow it to dry.

2. Apply CLEARFIL CERAMIC PRIMER PLUS to the restoration surface, then proceed to Apply & Go. Dry the entire surface using a gentle air flow.

3. Apply PANAVIA V5 Tooth Primer to the element and leave it to take effect for 20 seconds. Dry the surface with air.

4. Apply PANAVIA V5 Paste to the restoration surface and
position the restoration.

Applying the paste.

Positioning
After placement, remove excess cement using a gauze, a small brush, or something similar.

5. Remove surplus cement and light-cure. Always take account of the self-curing time needed for opaque elements and the use of PANAVIA V5 Opaque..

Daniele Rondoni

Owner of a dental laboratory in Savona

Professor Matthias Kern

Christian-Albrechts University