With 40 years of success in the commercial dental products market, Kuraray Noritake Dental has firmly established its commitment to providing leading-edge solutions for adhesive dentistry. The 1983 introduction of the PANAVIA™ EX resin cement, which utilized Kuraray’s original MDP monomer technology, set the industry standard for adhesion and has continued to do so for over 30 years since. With PANAVIA™ V5, and PANAVIA™ SA Cement Universal which is the latest addition to PANAVIA™ family, Kuraray Noritake Dental presents a pair of resin cements designed for strong, durable bonding for zirconia-based and other restorations.

PANAVIA™ V5

PANAVIA™ V5 is a resin cement with exceptional procedural simplicity and predictability. It sets a new standard for adhesion to the KATANA™ Zirconia Block or other zirconia, allowing for self-cure dentine bond strengths equal to our gold-standard light-cure bonding agent, CLEARFIL™ SE BOND. PANAVIA™ V5 offers natural aesthetic stability in shading through its amine-free paste, which is available in five shades and has been scientifically proven to demonstrate a lower level of post-curing colour variance than other cements.

PANAVIA™ SA Cement Universal

PANAVIA™ SA Cement Universal is a forerunner in self-adhesive resin cements that adheres virtually to all materials including glass ceramics. The original silane coupling agent, LCSi monomer, incorporated in the paste creates a strong chemical bond to porcelain, lithium disilicate and composite resin. Available in an automix or handmix option, its high concentration of MDP monomer allows for increased chemical reactiveness with zirconia, which, combined with mechanical retention created by sandblasting, has been demonstrated as crucial for durable bonding to this material. Building upon the success of our PANAVIA™ SA Cement Plus, it offers a wide range of indications for adhesion and is suitable for crowns/bridges, inlays/onlays, posts, and even adhesion bridges.

Case by Aleksandra Łyżwińska, DMD

This clinical case concerns a patient with a lesion on the occluso-distal aspect of the mandibular left first premolar. We opted for a direct treatment approach with a combination of flowable and high-viscosity composite resin (CLEARFIL MAJESTY™ ES Flow - Super Low A2, CLEARFIL MAJESTY™ ES-2 Classic A2). In order to establish a strong bond between the tooth structure and the restorative material, we decided to selectively etch the enamel and then apply a clinically proven self-etch adhesive (CLEARFIL™ SE BOND 2).

Fig. 1. Initial clinical situation.

Fig. 2. Appearance of the premolar after caries removal.

Fig. 3. Placement of a sectional matrix for anatomical shaping, the establishing of tight interproximal contacts and protection of the adjacent tooth.

Fig. 4. Appearance of the tooth structure after selective enamel etching.

Fig. 5. Interproximal wall built up with CLEARFIL MAJESTY™ ES-2 Classic (A2 shade) and cavity filled with CLEARFIL MAJESTY™ ES Flow - Super Low A2.

Fig. 6. After initial polishing.

FINAL SITUATION

Fig. 7. Occlusal view of the treatment outcome after finishing and polishing.

Fig. 8. Follow up after 1 week.

Dentist:

ALEKSANDRA ŁYŻWIŃSKA
Warsaw, Poland

Aleksandra Łyżwińska, DMD, is a passionate aesthetic and adhesive dentist. Driven by Evidence Based Dentistry, her goal includes using modern composite materials and bonding agents in her clinical practise. In addition to her primary job, she worked as a lecturer and an assistant professor at the Department of Conservative Dentistry and Endodontics of Medical University of Warsaw, her alma mater.

Case by Dr. Michał Pokojski

Universal resin composites with a simplified shade concept are popular as they streamline direct restoration procedures. Unfortunately, many of the available products that claim to blend in well with the surrounding tooth structure independent of its shade need a blocker or opaquer to mask dark areas. According to Kuraray Noritake Dental, CLEARFIL MAJESTY™ ES-2 Universal is different. This is why I decided to test its Universal shade (U) designed for all kinds of restorations in the posterior region in the context of replacing an amalgam restoration.

The restoration that needed to be replaced due to secondary caries was located in the maxillary molar region of a male patient. As usual under amalgam restorations, the remaining healthy tooth structure showed some discolouration. The cavity was prepared, the enamel etched and the whole bonding surface treated with CLEARFIL™ SE Bond. Subsequently, the restoration was built up using CLEARFIL MAJESTY™ ES-2 Universal in several layers. For a natural appearance, some brown tint was added to the fissures before finishing and polishing. The restoration shows a natural integration into the surrounding structure and is able to mask the discolouration on the cavity floor.

Fig. 1. Pre-operative image showing the amalgam restorations to be replaced.

Fig. 2. Appearance of the tooth after removal of the amalgam, caries excavation and cavity preparation.

Fig. 3. Tooth built up with CLEARFIL MAJESTY™ ES-2 Universal (U shade).

FINAL SITUATION

Fig. 4. Immediate treatment outcome.

Dentist:

DR. MICHAŁ POKOJSKI

Dr. Michał Pokojski is a graduate of the Medical University of Łódź, Poland. He maintains his private practice in Starachowice, Świętokrzyskie Voivodeship. His passion is endodontics and esthetic conservative dentistry. In his everyday duties microscope and camera are his main tools to provide his patients with professional and precise procedures and to ensure proper level of communication and understanding. His practice was guided by EBD from the very beginning, because in his opinion knowledge, scientific facts and dedication for what you do are the fundamentals of medicine and dentistry as well. His goal is to treat patients at the highest level of quality using the best available materials, instruments and procedures. His cases are well-known in the world thanks to modern ways of communication like Facebook and Instagram.

Clinical case by Dr Salvatore Scolavino

This video illustrates the recontouring treatment with dental light-cured restorative composite CLEARFIL MAJESTY ES-2.

Dentist:

DR SALVATORE SCOLAVINO

• Specialist in Asthetic Dentistry from Naples, Italy
• Member of the Styleitaliano group which focuses on minimally invasive dentistry techniques
• Private practice in Nola (NA)
• Active member SIDOC (Italian Society of Conservative Dentistry), IAED (Italian Academy of Esthetic Dentistry)
• Author and co-author of scientific publications on national and international journals
• Lecturer in national and international congresses and events

Case by Dr Adrien Lavenant

Introduction

The patient consulted for a follow-up examination and presented with recurrent caries at the maxillary right first molar. A direct treatment with composite needed to be performed. We decided to use Kuraray Noritake Dental Inc.´s CLEARFIL MAJESTY™ ES-2 Universal composite for several reasons: the efficiency of the treatment, favourable handling properties and ease of use.

The clinical case illustrations below show the step-by-step approach carried out during a 30-minute treatment session.

Fig. 1. Initial situation showing an occlusal caries lesion on the maxillary right first molar.

Fig. 2. Pre-operative X-ray.

Fig. 3. Isolation of the working field with rubber dam.

Fig. 4. Situation after caries excavation and tissue preparation.

Fig. 5. Cavity ready for the application of the universal composite: CLEARFIL™ Universal Bond Quick is visible on dentin and enamel and the cavity floor is covered by a thin layer of CLEARFIL MAJESTY™ ES Flow Low.

Fig. 6. Appearance of the tooth after buildup of the restoration with several layers of CLEARFIL MAJESTY™ ES-2 Universal composite (in the shade U developed for the posterior area).

Fig. 7. Stains applied in the occlusal fissures ensure an even more natural appearance.

Fig. 8. Final result after polishing with CLEARFIL™ Twist DIA and checking of the occlusion.

Fig. 9. Final result immediately after rubber dam removal.

Fig. 10. Post-operative X-ray.

FINAL SITUATION

Fig. 11. Check-up after 15 days with rehydrated dental tissues.

Dentist:

DR ADRIEN LAVENANT

Dr Adrien Lavenant obtained his DDS degree at the University of Aix-Marseille in 2010. He pursued his post-graduate education in the field of periodontology, restorative and aesthetic dentistry (University Aix-Marseille and Paris).

Dr Lavenant is a former member of the teaching staff of the University of Aix-Marseille since 2011 and he continues to teach in the postgraduate program in restorative and aesthetic dentistry.

Since 2010, he owns a private practice in Aix-en-Provence specialised in restorative, prosthetic and aesthetic implant dentistry. He has been part of the international Bio-emulation group since 2019 and shares his philosophy of patient care in accordance with the principles of biomimetic dentistry.

Case by Dr. Max Andrup

This patient presented with a fractured amalgam restoration in the occlusal aspect of the mandibular right first molar. The cavity was shallow resulting in a very favourable C-factor. The C-factor describes the relationship between bonded and unbonded restorative material surfaces and is used as an indicator for polymerization shrinkage stress development in a cavity. Hence, it is essential to manage this factor when working with resin composites.

Fig. 1. Initial situation with the fractured amalgam restoration. In the distal aspect of the restoration, some recurrent decay is also visible.

Fig. 2. First molar ready for a new restoration after removal of the amalgam and bevelling of the enamel.

Fig. 3. Selective etching of the enamel prior to the application of CLEARFIL™ SE Protect into the cavity. Selective etching is performed in order to maximize the bond strength to enamel (by etching) and to dentin (without etching).

FINAL SITUATION

Fig. 4. Final situation after restoration of the cavity with CLEARFIL MAJESTY™ ES-2 Universal in the shade U developed for posterior restorations. The favourable C-factor and the fact that the polymerization shrinkage stress produced by the selected material is very low provide the conditions for a good long-term behaviour of the new restoration.

Dentist:

Dr. Max Andrup graduated from the University of Umeå in 2010 and today runs his private practice in the city of Hudiksvall, Sweden. He has a passion for restorative dentistry with a biomimetic approach.

Case by Dr. Michał Pokojski

When restoring primary carious lesions in the posterior area with composite, I wish to use a material that allows me to produce high-quality outcomes in an efficient procedure. The most important qualities of the restoration are its perfect marginal integrity and reliable long-term behaviour, which set the stage for a long and healthy life of the otherwise healthy tooth.

Reliability paired with ease of use is what I expected from the selected material combination: CLEARFIL™ SE Bond 2, a popular self-etch adhesive containing the original MDP monomer, and CLEARFIL MAJESTY™ ES-2 Universal. According to Kuraray Noritake Dental, the innovative resin composite comes with a universal shade concept and mechanical properties such as shrinkage, wear resistance and colour stability similar to those of proven CLEARFIL MAJESTY™ products. As a single shade is available for the posterior region, the need for shade determination is eliminated, which allows the dental practitioner to focus on the clinical work steps. In this case, a small primary defect in a third molar was restored. The outcome speaks for itself.

Fig. 1. Situation during cavity preparation revealing the carious lesion.

Fig. 2. Prepared cavity after the application of the bonding agent.

FINAL SITUATION

Fig. 3. Treatment outcome with the composite harmoniously integrated into the surrounding structure.

Dentist:

DR. MICHAŁ POKOJSKI

Dr. Michał Pokojski is a graduate of the Medical University of Łódź, Poland. He maintains his private practice in Starachowice, Świętokrzyskie Voivodeship. His passion is endodontics and esthetic conservative dentistry. In his everyday duties microscope and camera are his main tools to provide his patients with professional and precise procedures and to ensure proper level of communication and understanding. His practice was guided by EBD from the very beginning, because in his opinion knowledge, scientific facts and dedication for what you do are the fundamentals of medicine and dentistry as well. His goal is to treat patients at the highest level of quality using the best available materials, instruments and procedures. His cases are well-known in the world thanks to modern ways of communication like Facebook and Instagram.

CLEARFIL MAJESTY™ ES-2 Universal Composite

A smart and easy-to-use system that works for the vast majority of your daily cases

Webinar to learn how intelligent simplification benefits your daily work. Discover MAJESTY ES-2 Universal, a smart and easy-to-use system that will work for the vast majority of your daily cases. Its light-cure, radiopaque restorative material provides accurate color matching, high polishability and excellent physical properties. This makes the product ideal for both anterior and posterior restorations.

ABOUT DR JORGE ESPIGARES, DDS, PHD

Dr. Jorge Espigares received his DDS degree at the Faculty of Dentistry, University of Granada in Spain and obtained his PhD degree under the supervision of Prof. Tagami at Tokyo Medical and Dental University in Japan. Specialized in Cariology and Operative Dentistry, Dr. Jorge Espigares has clinical experience in Spain and UK, and has authored and coauthored full-length research publications with his colleagues at TMDU.

In this interview, Dr Adham Elsayed, certified specialist in dental prosthodontics and implants and clinical and scientific manager at Kuraray Noritake Dental, details the benefits of the company’s new CLEARFIL MAJESTY™ ES-2 Universal composite and explains its application in the daily dental workflow.

Though dentists are becoming increasingly specialised, there’s a growing demand for products that can be used for all indications. How does CLEARFIL MAJESTY™ ES-2 Universal fit this model?

First, we need to explain the meaning of the term ‘universal’ in this context. Previously, there have been two types of composites that differ according to the area of application: anterior composites, used in Class III, IV and V restorations where the aesthetic outcome is the priority, and posterior composites, in which the mechanical properties like strength and wear rate are more important. Universal composites, then, are those that can be used for all types of restorations in the anterior as well as the posterior region.

Another way in which ‘universal’ can be considered is in relation to shade. In this case, the term is used to describe a restorative composite system that exists in fewer shades, one that can adapt to the tooth structure independent of the colour of the tooth. A major benefit of this type of composites is that it offers a simplified workflow.

CLEARFIL MAJESTY™ ES-2 Universal is essentially universal in both meanings: it is one system that can be used for posterior and anterior restorations, and it is also provided in only three shades—one for posterior, and two for anterior.

Universal products, whether they are luting cements, bonding agents or composites, are attractive to dentists as long as they offer simplification of the treatment procedure without compromising quality and durability.

How does CLEARFIL MAJESTY™ ES-2 Universal build upon the success of the CLEARFIL MAJESTY™ range?

The CLEARFIL MAJESTY™ family is very well established at this stage. It includes such products as CLEARFIL MAJESTY™ Posterior, one of the most popular posterior composites owing to its superior mechanical properties and minimal polymerisation shrinkage. CLEARFIL MAJESTY™ ES-2 is an extensive system that is highly beneficial thanks to its outstanding optical properties and ability to produce high-end aesthetics in the anterior region using Kuraray Noritake Dental’s multilayering technique. The three flowable alternatives of CLEARFIL MAJESTY™ ES Flow, with different consistencies, are also other successful members of the family.

Kuraray Noritake Dental now continues the success story of CLEARFIL MAJESTY™ with the latest innovative product that can change the definition of the universal composite. CLEARFIL MAJESTY™ ES-2 Universal incorporates several attributes from the well-established ES-2 and ES Flow, including Kuraray Noritake Dental’s light diffusion technology (LDT).

Speaking of LDT—how does this technology benefit the composite?

LDT allows the material to scatter and reflect light rays at many different angles, which, in turn, allows the composite restoration to diffuse light in a similar way to the surrounding tooth structure. Hence, it eliminates aesthetic problems like the visibility of restoration and preparation borders. Thanks to innovative LDT, optimal particle fillers and opacity, CLEARFIL MAJESTY™ ES-2 Universal blends seamlessly with the surrounding tooth structure and emulates natural teeth, eliminating the need for shade selection.

As you mentioned, CLEARFIL MAJESTY™ ES-2 Universal comes with one shade for posterior restorations and two for anterior restorations. Can such a reduced shade range still truly deliver aesthetic restorations?

CLEARFIL MAJESTY™ ES-2 Universal is not the first composite on the market with a reduced shade system. However, we can safely say that it is the first to focus on aesthetics and not just on reducing the number of shades.

We know from experience that using one-shade composite systems in the anterior region mostly leads to unsatisfying aesthetic results, even with the use of an opaquer composite to reduce shade-matching interference. This is due to the fact that trying to provide one shade for all posterior and anterior restorations, and for all tooth shades, compromises the aesthetic to a high extent. In other words, using a highly translucent material to try to match all restorations and shades will result in the interference of other objects in the mouth, such as the tongue, gingivae and so on.

Kuraray Noritake understood this fact well and solved the problem by introducing three shades with translucencies designed to match specific indications. It is important to note the simplicity of the workflow, since only one syringe per restoration is required. This makes CLEARFIL Majesty™ ES-2 Universal a true game-changer, as it provides the perfect match between simplicity and aesthetics.

What other advantages does this new composite deliver?

Other advantages include the superior mechanical properties for which the CLEARFIL MAJESTY™ family is already known, such as favourable wear properties, low shrinkage stress and high strength. It can be polished easily and retains its gloss. Moreover, the handling of the material is a huge advantage: this includes a long working time of about 270 seconds under ambient light. It is non-sticky and can be sculpted easily.

Which dental professionals would benefit most from this product?

The perfect match between simplicity and aesthetics offers the clinician several benefits. It delivers a very straightforward time-saving procedure without compromising aesthetic results. There is no need for exact shade selection, thereby excluding visible errors of non-matching shades, and there is also a reduced amount of material stock needed. Therefore, in my opinion, this should be the product of choice for most cases in everyday practice.

Advances and developments in dental materials are rapidly accelerating, and clinicians should integrate these innovations and make their daily practice more efficient with simplified workflows, time-saving procedures, fewer material selections and, accordingly, less technique sensitivity and less need for dental practice personnel to become acquainted with an abundance of materials.

INTELIĢENTAIS KOMPOZĪTMATERIĀLS
Efektīvas un estētiskas tiešās restaurācijas, izmantojot jauno
CLEARFIL MAJESTY™ ES-2 Universal

Zobārstniecības kabinetos allaž darbs dzen darbu, un COVID-19 sanitārās apstrādes prasības papildina darāmo darbu sarakstu. Procedūru vienkāršošana ir loģiska stratēģija, kas saīsina pacienta krēslā pavadīto laiku; tomēr šai optimizācijai joprojām jānodrošina augsts ārstēšanas standarts un estētiskais rezultāts.

Izmantojot Kuraray Noritake Dental ražoto līdzekli CLEARFIL MAJESTY™ ES-2 Universal, varēsit: ātri noteikt toni un standarta gadījumos izveidot estētiskas, ilgmūžīgas tiešās restaurācijas ar vienu toni.

Vairs nav nepieciešama toņa noņemšana. Inteliģentā optiskā integrācija nodrošina, ka CLEARFIL MAJESTY™ ES-2 Universal nemanāmi iekļaujas apkārtējos zoba audos.

CLEARFIL MAJESTY™ ES-2 Universal sastāv no kompakta toņu diapazona.

• Universālais (U) tonis ir paredzēts visām sānu restaurācijām.
• Priekšzobiem, kuriem ir augstākas estētiskās prasības, var izvēlēties divas toņu iespējas: universālu gaišo (universal light; UL) un universālu tumšo (universal dark; UD) toni.
• Dažos gadījumos, piemēram, restaurējot primāros zobus, tiek izmantots universāls baltais (universal white, UW) tonis.

Kompaktais toņu klāsts ir piemērots visiem gadījumiem, jo Kuraray Noritake Dental gaismas difūzijas tehnoloģija liek atjaunotajam slānim lauzt gaismu līdzīgi, kā gaismu lauž zoba struktūra. Attiecīgi uzklātais materiāls gandrīz nemanāmi saplūst ar apkārtējo zobu struktūru.

CLEARFIL MAJESTY™ ES-2 Universal toņiem ir pārliecinošas mehāniskās izturības īpašības, tāpēc tie ir vienlīdz labi piemēroti gan priekšzobu, gan sānu zobu restaurācijām. Tāpat kā citi CLEARFIL MAJESTY™ ES-2 grupas izstrādājumi, arī šis novatoriskais produkts sniedz augstu izturību, pieņemamu nodilumu un līdzsvarotu saraušanās spriegumu. Tas ir uzticams, tāpēc piemērots pat sānu zobiem, kas pakļauti lielākai slodzei. Materiālu ir viegli pulēt, un tas saglabā spīdumu, nodrošinot dabisku izskatu, kas ir īpaši nozīmīgi priekšzobiem.

CLEARFIL MAJESTY™ ES-2 Universal toņi ir pieejami iepriekš uzpildītās kapsulās un šļircēs, tādējādi nodrošinot laiku taupošus un vienkāršotus līdzekļus estētiskām, izturīgām un ilgmūžīgām restaurācijām.

Papildinformācija pieejama tiešsaistē: kuraraynoritake.eu/lv/clearfil-majesty-es2-universal

Preses jautājumiem: [email protected]

One for all: With KATANA™ Zirconia YML (yttria multi-layered), Kuraray Noritake Dental Inc. has launched a true allrounder covering traditional and new zirconia indications. At the KATANA™ Zirconia YML Virtual Kick-Off Symposium on July 3, 2021, professionals from the clinical and technical field as well as scientific experts from Kuraray Noritake Inc. provided insights into the properties and benefits of the innovation. We had a conversation with three of them about the specific features of KATANA™ Zirconia YML and its potential role in the dental practice and laboratory. Mathias Fernandez Y Lombardi, EU Scientific Manager Dental Ceramics & CAD/CAM Materials, provided insights from inside the company, while Prof. Dr. Florian Beuer MME, Charité – Universitätsmedizin Berlin and MDT Nondas Vlachopoulos, owner of the dental laboratory AestheticLab in Athens, shared their external perspectives.

Prof. Dr. Florian Beuer MME and Mathias Fernandez Y Lombardi during the conversation at the Kick-Off Symposium in Munich.

MDT Nondas Vlachopoulos virtually attended the meeting.

What are the most important features and benefits of the new KATANA™ Zirconia YML?

Mathias Fernandez Y Lombardi: KATANA™ Zirconia YML is a 5^th generation zirconia featuring next-generation multi-layered technology: it offers colour, translucency and flexural strength gradation in one disc – for a virtually unlimited indication range. As it may be used as the only zirconia or even ceramic CAD/CAM material in a laboratory or milling centre, it is designed for everyone who would like to simplify and standardize laboratory procedures. It may be sintered within 54 minutes, offers a high accuracy of fit and may be finished using time-saving techniques.

The new discs presented at the KATANA™ Zirconia YML Virtual Kick-Off Symposium.

Multi-layered structure of KATANA™ Zirconia YML.

What are the benefits of using a single zirconia for every indication from the dental technician’s perspective?

Nondas Vlachopoulos: The use of a universal zirconia solution with a high aesthetic potential and well-aligned mechanical properties allows dental technicians to reduce their inventory and streamline their procedures – from designing to finishing. Nowadays, we all know that, in order to optimize the outcomes, it is essential that we develop a deep understanding of a material’s properties, respect its design parameters (like minimum wall thicknesses) and adhere to the sintering protocols. It is much easier to accomplish this for a single material than for many different ceramics, and the potential for errors is minimized with a single-material approach. With KATANA™ Zirconia YML, this approach enables us to produce very different outcomes depending on where the restoration is placed in the multi-layered blank.

What are the benefits of using KATANA™ Zirconia YML as the only ceramic material from the dental practitioner’s perspective?

Florian Beuer: To my mind, the most important benefit of using a single zirconia every time lies in a simplified documentation. When different ceramic materials are used in the dental laboratory, we need to keep track of the material selected in every single case. Only in this way, it is possible to make the right cementation decisions (regarding cement selection and the appropriate pre-treatment of the restoration). In addition, when it comes to failure of the restoration, we need to know which material was used to prove that it has been processed correctly and is suitable for the actual indication. This is much easier when a single material is used every time. Zirconia is predestined for this approach as it is forgiving, supports minimally invasive preparations and – in case of KATANA™ Zirconia YML – almost everything can be done with it.

What are the secrets of KATANA™ Zirconia YML that allow for excellent treatment outcomes despite the one-for-all approach?

Mathias Fernandez Y Lombardi: KATANA™ Zirconia YML is based on a completely new, seamless multi-layer technology combining different, newly developed raw materials with varying yttria concentrations in a single blank. The inhouse development of the powders and their precise adjustment of each other in terms of properties like shrinkage and coefficients of thermal expansion are prerequisites for a smooth transition from one layer to the next. Only if the layers are very well integrated, it will be possible to reliably produce even long-span restorations with a delicate design, perfect fit and flawless aesthetics (without transition lines). The aesthetic properties were also optimized by integrating clinical instead of purely technical translucency.

Please explain the term clinical translucency.

Mathias Fernandez Y Lombardi: Usually, translucency of dental materials like zirconia is measured in its white, pre-shaded state. This so-called technical translucency value is increased by adding yttria to the formulation, which makes the zirconia itself appear brighter (increasing the whiteness). The translucency of the final restoration, however, is also affected by pigments and other additives in the formulation. Consequently, monolithic restorations made of different materials with the same technical translucency value may vary widely in terms of their actual, clinical translucency, which affect the overall aesthetic potential. The formulation of KATANA™ Zirconia YML has been optimized by carefully selecting and combining the right additives to obtain a natural, tooth-like translucency.

Translucency and shade appearance of KATANA™ Zirconia YML (left column) compared to various other 5^th generation zirconia materials.

Nondas Vlachopoulos, is this measure of optimizing the clinical translucency a key feature enabling the one-for-all approach of KATANA™ Zirconia YML?

Nondas Vlachopoulos: The positive effect attributed to this measure is noticeable, as KATANA™ Zirconia YML has a particularly warm and natural appearance especially in the body area some other materials with flexural strength gradation are lacking. This leads to an exact colour match with the VITA classical A1-D4 shade guide, and reduces the need for manual shade adjustments. This is important for a one-for-all approach, as the material should be a perfect basis for the production of monolithic restorations, which are not covered by a thick porcelain layer able to mask any imperfections. However, there is another key feature that facilitates the zirconia’s use for virtually every indication: Its exceptional design flexibility. It enables users to control the translucency and overall aesthetics by positioning the restoration quite freely within the blank. For restorations with up to three units, there is a complete freedom of placement. Larger restorations with four or more units need to be positioned in a way that at least 50% of the connector cross-section is in the bottom half of the disc. This is easily accomplished and gives us optimal options to exploit the various properties of each layer depending on the aesthetics and strength needed in each specific case.

Positioning guidelines for KATANA™ Zirconia YML.

What is the recommended finishing procedure?

Mathias Fernandez Y Lombardi: In principle, all designs and finishing options are available for KATANA™ Zirconia YML – from a monolithic design individualized with liquid ceramics to microlayering after a minimal vestibular cutback or even full ceramic layering on frameworks. As the aesthetic potential of the zirconia is already high, however, we believe that in most cases, the first option is absolutely sufficient. In this case, a monolithic restoration is milled and the surface subsequently treated with our liquid ceramic system CERABIEN™ ZR FC Paste Stain. The pastes are easily applied in ultra-thin layers, very well controllable and wear resistant.

Anterior and posterior crown made of KATANA™ Zirconia YML after sintering (left part) and after sintering and finishing with CERABIEN™ ZR FC PASTE STAIN (right part).

Nondas Vlachopoulos, what is your preferred finishing procedure for restorations made of KATANA™ Zirconia YML?

Nondas Vlachopoulos: In the posterior area, I often opt for monolithic restorations individualized with CERABIEN™ ZR FC Paste Stain. The technique leads to beautiful outcomes a large majority of patients would love to see even in the anterior region. However, as orders for the production of anterior restorations coming my way are usually placed by clinicians and patients with the highest possible aesthetic demands, I often go for a framework design and full porcelain layering with CERABIEN ZR Porcelains. The materials (like EX-3 portfolio for metal frameworks) are based on synthetic feldspathic porcelain with a structure and particle distribution very similar to natural dentin and enamel. All in all, I like the fact that I can select the most suitable finishing technique for every individual case, and I believe that it is often possible to reduce the finishing effort to a minimum.

Clinical translucency, design flexibility, mechanical properties: Apparently, the differences between the available zirconia materials – even of the 5^th generation – are huge. How can users ensure that the material they select is of high quality and offers favourable mechanical as well as optical properties?

Florian Beuer: When the first-generation zirconia materials appeared on the dental market, laboratory testing revealed that there are huge differences in quality between materials of different manufacturers. Although independent studies comparing the properties and behaviour of 5^th generation zirconia are still scarce, it may be assumed that differences do exist. My recommendation is to select a several materials from well-known manufacturers supporting clinical studies, compare the study results already available, and test the selected options in the laboratory setting. Directly comparing design concepts, the processing quality and final appearance will most likely reveal which material is a dental technician’s favourite. I am sure that KATANA™ Zirconia YML is among the materials worth being tested.

Thank you for this insightful conversation.