Interview with Tomohiro Emoto.

Kuraray Noritake Dental Inc. Launched its first porcelain for porcelain-fused-to-metal restorations – Noritake Super Porcelain AAA*, still available after more than 30 years under the name Noritake Super Porcelain EX-3* – in 1987. The knowledge acquired since then formed the basis for the development of CERABIEN™ ZR and the brand-new CERABIEN™ MiLai portfolio. How much of Noritake Super Porcelain is found in CERABIEN™ MiLai?

*Noritake Super Porcelain AAA and Noritake Super Porcelain EX-3 were designed and launched by Noritake Company Ltd., the predecessor of Kuraray Noritake Dental Inc.

Naturally, the knowledge we have acquired on developing porcelain products has been fully applied in the development of CERABIEN™ MiLai. The methods used to handle Synthetic Feldspar - such as low firing technologies, stable thermal expansion even with multiple baking, particle distribution control – are amongst the most important findings we have acquired since the development of Noritake Super Porcelain AAA. This expertise has been utilized to create both the design concept and development of CERABIEN™ MiLai.

WHAT ARE THE MOST DECISIVE DIFFERENCES FROM OTHERS?

The most decisive difference between CERABIEN™ MiLai and others is that we focus on micro-layering technique with this product. CERABIEN™ MiLai enables you to express life-like colours even with thin layers of porcelain. Also, this is the first porcelain we have launched which is compatible with lithium disilicate as well as zirconia.

Photo: MDT Andreas Chatzimpatzakis

WITH CERABIEN™ ZR BEING AVAILABLE AND CLINICALLY SUCCESSFUL, WHY DID YOU DECIDE TO DEVELOP A NEW LINE OF PORCELAINS AND INTERNAL STAINS?

The best way that we propose to create aesthetic restorations is Porcelain Fused to Zirconia (PFZ) with CERABIEN™ ZR. However, this method requires high levels of expertise and experience which is a lengthy learning curve for beginner dental technicians. As a result, Full Contour Zirconia (FCZ), which does not require such advanced skills and expertise, and which allows virtually anyone to create (albeit not perfect but nevertheless acceptable) restorations, is becoming increasingly popular. CERABIEN™ MiLai sits in the middle of these two methods. It enables technicians to create more aesthetic restorations with a simple, single micro-layering technique, making it ideal for those who wish to produce aesthetic restorations but without the high learning-curve associated with the traditional method, or those who use lithium disilicate materials.

CERABIEN™ MiLai enables you to express life-like colours even with thin layers of porcelain.

IS CERABIEN™ MILAI THE ANSWER TO THE NEW GENERATION OF MILLABLE CERAMIC MATERIALS THAT HAVE IMPROVED A LOT IN TERMS OF MECHANICAL BUT ALSO OPTICAL PROPERTIES IN RECENT YEARS, SUCH AS THE ENTIRE KATANA™ ZIRCONIA LINE-UP, TO OFFER FOR THIS KIND OF MATERIALS A FASTER AND ALSO HIGHLY AESTHETIC FINISHING OPTION?

Yes, it is. Formerly, zirconia materials were mono-coloured and not translucent. However, the improvement of zirconia materials, which began with KATANA™ Zirconia ML followed by KATANA™ Zirconia STML/UTML and KATANA™ Zirconia YML, has been an ongoing process and the aesthetics of the material itself is now very high thanks to improvements in translucency. This has led to the development of CERABIEN™ MiLai, a simple process that can achieve highly aesthetic restorations with thin layers, making the most of the high translucency of the zirconia materials.

WHAT ARE THE SPECIFIC NEEDS OF USERS FAVORING THE MICRO-LAYERING TECHNIQUE WITH RESPECT TO FEATURES OF THE VENEERING PORCELAIN?

When dental zirconia materials were first launched, chipping issues with porcelains for dental zirconia materials were a problem. At that time, dental porcelains were built up on a zirconia framework, the design of which failed to take into account the final shape. As a result, dental technicians were prone to building excessive thickness into porcelain layers which were unable to resist high occlusal pressure. Nowadays, it is standard for the final shape to be taken into account in the framework design resulting in reduced chipping issues. I must mention here that CERABIEN™ ZR, which was launched at that time, showed a higher endurance ratio than others in trials and was well accepted by the market.

What we want to offer with CERABIEN™ MiLai is a similar or developed version concept of this framework design. You can reduce the risk of problems post-installation of the restoration by minimizing the porcelain thickness while maximizing the area of dental zirconia which has such strong properties that almost no chipping issue can be expected.

As a result, the micro-layering technique, which can prevent post-installation problems, should prove ground-breaking for dental technicians.

Photo: MDT Giuliano Moustakis

WHAT DID YOU DO TO MEET THESE DEMANDS?

The thinking behind the development of CERABIEN™ MiLai has been to focus on delivering thin layering that replicates the enamel structure, thus allowing technicians to achieve desired shades regardless of the depth of a layer.

HOW DID YOU MANAGE TO DECREASE THE FIRING TEMPERATURES AND WHAT IS THE EFFECT OF THIS FEATURE?

Up to now, it has generally been tricky to achieve low firing temperature while maintaining a low coefficient of thermal expansion, because they contradict each other. However, thanks to the technologies and knowledge we have cultivated since the development of Noritake Super Porcelain AAA, we could finally be breaking through this obstacle. As a result, CERABIEN™ MiLai can even be used with lithium disilicate materials, which should be baked at low temperature to avoid damaging the material.

DUE TO THE FACT THAT CERABIEN™ MILAI CAN BE APPLIED NOT ONLY TO ZIRCONIA BUT ALSO TO LITHIUM DISILICATE MATERIALS, E.MAX FOR EXAMPLE, HAVE NEW SHADES/MASSES BEEN SPECIALLY DEVELOPED THAT HAVE BEEN PERFECTLY ADAPTED FOR LITHIUM DISILICATE MATERIALS?

The Value Liner has primarily been developed to achieve high aesthetics from lithium disilicate materials, even lithium disilicate which has high translucency compared to zirconia materials. Also, the key for adapting for lithium disilicate is the firing temperature which I mentioned earlier. To match the colour of restoration with the tooth, the selection of framework colour is important both for lithium disilicate materials and zirconia materials. We recommend selecting one shade brighter than the target shade taking into consideration the utilization of internal stain to express the detailed character of a tooth.

CERABIEN™ MiLai can even be used with lithium disilicate materials, which should be baked at low temperature to avoid damaging the material.

WHAT DID YOU DO TO ENABLE THE IMITATION OF VIRTUALLY EVERY TOOTH SHADE WITH JUST 16 PORCELAINS AND 15 INTERNAL STAINS?

We have prepared Value Liner porcelains, which can be utilized for adjusting the value of restorations. These Value Liner porcelains and internal stains are important to adjust colour and express detailed characters. As micro-layering does not require body porcelains, since it is expected that the framework material itself – either zirconia or lithium disilicate – would express the dentine structure, adjusting the colour and value respectively with internal stains and Value Liners is essential. To reproduce the enamel structure, users can use the 16 shades of porcelains as they are, or they can mix the shades to find the desired colour. These 16 porcelains and 15 internal stains have been through trials conducted with KOLs across the world, including Europe, so we want to reassure you that even the world’s most skilled KOLs have tested and confirmed quality and effectiveness of CERABIEN™ MiLai.

Photo: MDT Giuliano Moustakis

WHAT IS THE BENEFIT OF THIS SLIM LINE-UP?

The biggest benefit of CERABIEN™ MiLai is a simple procedure. Thanks to its simplicity, not only Kuraray Noritake Dental porcelain users but also new users and beginners can achieve excellent results with this porcelain series without struggling with complicated procedures.

HOW LONG DID IT TAKE YOU TO DEVELOP CERABIEN™ MILAI (FROM THE INITIAL IDEA TO THE AVAILABLE PRODUCT)?

We initially came up with the concept in 2015 when KATANA™ Zirconia STML and UTML were launched. The development project itself was started in 2019.

We created CERABIEN™ MiLai believing that the micro-layering technique would become the standard in porcelain restorations and that CERABIEN™ MiLai would become the material of choice for dental technicians.

DID YOU COME ACROSS ANY SPECIFIC CHALLENGES DURING THE DEVELOPMENT PROCESS?

The biggest challenge we faced was the development of a material which would be compatible with lithium disilicate. We had already produced porcelains which are compatible with zirconia or metal, but up to that point we had not created porcelains for lithium disilicate before CERABIEN™ MiLai. Not only did we have to develop the material within our R&D department, but also alter the production and inspection processes in collaboration with many other departments.

THE PRODUCT NAME CERABIEN™ MILAI IS DERIVED FROM THE WORD "MIRAI", WHICH MEANS AS MUCH AS "FUTURE" IN JAPANESE. HOW MUCH FUTURE IS THERE IN THIS MATERIAL OR, TO BE MORE PRECISE, IS THIS MATERIAL A PIONEER FOR THE FUTURE PRODUCTION OF HIGHLY AESTHETIC RESTORATIONS?

We created CERABIEN™ MiLai believing that the micro-layering technique would become the standard in porcelain restorations and that CERABIEN™ MiLai would become the material of choice for dental technicians.

Building up dental porcelains is not an easy process; it takes time to acquire the knowledge and master the technique. On top of this, dental technicians have long been plagued with post-installation problems such as chipping.

Micro-layering with CERABIEN™ MiLai enables every dental technician, from newcomers through to those with many years’ experience, to create better restorations. It is our hope that dental technicians everywhere will get to experience the ease at which aesthetic restorations can be realised with CERABIEN™ MiLai, just adding one step of micro-layering.

WHAT IS YOUR VISION WITH REGARD TO FUTURE DEVELOPMENTS IN THE AREA OF PORCELAIN FOR CERAMIC LAYERING?

Personally, I think the trend will continue to shift towards easier handling while maintaining good aesthetics, as can be seen by the recent increase in popularity of the micro-layering technique.

WHAT ABOUT THE POTENTIAL OF NEW CERAMIC CAD/CAM MATERIALS AND THEIR SUITABILITY FOR MONOLITHIC USE?

We believe that monolithic use will increase further, because the perception of aesthetics is changing among patients as well as dentists and dental technicians. Before, a "natural" restoration was considered acceptable; now it can also be "cosmetically" aesthetic. Formerly, it was said that monolithic use was not suitable as it could not reproduce life-like restorations. Now, we believe it will be increasingly embraced as patients show a demand for cosmetically aesthetic restorations.

Our KATANA™ Zirconia has mechanical advantages: high strength and high translucency, and high potential in longevity. Since dental zirconia appeared in dental material market, its aesthetics have been improved remarkably. And we, at Kuraray Noritake Dental Inc., have been developing outstanding CAD/CAM materials and will continue creating innovative materials from now on too.

We are convinced that developing better products for monolithic use is crucial for releasing dentists and dental technicians from complicated procedures while at the same time giving patients a sense of safety as well as aesthetic satisfaction.

WHY SHOULD A DENTAL TECHNICIAN TEST CERABIEN™ MILAI?

We are convinced that, once dental technicians who use either zirconia materials or lithium disilicate to make restorations, experience the ease at which they can achieve aesthetically-pleasing restorations with CERABIEN™ MiLai, demand will grow. We would therefore like to encourage all dental technicians to give it a go and see the results for themselves!

IS THERE ANYTHING ELSE YOU WOULD LIKE TO ADD FOR CUSTOMERS?

Thank you so much for reading this article to the end. I am very honoured to finally launch CERABIEN™ MiLai. This product is the result of many struggles. I am firmly convinced that it is the answer for any dental technician eager to realise high levels of aesthetics in a restoration in just a simple step. I would ask them to please try out CERABIEN™ MiLai for themselves and experience what will become standard practice in the future, right now.

TOMOHIRO EMOTO

R&D Department Technical Group Manager
Japan Academy of Esthetic Dentistry Executive Member
Academic Lecture Committee Member

With highly aesthetic ceramic materials available for the production of indirect restorations, it is no longer necessary to always design high strength frameworks and add multiple layers of porcelain. Nowadays, due to the rapid technological and optical improvements of zirconia and Lithium Disilicate (LiDiSi), a restoration may be manufactured with a monolithic design or minimal cut-back. Using appropriate materials, a less complex micro-layering technique will produce the desired outcomes, even if the aesthetic expectations are high. A new porcelain system specifically designed for this purpose is CERABIEN™ MiLai from Kuraray Noritake Dental Inc. The compact line-up of low-fusing porcelains and internal stains for micro-layering supports effiicient, economic finishing procedures leading to outstanding aesthetics at the first go.

The CERABIEN™ MiLai system consists of 16 base shades and 15 internal stains, which are easy to select and manage, and may even be mixed for additional shade effects. Due to the low firing temperature of all system components (740° C / 1,364° F), CERABIEN™ MiLai is not only compatible with zirconia, but also with silicate ceramic (such as IPS e.max) substructures. This means that fewer lines of porcelain are needed, the porcelain inventory is reduced once again, and fewer decisions need to be taken.

In order to provide for persistent handling properties and predictable outcomes, CERABIEN™ MiLai, like all other porcelains from Kuraray Noritake Dental Inc., are based on synthetic feldspathic porcelain technology. It is special in that its material structure and particle distribution resemble those of natural teeth, and its properties remain stable even after multiple firing cycles – giving dental technicians exactly what they expect. CERABIEN™ MiLai (tooth shades) are fluorescent, which adds to the vitality and life-like appearance of the restorations.

With these properties, CERABIEN™ MiLai is the outstandinig solution for every dental technician who would like to turn the finishing of zirconia and lithium disilicate restorations into a straightforward, efficient and economic procedure that produces predictably beautiful outcomes every time.

No matter whether you are a dental practitioner or dental technician, there is one thing you surely want to avoid: failure of indirect restorations. While it is clear that on both sides, the use of high-performance materials and appropriate techniques will contribute to achieving the desired outcomes, there is one aspect that should generally be given more attention: proper communication and exchange of information between the dental practice and laboratory.

As a dental professional: Are you aware of the information and details your case partners need to know in order to achieve the best possible result regarding fit, function and aesthetics?

For both, dental practitioner and dental technician, it is essential to know what precisely the respective partner does need to produce the desired outcomes. Hence, if it is not clear what information is needed and how it should be delivered, it is essential to sit down with your partner and find out. The goal of this personal or virtual meeting should be the establishing of a standardized flow of information between your companies. The necessary information might differ depending on the complexity of the case, but most details are always the same.

During the meeting, it is essential to focus on every step in the procedure that benefits from interaction between the practice and laboratory. It starts after the patient’s initial appointment and ends when the restoration is in place. In the following sections, the required information for indirect restoration planning, possible ways of communication to provide for a healthy flow of required information and important details are listed.

Teamwork starts before the actual treatment

Most dental technicians know a lot about the different restorative materials available and their suitability for specific clinical situations. Leverage this knowledge by involving your partner early – ideally before tooth preparation. This is most important for complex reconstructions, but also relevant when a single tooth needs to be restored: The restorative material and restoration design (monolithic, cutback, framework) have an impact on the space required and hence on the amount of tooth structure that needs to be removed. Aiming to opt for the least invasive treatment possible, it is essential that tooth preparation is limited to the necessary minimum.

The better the records, the better the fit of the final restoration

When it comes to taking records of the initial situation and the situation after tooth preparation, dental practitioners are often confronted with challenges. Limited mouth opening, a lack of time, or difficult moisture conditions are only some of the numerous factors that might prevent a clinician from taking a precise impression and bite registration. Nevertheless, it is decisive for the work in the dental laboratory to receive accurate records with all the necessary details such as the preparation margin. Understanding what exactly a dental technician needs to deliver a precisely fitting restoration will surely have a positive impact on the motivation to get the records right from the start, independent of the challenges.

Personally seeing the patient provides valuable additional information on a patient’s facial characteristics, on the status and appearance of the teeth and on their internal colour structure. These details can support a dental technician optimally in producing true-to-life dental restorations.

Structured try-in feedback facilitates targeted adjustments

Whenever try-in reveals that adjustments are required, well-structured feedback is important. It helps modify the restorations exactly as desired, hence avoiding additional appointments and wasting time in the practice and laboratory.

“Digitalization has made physical distance irrelevant, and we are able to deliver high-quality restorations even if the patient is hundreds of miles away”
- Dr Efe Celebi -

How to standardize

There are many possible ways to standardize the flow of information between the dental practice and laboratory. Depending on the individual preferences and established workflows, a personal or digital approach may be selected. Those preferring a personal approach will possibly want to develop paper forms for some steps, while relying on personal interaction for others. The digital approach uses a combination of digital imaging technologies, case management software and communication platforms to exchange relevant information.

A personal approach

At the Laboratorio odontotecnico Castellano in Bologna, Italy, the team around Vincenzo Castellano pursues the approach of personally seeing almost every patient prior to treatment planning. The laboratory technicians’ opinion is determinant for the treatment plan to be developed. Their partner practitioners value their expertise in restorative materials and digital technologies, which are evolving very quickly. The team is simply able to tell which material to choose in a specific situation to best manage the expectations of the patient and the functional needs. “Determining the restorative material in this early phase is very important, as its mechanical parameters (minimum wall thickness etc.) have an impact on the preparation design and depth. In fact, patients are always happy if they are able to meet the dental technician who produces their restorations, and – already well-informed by their dentist and the internet – often seize the opportunity to gather additional information about their planned treatment”, Vincenzo Castellano states.

Also, during subsequent appointments like try-in, the responsible dental technician is present to evaluate the situation and gather feedback from the patient directly. In his laboratory, online meetings conducted with patients substitute personal meetings only when this is the only way to enable personal interaction, as – in his opinion – personal meetings always deliver more details important for a great outcome. He says: “The most important approach to the patient is the human one. When using advanced digital technologies, we risk standardizing protocols to the extent that we forget there is an individual in front of us, with their own unique characteristics and wishes, entrusting us with their most precious asset: their smile.”

A digital approach

A perfect example of a laboratory with a purely digital approach is DentLab, a Turkish dental laboratory founded in 2015 by Dentgroup, Turkey’s largest Dental Service Organization (DSO). Its founder Dr Efe Celebi and his team have developed a special lab module for the group’s own practice management software, DentSoft. The module allows dental professionals to submit their orders electronically by using online forms and adding digital image data such as X-rays, intraoral scans, face scans and photographs. Users are able to see at a glance which data and information is strictly required. If desired, a user even receives procedural guidance: Specific devices like intraoral scanners, procedures and materials are recommended.

Once an order is submitted, the software sends a delivery date notification, so that the next appointment can be scheduled right away. Then, the incoming order is checked. Whenever some details are missing, the practice is contacted via a chat function in the software. Orders with incomplete or inaccurate data are rejected. A feedback function allows the technician to specify what needs to be repeated, improved or modified. Once accepted, the ordered items are produced and shipped to the office in a trackable box. It arrives with pre-treatment and cementation recommendations. Whenever necessary, patient feedback at try-in can be recorded on video or discussed live in a virtual meeting. “Digitalization has made physical distance irrelevant, and we are able to deliver high-quality restorations even if the patient is hundreds of miles away,” says Dr Efe Celebi. To facilitate improvement in the dental laboratory, the software has a case evaluation function that allows dental practitioners to evaluate the fit, function and look of every restoration.

“The most important approach to the patient is the human one. When using advanced digital technologies, we risk standardizing protocols to the extent that we forget there is an individual in front of us, with their own unique characteristics and wishes, entrusting us with their most precious asset: their smile.”
- MDT Vincenzo Castellano -

Conclusion

By establishing a well-structured, standardized and bidirectional flow of information between the dental office and laboratory, it is possible to improve the overall quality of prosthodontic treatments. It can be implemented with the aid of existing workflow management software, or set up according to individual demands using paper forms and personal meetings.

Anyway, sitting down together to discuss the topic of communication in a personal or virtual meeting has additional advantages, as it will help everyone involved develop a better understanding of the procedures carried out and challenges faced by their respective partner in the busy work environment. With this knowledge, it becomes easier to build a strong relationship that grows from mutual feedback and advice promoting common strategies for improvement. The result will be more streamlined work processes with less stress, higher-quality outcomes and happier patients.

We would like to express our gratitude to MDT Vincenzo Castellano and Dr Efe Celebi for sharing their individual approaches and the thinking behind them.

BEHIND-THE-SCENES OF NIIGATA FACTORY

Take a tour of Kuraray Noritake Dental Inc.'s state-of-the-art Niigata Plant, where high-quality dental materials come to life.

This fascinating video highlights our meticulous production process, from initial R&D to final inspections, showcasing the care and precision that go into creating bonding agents, composite resins, and cements. Learn how strict hygiene control, advanced machinery, and skilled craftsmanship ensure a consistent supply of premium dental materials to over 90 countries worldwide.

Watch the video to discover how innovation and dedication drive better oral health for people around the globe!

This year, the Kuraray Noritake Dental stand will be packed with news from the world of dentistry, so we offer not just one reason to visit, but a whole range: new chairside products, new labside products, inspiring lectures, enlightening hands-on demonstrations… And the best thing? You don´t have to choose just one thing, come and see them all at the Kuraray Noritake Dental booth in Hall 11.3 | Stand E010!

Chairside – smart streamlined solutions

When it comes to a dental practice, our vision is clear: a world where your materials and tools work seamlessly in your hands, where complexity is minimized, and where you are given enough time to focus on what matters most: the individual desires and needs of every single patient. This is the future of dentistry - and we are leading the way. Come discover our new additions to the UNIVERSAL EXCELLENCE family: a flowable universal composite and a new generation of a universal bond!

Labside – speed and aesthetics hand in hand

No matter whether a minimally invasive procedure or the best aesthetic outcomes are desired: Kuraray Noritake Dental has the products for you. New in the portfolio: CERABIEN™ MiLai - low-fusing porcelains and internal stains. Come and see for yourself its ultra-thin layering, exceptional mechanical properties and consistent handling for both zirconia and lithium disilicate. And while you're there, have a coffee while speed-sintering with our KATANA™ Zirconia discs takes place in real time.

Get inspired by 12 expert speakers on 2 stages

Are you a user of or interested in one of Kuraray Noritake Dental’s products or solutions, but eager to learn more about their practical use from proven experts in your field? From Wednesday until Saturday, we offer a programme of exciting lectures and live demonstrations - this time simultaneously on two stages: one dedicated to chairside and the other one to labside topics!

Warm welcome

Everyone, from sales person to scientific marketeer, looks forward to giving you a warm welcome, answering your questions and introducing you to the world of innovative Kuraray Noritake Dental products, solutions and workflows. And while you are already in Cologne anyway, why not enjoy the breathtaking beauty of the old town? Have you ever seen its famous Gothic Cathedral? Or its Old Town inviting you to stroll through its narrow alleys, finding traces of history around every corner? This year's IDS offers so many reasons to attend that it's hard not to accept the invitation.

Additional information and the full programme of lectures and hands-on courses at the IDS is available online.

Discover a detailed walkthrough of an advanced shade reproduction technique with this comprehensive guide by DT Tomáš Forejtek. Tailored for professionals working with CERABIEN™ ZR ceramics (Kuraray Noritake Dental Inc.) and the eLAB protocol, this case study provides step-by-step insights into achieving exceptional results, from documentation to shade selection and framework design to final polish. Whether you are refining your craft or exploring new methods, this resource is a valuable addition to your toolkit.

Article by Peter Schouten

Ceramic primers vary widely in composition and effectiveness, despite what their name might suggest. Most common primers include silane, but silane alone is insufficient for pre-treating all materials commonly used in indirect restorations before bonding.

Silane—typically in the form of γ-MPS—has a strong affinity for silica- or glass-based materials. While certain metals and their oxides can chemically react with silane, other components provide a stronger and more reliable bond to metals and metal oxides and should be seriously considered.

For metal(oxide) pretreatment in bonding, the MDP monomer is far more reactive than silane. The original MDP monomer, developed by Kuraray Co., Ltd. in 1981, remains the highest-quality MDP available, as confirmed by research.¹

CLEARFIL™ CERAMIC PRIMER PLUS is a single-component adhesive primer that forms strong bonds with a wide range of restorative materials. This two-in-one primer incorporates the original MDP monomer, which establishes a robust bond with metals and zirconia. Simultaneously, the silane coupling agent (γ-MPS) ensures excellent adhesion to resin composites, hybrid ceramics, and glass-based ceramics such as lithium disilicate and porcelain.

ENHANCED BOTTLE DESIGN

The primer bottle is designed for effortless one-handed operation. Its unique nozzle ensures precise dispensing, minimizing the risk of contamination and spills.

PROVEN EFFECTIVENESS OF MDP-CONTAINING PRIMERS

To enhance the bonding of prosthetic materials, use a primer containing both MDP and silane. Numerous studies have demonstrated the effectiveness of this combination.

OPTIMAL PRIMING FOR ADHESIVE CEMENTING

These studies underscore the critical role of MDP-containing primers in achieving reliable and durable adhesion for prosthetic materials. Products containing only silane, such as RelyX™ Ceramic Primer (3M ESPE), are less effective at creating a durable bond between resin cements or composites and ceramic- or metal-based prosthetic materials.

Image from clinical case by MDT Rondoni and Dr. Attanasio

STRAIGHTFORWARD AND EFFICIENT

The use of CLEARFIL™ CERAMIC PRIMER PLUS is straightforward: just apply it to the bonding surface, dry it, and proceed with the following treatment step. Incorporated into your process to streamline adhesion preparation and achieve reliable results!

JUST APPLY AND DRY

CLEARFIL™ CERAMIC PRIMER PLUS may be applied to any restoration surface after the required pretreatment. Pretreat the adherent surface of the restoration as indicated:

* If your laboratory already treated with a hydrofluoric acid, cleaning and activating with K-ETCHANT Syringe just before applying CLEARFIL™ CERAMIC PRIMER PLUS is recommended.

**When using with PANAVIA™ V5 or CLEARFIL™ DC CORE PLUS

Universal prosthetic primer designed for a strong bond and procedural simplicity

Author:

PETER SCHOUTEN

References

1. Yoshihara K., et al.(2015) Functional monomer impurity affects adhesive performance, Dental Materials, Volume 31, Issue 12, https://doi.org/10.1016/j.dental.2015.09.019. Pilo, R., et al. (2018). “Effect of tribochemical treatments and silane reactivity on resin bonding to zirconia.” Dent Mater 34(2): 306-316.
2. Cao, Y., et al. (2021). The effects of four primers and two cement types on the bonding strength of zirconia. Annals of Translational Medicine. 10. 10.21037/atm-21-4909.
3. Reymus, M., et al. (2019). “Bonding to new CAD/CAM resin composites: influence of air abrasion and conditioning agents as pretreatment strategy.” Clin Oral Investig 23(2): 529-538.
4. Uğur, M., et al. (2023). Effect of ceramic primers with different chemical contents on the shear bond strength of CAD/CAM ceramics with resin cement after thermal ageing. BMC Oral Health. 23. 10.1186/s12903-023-02909-z.
5. Pilo, R., et al. (2018). “Effect of tribochemical treatments and silane reactivity on resin bonding to zirconia.” Dent Mater 34(2): 306-316.
6. Inokoshi, M., et al. (2014). “Bonding effectiveness to different chemically pre-treated dental zirconia.” Clin Oral Investig 18(7): 1803-1812.

THE ART OF RESTORING SMILES: MASTERING THE CHALLENGE OF A SINGLE CENTRAL INCISOR

Restoring a single maxillary central incisor is possibly the biggest challenge a dental technician can face in everyday work. Especially when a patient is young, it is extremely important to restore her or his smile to its original beauty. Any restoration that is perceivable as such might have a negative impact on their self-confidence and quality of life even in the long term.

A STORY OF JOY AND DESPERATION

Take Ioanna, a 14-year-old girl who presented in her dental office in a state of desperation. In the hours before, she had been floating on cloud nine: Her favourite band performed in Cyprus for the first time and she had managed to buy tickets for herself and her best friend. Thrilled, they had arrived at the concert, the band started playing and the crowd danced to the music. It felt like this was going to be the best day of her life. At the time the band played its most popular song, people were delirious, jumping up and down in ecstasy. Between all the exuberant dancing and laughing, however, Ioanna suddenly was hit by a strong push. She fell, her face hitting something hard – a seat in front of her. Pain froze time and it took a few seconds before she understood what had happened: Tasting blood in her mouth, she explored her teeth with her tongue and realized that one of her central incisors had fractured.

AFFECTING THE QUALITY OF LIFE

This is one of the many touching stories we listen to every day. A fall during a concert, a push at somebody’s birthday party, a car accident: There are many incidences that can ruin a young, beautiful smile. By paying attention to the involved patients and their stories, one will come to realize how strongly some of them are affected by all this. They cover their mouths when they laugh or hold back their smiles.

Any dental technician who is committed to restoring their lost smile in the best possible way is probably aware of the impact his or her work can have and the responsibility coming with it: A Beautiful result will restore not only their smile, but also their self-confidence, will let them start laughing happily, expressing themselves comfortably and simply enjoying social interaction again (Figs. 1 to 5). Compromised outcomes, on the other hand, might have the opposite effect. Being aware of this role should be every technician’s motivation to become better day by day. Evolve for these moments, when our work brings tears of joy to our patients.

Fig. 1. Layering sketch for the restoration of a fractured central incisor in three layers: Layer one.

Fig. 2. Layering sketch for the restoration of a fractured central incisor in three layers: Layer two.

Fig. 3. Layering sketch for the restoration of a fractured central incisor in three layers: Layer three. After the first bake, small details were integrated, followed by a second bake. Finally, the restoration was finished with CERABIEN™ ZR FC Paste Stain and Glaze.

Fig. 4. Treatment outcome able to restore not only the smile, but also the self-confidence of the young girl.

Fig. 5. Immediately after cementation of the restoration, the restoration is barely identifiable, only the soft tissue needs some time for recovery.

ASPECTS TO BE CONSIDERED

But how to proceed in restoring single central incisors in the best possible way? The success of this type of restoration is hidden in the shape, which is the most difficult part. Managing to create a natural morphology is more than half the battle. The other important part is colour. The key to reproducing colour is in understanding how the utilized porcelains work. It is all about light reflection, absorption, translucency and opalescence, value and characteristic details. The more you gain experience and understand the optical properties of teeth and ceramics, the better your outcomes will be. Support is offered by a camera, a macro lens and a twin flash, which are used to capture and analyse the intraoral situation. For an initial analysis and understanding of shape and colour, I like to see the patients in my dental laboratory. Feeling the colour helps to develop the most realistic picture of what needs to be created. The key to successful realisation of the plan just developed is the use of reliable, easy-to-handle materials – in my case KATANA™ Zirconia and CERABIEN™ ZR Porcelains (both Kuraray Noritake Dental Inc.).

POSSIBLE STEPS

The first thing to focus on when starting to produce an anterior restoration – like in the case presented in figures 6 to 14 – is the correct value of the tooth. As soon as the framework or base is produced in the right value, you need to place what you see. Does the adjacent tooth show mamelons, traces of blue and orange? Those characteristics simply need to be observed and copied. There is no need to create something fancy. The tricky part is to use the available space reasonably. When there is plenty of space for the porcelain, it may be challenging to keep the value of the framework and avoid a greyish appearance. Depending on the die colour, age of the patient, natural surface texture and space available, an appropriate layering approach and finishing technique may be selected.

Fig. 6. Replacement of an anterior crown: Prepared tooth with severe discolouration. The adjacent central incisor has a special shape and vivid inner colour structure.

Fig. 7. Framework made of KATANA™ Zirconia ML in the shade A3. The target shade being A3.5, a quite opaque material was selected in a slightly brighter shade to achieve the required masking effect.

Fig. 8. Single-bake layering procedure: Application of CERABIEN™ ZR Opacious Body, …

Fig. 9. … Cervical Body, …

Fig. 10. … Body and Transitional Body.

Fig. 11. Incisal cut-back …

Fig. 12. … and creation of the mamelon structure.

Fig. 13. Application of Aqua Blue 1 …

Fig. 14. … followed by T Blue …

Fig. 15. … and Luster Porcelains.

Fig. 16. Halo effect created with Body.

Fig. 17. Treatment outcome. (After a first bake followed by minor adjustments, a second bake, surface texturing and glazing with CERABIEN™ ZR FC Paste Stain Clear Glaze.)

CONCLUSION

Creating a single central takes us out of our comfort zone. By paying attention, observing the adjacent teeth carefully and using materials we really understand, it is possible to meet or exceed our patients’ expectations. While specific tools like cameras and experience with the utilized materials offer support in producing predictable outcomes, my main credo is “If you want things around you to change, you must first change yourself”. For continued improvement, it is thus necessary to focus on professional growth and advancement. With the right mentors who will teach us the secrets of stratification and inspire and motivate us to continue advancing, it becomes easier to restore the smiles and self-confidence of our patients every time they need us to.

Acknowledgements

Special thanks go to the dental practitioners who treated the patients presented above – Andreas Skyllouriotis DDS, MSD, Surgically-Trained Prosthodontist, and Theo Odysseos, DDS, Diplomate, American Board of Oral Implantology / Implant Dentistry.

Dental Technician:

VASILIS VASILIOU

Vasilis Vasiliou was born in Nicosia, Cyprus, and graduated from the Technical School for Dental Technicians in Athens in 2004. He has furthered his education by attending several advanced seminars led by mentors and experts in the field, such as Ilias Psarris and Nondas Vlachopoulos.

Throughout his career, Vasilis has made significant contributions to the dental community, including presenting at various conferences in Greece and publishing articles in Greek dental magazines. Since 2020, he has been a key opinion leader for MPF Brush Company and, since 2022, a HASS Ambassador. Vasilis has been an active member of the International Team for Implantology (ITI) since 2019.

Together with his father, Vasilis runs a successful dental laboratory in Nicosia, specializing in all-ceramic and implant restorations. His extensive experience and commitment to excellence have established him as a respected professional in his field.

Interview with Dr. Efe Celebi

In March 2024, Dr Ahmad Al-Hassiny, Director of the Institute of Digital Dentistry, shared his observations from LMT Lab Day 2024 in Chicago, noting that over 90 percent of U.S. dental laboratories and nearly 50 percent of dental practices have already adopted digital technologies and workflows. These advancements streamline the production of dental models, restorations across various materials, and much more.

Our company Kuraray Noritake Dental Inc. is dedicated not only to developing high-quality products and constantly adapting them to the needs of dentistry, but also to streamlining procedures in the dental laboratory and practice. Aiming to understand the current needs of dental technicians and dental practitioners around the world to provide what would really make a difference, we are in close dialogue with experts in the field. We love to listen to their stories, learn how digital technologies and artificial intelligence are already transforming dental procedures and see how we can contribute to a smooth transition – e.g. with products that support efficient workflows and great outcomes.

Lately, we had the chance to sit down with a leading figure in Turkey’s digital dentistry transformation, Dr Efe Celebi, to discuss the current landscape and future of digital innovation in dentistry. Being convinced that his experience is worth being shared with a broader audience, we have summarized the conversation.

Dr. Celebi, you’re known as a pioneer in digital dentistry. What drove you to establish companies with a strong digital focus?

As the founder of Dentgroup, Turkey’s largest Dental Service Organization (DSO), I have always believed in the power of digital dentistry. My goal was to establish digital workflows for producing indirect restorations, beginning with intraoral scanning at our practices. Initially, we sought laboratory partners in Turkey willing to make this transition with us. But at that time, none of our partner labs were prepared to take the leap, so we decided to build our own. Digitalization, after all, is simplifying work in almost every field, and dentistry is no exception. So, in 2015, we founded DentLab to provide cutting-edge digital laboratory services.

How did you go about implementing digital workflows?

From the very beginning, we aimed to digitize every aspect of our work—from production to data management and communication. Our practices already used our own practice management software, DentSoft, successfully. To connect our clinics with the lab, we developed a specialized lab module. This allowed our dental practitioners to submit every order electronically. It was a huge improvement over the old process, where forms with sketches were mailed physically, just as it had been in in the old days. Now, practitioners can select the teeth in need of treatment, specify restoration colour and design, and upload radiographs, photos, and intraoral scans with just a few clicks. Over time, we have continuously enhanced communication features between clinics and labs, adding things like delivery date notifications for orders, so patients can book their next appointment before they even leave the clinic. These tools have greatly improved coordination between our dentists and lab technicians.

How is communication organized in the software?

We created a chat-style communication area where different team members can talk, with all records saved and accessible to anyone involved in a treatment. This setup is a major improvement over phone calls, as every detail—from treatment notes to radiographs and photos—is stored and easy to reference. We even enabled practitioners to rate the products they receive, and every necessary remake is documented along with the responsible technician. This feedback system has allowed us to maintain high-quality standards, identify issues, and provide targeted training where needed.

Modern digital technologies used at DentLab to provide cutting-edge digital laboratory services.

Have you made other improvements in workflow and communication between clinics and laboratories?

DentLab initially served Dentgroup practices exclusively, but we eventually opened its services to other clinics. In this context, we set standards for incoming orders—from the required data to impression quality. If an order does not meet these standards, we reserve the right to reject it, explaining why, so the submitter can improve. We also implemented a loyalty programme and developed a special, trackable package with a QR code to prevent loss of items in transit. This innovation lets both the team in the lab and the clinic track each package’s location in real time, solving a common logistical challenge. We have even patented this unique packaging system.

Unique patented delivery box used at DentLab to prevent loss of items.

Do you provide guidance on materials and tools for clinics?

Yes, as part of our commitment to quality, we recommend specific intraoral scanners and even distribute them to customers outside our network. We also advise clinics on material choices, pre-treatment needs, and compatible resin cements for permanent placement of the produced restorations. Our protocols cover the entire restorative procedure. For aesthetic cases, we recommend starting with a smile design and using mock-ups. The mock-up evaluation lets practitioners and patients provide feedback, so the responsible lab technician can produce the final restoration with precision.

With digital workflows so well-established, do you think technicians still benefit from meeting patients face-to-face?

Not necessarily. Occasionally, a dentist may request a patient visit the lab, and we accommodate this. However, digitalization has made physical distance irrelevant, as clinics and labs can now work seamlessly from anywhere. In fact, we serve offices in Europe without any face-to-face interactions between patients and lab technicians. For patients, especially in a city like Istanbul, avoiding long travel times is a big plus, while we can still ensure high-quality outcomes.

Would you say digitalization has improved treatment quality overall?

Absolutely. There is a learning curve to digital processes, but once practitioners adjust, the quality is noticeably higher. In traditional workflows, practitioners might bend the rules, asking technicians to work with suboptimal impressions, for example. Digital systems do not allow for such shortcuts; preparation quality is clear from the scan, and impression errors can be corrected instantly before submitting to the lab. Additionally, digital scans will never shrink, distort, or tear during production, unlike physical impressions.

What are the main challenges associated with digital dentistry today?

The biggest challenge is simply taking the first step. Dentistry has been hesitant to change after decades of doing things the same way. Going digital requires an investment in both time and money. But those who make the switch find the rewards—better outcomes and more efficient procedures—well worth it.

What is next for digital dentistry?

With AI advancing quickly, the field is evolving in exciting ways. Today, we can combine digital impressions, facial scans, photographs, and 3D imaging to create a “virtual patient”. Some clinics are already using software to analyze digital data, like dental X-rays, and I predict that robot-assisted or even autonomous clinical procedures are on the horizon. Imagine robot arms taking impressions or patients scanning their own teeth with smartphones. Impression-taking procedures carried out at home already support aligner treatments in some cases. As these technologies advance, the need for dental assistants will likely decrease. The digital future for dentistry is incredibly promising, filled with tools that can transform patient care and practice efficiency on a global scale.

Example of beautiful, precisely fitting all-ceramic restorations produced at DentLab.

INTRODUCING BRAND NEW PRODUCTS FOR SUCCESS WITH STREAMLINED, SMART SOLUTIONS

Kuraray Noritake Dental is pleased to announce that at IDS 2025 it will present a number of innovations that fundamentally improve dental procedures without compromising the quality of the result. Additionally, a number of internationally recognized experts will present their lectures and hands-on demonstrations on two separate stages: one dedicated to chair-side and the other one to lab-side topics. All of this represents not one, but a whole host of reasons to visit the stand (repeatedly).

CHAIR-SIDE NOVELTIES: UNIVERSAL EXCELLENCE

Development of the new products is rooted in a deep understanding of the demands of modern dental practice. Balancing complex procedures, tight schedules and patient needs is no easy task. That is why Kuraray Noritake´s team has been on a relentless journey to streamline, enhance and refine every step of work for decades. The vision is clear: a world where materials and tools work seamlessly in the dentist´s hands, where complexity is minimized, and where professionals are given enough time to focus on what matters most: the individual desires and needs of every single patient. Discover new additions to the UNIVERSAL EXCELLENCE family: a flowable universal composite and a new iteration of a universal bond.

CLEARFIL MAJESTY™ ES Flow Universal represents a fundamental shift in the idea of what universal composites can achieve. By integrating high filler loading and achieving high flexural strength, CLEARFIL MAJESTY™ ES Flow Universal challenges the traditional view of flowable composites as merely temporary fixes. Instead, it positions itself as a permanent solution capable of delivering both aesthetic excellence and structural reliability. Its unique light diffusion technology allows working with just two shades, and, in addition to that, offers a choice of two flowability options for easy handling.

CLEARFIL™ Universal Bond Quick 2 is the latest evolution in dental bonding technology, offering a streamlined, efficient solution for dental practitioners. Following the success of its predecessor CLEARFIL™ Universal Bond Quick, the new version “2” offers a redefined monomer technology that delivers exceptional bonding performance with minimal effort. Kuraray Noritake´s proprietary Advanced Rapid Bond Technology combines three key monomers – the original MDP, Amide and Urethane Tetra Methacrylate. Designed to enhance workflows, this adhesive provides robust performance across a wide variety of clinical situations.

LAB-SIDE NOVELTIES

Patient-centered prosthodontic approaches are enabled by innovative restorative materials and their correct processing in the dental laboratory. No matter whether a minimally invasive procedure or the best aesthetic outcomes are desired: Kuraray Noritake Dental has the solutions. In 2025, a new “smart” finishing material is being launched, delivering both on efficiency and aesthetics.

CERABIEN™ MiLai is a set of porcelains and internal stains specifically designed for the micro-layering technique. The name “MiLai” is derived from the term “micro-layering” and the Japanese word “mirai” (which means future). The innovative product based on synthetic feldspar enables dental technicians to add the final touch to their restorations in a simple and time-saving procedure – for outstanding aesthetics right from the start. The low firing temperature of CERABIEN™ MiLai (740°C) makes it the go-to solution for the finishing of both oxide ceramic (e.g. zirconia) and silicate ceramic (e.g. lithium disilicate) restorations. With fewer lines of porcelain needed, the porcelain inventory is reduced further and fewer decisions need to be taken.

Additional information and the full programme of lectures and hands-on courses at the IDS is available online.