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It is strong, it is pre-shaded like natural teeth, and it is reliable: KATANA™ Zirconia HTML, the highest strength version among KATANA™ multi-layered zirconia series. Now, Kuraray Noritake Dental Inc. has carefully optimized the product to further improve its optical properties and to harmonize the sintering schedules with all other materials of the KATANA™ Zirconia Multi-Layered Series.

The new KATANA™ Zirconia HTML Plus offers all popular properties of its predecessor, including the multi-layered colour structure and uniform strength distribution throughout the blank. It is suitable for a variety of indications including long-span bridges with a minimum wall thickness of just 0.4 mm in the anterior and 0.5 mm in the posterior region. This allows for minimally invasive preparations, while the user may choose between a monolithic, cut-back or framework design combined with the preferred finishing technique.

The PLUS refers to additional benefits like the material’s improved optical properties: KATANA™ Zirconia HTML Plus offers an increased translucency of 45 percent (compared to 43 percent KATANA™ Zirconia HTML) and an even more natural shade appearance of the manufactured restorations. “As the colour of the restorations appears deeper, more vivid and more saturated, and the translucency is closer to that of natural teeth, a great optical integration is achieved straight away. This leads to a reduced finishing effort”, says Mathias Fernandez Y Lombardi, EU Scientific Manager Dental Ceramics & CAD/CAM Materials at Kuraray Noritake Dental. At the same time, the high flexural strength (1,150 MPa) is maintained, providing for an unlimited range of indications.

Like its predecessor and all other materials of the KATANA™ Zirconia Multi-Layered Series, KATANA™ Zirconia HTML Plus is the result of an in-house development, powder compilation and blank production process that is able to control every detail. This enabled our specialists to achieve a precise alignment of the desired properties, while maintaining a high blank quality that leads to the accurate milling results with smooth surfaces and regular edges users of KATANA™ Zirconia HTML are familiar with.

The unique powder composition and specific in-house blank production procedure also allowed us to streamline the sintering protocols. For single-tooth restorations and bridges with up to three units, three different protocols are available: a 54-minute high-speed sintering programme specifically developed for remake and rush cases, a 90-minute schedule and the traditional seven-hour sintering programme. The latter is also suitable for long-span restorations.

These three options and identical schedules are available for KATANA™ Zirconia HTML Plus, KATANA™ Zirconia UTML, KATANA™ Zirconia STML and the new KATANA™ Zirconia YML with additional flexural strength and technical translucency gradation. With this feature, it becomes extraordinarily easy to standardize procedures despite an indication-specific selection of the best-suited KATANA™ Multi-Layered Zirconia.

Mathias Fernandez Y Lombardi concludes: “KATANA™ Zirconia HTML Plus is completely in line with our philosophy of developing products that support their users in streamlining and simplifying procedures without limiting choices. Users may choose from a whole range of highly specialized or universal zirconia solutions, may opt for their preferred design and finishing technique, and can select the sintering protocol that suits their individual needs. At the same time, the manual effort is reduced and the risk of starting the wrong sintering programme is eliminated.”

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.

Strauji augošs uzņēmums
Mēs meklējam zobārstniecības produktu tirdzniecības menedžeri, lai veicinātu mūsu uzņēmuma attīstību Baltijas reģionā. Jūs sagaida darbs jaunā, aizrautīgā un panākumiem bagātā starptautiskā komandā.

Amata apraksts
Zobārstniecības produktu tirdzniecības menedžeris/-e tiekas ar zobārstiem, zobu tehniķiem, zobārstniecības produktu tirgotājiem un universitātēm Latvijā un sniedz atbalstu pārdošanas nodaļas kolēģiem citās Baltijas valstīs. Jums piemīt lieliskas pārdošanas un klientu pārliecināšanas spējas, kā arī prasme sekmīgi vadīt sadarbības, tajā skaitā ilgus un sarežģītus pārdošanas procesus, kuros jāpieņem daudzi lēmumi un jāspēj tos novest līdz pozitīvam rezultātam. Jūs nepārtraukti uzturat interesi par jaunumiem zobārstniecības nozarē. Jums piemīt vēlme apgūt visu jauno un jūs protat aizraut ne vien klientus, bet arī kolēģus. Pieredze zobārstniecības jomā tiks uzskatīta par priekšrocību.

Amata pienākumi

• Jaunu klientu piesaiste un darbs ar esošajiem uzņēmuma klientiem
• Ilgtermiņa attiecību veidošana ar klientiem
• Produktu tehniskās informācijas sniegšana, rīkojot apmācības un kursus
• Zīmola popularizēšana
• Pārdošanas mērķu sasniegšana

Jūsu menedžeris būs Baltijas un Ziemeļvalstu pārdošanas un mārketinga vadītājs. Jūsu darba galvenais uzdevums būs noteiktu kvalitatīvu un kvantitatīvu mērķu sasniegšana. Pēc vispusīgas apmācības pabeigšanas Jūs varēsiet neatkarīgi vadīt apmācības un kursus, kā arī strādāt zobārstniecības tehnoloģiju jomā.

Kvalifikācijas
Mēs meklējam komunikablu, radošu un zinātkāru personu ar augstu atbildības sajūtu un nopietnu attieksmi pret darbu. Tādu, kas vēlas ieguldīt laiku savu zināšanu paplašināšanā, kas palīdzētu klientu pārliecināšanas procesā.

• Ir saistība ar zobārstniecības jomu.
• Prot uzmanīgi klausī
• Izcilas prezentēšanas prasmes.
• Zinātkāre, radošums un mērķtiecība.
• Pieredze darbā ar CRM sistēmu.
• Labas latviešu, angļu un krievu valodas zināšanas.

Kāpēc pievienoties mūsu komandai?
Uzsākot darbu uzņēmumā Kuraray Noritake, jūs pievienosieties atvērtam, daudzveidīgam, uz panākumiem orientētam un talantīgam kolektīvam. Ar lepnumu varam pastāstīt, ka mūsu produkti ir saņēmuši neskaitāmas balvas, mums pieder vairāki patenti zobārstniecības jomā, kas ir veicinājuši mūsu konkurētspēju un uzņēmuma izaugsmi gadu pēc gada. Ņemot vērā 2021. gadam plānoto uzņēmuma izaugsmi, šī ir lieliska iespēja Jūsu personīgā talanta attīstībai uzņēmumā Kuraray Noritake.

Darbs, protams, nebūs jāveic vienatnē - pienākumu izpildei būs pieejams mārketinga komandas un tehniskais atbalsts. Uzsākot darbu, saņemsiet detalizētu apmācības programmu, tāpēc zobārstniecības zināšanas ir uzskatāmas par priekšrocību, bet nav obligātas.

Mēs Jums piedāvājam algu, atbilstošu Jūsu pieredzes līmenim, darba automašīnu, tālruni, datoru, bonusu sistēmu, apmācības un izaugsmes iespējas.

Vai esat ieinteresēts?
Ja Jūs interesē šis piedāvājums, iesniedziet CV angļu valodā un pievienojiet pieteikuma vēstuli.

Adrese papildinformācijai un pieteikumiem: Kuraray Europe Benelux, P.O. Box 299, 1970 AG IJmuiden, Nīderlande, Tālruņa nr.: +31 255 523 701, hrbenelux@kuraray.com, Claire Heslenfeld, Head of HR. Darbā iekārtošanas aģentūras lūdzam neatbildēt uz šo sludinājumu.

Uzņēmuma Kuraray Noritake Dental – Born in Japan Uzņēmums Kuraray tika dibināts pirms 90 gadiem Japānas pilsētā Kurašiki; tā gada apgrozījums ir vairāk nekā 3,7 miljardi un uzņēmumā strādā vairāk nekā 8300 darbinieku. Daudzi mūsu produkti tiek lietoti ikdienā, piemēram, Kuraray aizsargstikli ir Berlīnes Reihstāgā un Londonas panorāmas ratā London Eye. 1970. gados Kuraray sāka izstrādāt zobārstniecības produktus. Mūsdienās uzņēmums ir atpazīstams kā jaunievedumu ieviesējs zobārstniecības produktu izpētes un attīstības jomā, un šie produkti padara vienkāršākas ikdienas zobārstniecības procedūras un vienlaikus nodrošina ilgtspējīgus augstākās klases rezultātus. 2012. gada aprīlī uzņēmumi Kuraray Medical Inc. un Noritake Dental Supply Co., Ltd. tika apvienoti un kļuva par Kuraray Noritake Dental Inc.

Mūsdienās uzņēmuma priekšrocība ir izcila pieredze organiskajā un neorganiskajā ķīmijā. Uzņēmums Kuraray Noritake Dental darbojas dažādās jomās, tāpēc pašlaik uzmanība tiek pievērsta dažādu augstākās klases zobārstniecības produktu izstrādei - no keramikas līdz kompozīta produktiem un pat biomateriāliem, lai nodrošinātu zobārstu un zobārstniecības laboratoriju tehniķu vajadzības visā pasaulē.

Reizēm ir nepieciešams plūstošs materiāls, kas iekļūst katrā stūrī un rievā, bet citreiz ir labāk, ka materiāls paliek uzlikšanas vietā un ir veidojams, lai iegūtu nepieciešamo formu. Ja ir pieejama tikai viena viskozitātes pakāpe, ir grūti ar to izlīdzēties katrā klīniskajā situācijā, kurā ir indikācija plūstošā kompozītmateriāla izmantošanai. Tāpēc Kuraray Noritake Dental Inc. piedāvā CLEARFIL MAJESTY™ ES Flow ar trim dažādām plūstamības pakāpēm: High, Low un Super Low. Plūstamības līmenis tiek izvēlēts atkarībā no klīniskās situācijas, kā arī kavitātes ģeometrijas un lieluma. Piemēram, augstas plūstamības materiāls ir vispiemērotākais, lai to izmantotu kā kavitātes aizsargslāni, bet īpaši zemās plūstamības materiāls ir ieteicams darbā ar kompozītmateriālu venīriem.

Tomēr šis materiāls sniedz vēl daudz vairāk iespēju, par ko pārliecinājās „Dental Advisor“ konsultanti, jau sesto reizi pēc kārtas piešķirot šim produktam „Editors’ Choice“ uzlīmi un balvu „Top Product Award“ (38. izdevums, 01. numurs, 2021. gada janvāris–februāris).

29 „Dental Advisor“ konsultanti savās zobārstniecības prakses vietās pārbaudīja CLEARFIL MAJESTY™ ES Flow vidējās plūstamības variantu (Low). Viņi izvērtēja produkta sniegumu attiecībā uz ievietošanu/darbu ar to, estētiku, viskozitāti un pulējamību. Par visām četrām īpašībām produkts saņēma vērtējumu „izcili“. CLEARFIL MAJESTY™ ES Flow Low netek ievietošanas laikā, nodrošina labu pielāgošanos kavitātes sieniņām, kā arī vienmērīgu plūsmu šaurākās vietās. Uzņēmuma Kuraray Noritake Dental Inc. gaismas difūzijas tehnoloģija nodrošina, ka materiāls nemanāmi integrējas apkārtējā zobu struktūrā, un spīdīgu virsmu var iegūt, vienkārši noslaukot to ar spirtā samitrinātu kokvilnas vatīti.

Pateicoties šīm īpašībām un pārliecinošam vispārējam sniegumam, produkta saņemtais vērtējums ir 98%, un visi 29 konsultanti apliecināja, ka viņi ieteiktu CLEARFIL MAJESTY™ ES Flow saviem kolēģiem. Kopš 2015. gada produkts atkārtoti ir saņēmis balvu „Top Product Award“; tas ir pieejams ar trim dažādām viskozitātēm, tāpēc visdrīzāk tas kļūs par produktu, ko izvēlas vēl plašākam klīnisko indikāciju lokam.

The Function that becomes aesthetics

Italian dental technician, CDT Stefano Lograno, demonstrates how it is possible for the medical-technical prosthetic team to adopt a protocol from diagnostics to cementation, in which aesthetics can be functionally guided in a simple, predictable and standardized workflow following the criteria of the gnathological school of Vienna of Prof. Rudolf Slavicek.

Click here to read. Enjoy!

Start Reading: BOND | SPECIAL EDITION | 6/2021

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BOND | VOLUME 7 | 10/2020

Pīters Šoutens

Tehniskais vadītājs Kuraray Europe Benelux

Pirmie plūstošie kompozīta materiāli zobārstniecības tirgū parādījās deviņdesmitajos gados. Tad šo materiālu sastāvs pilnībā balstījās uz jau esošajiem blīvējamajiem kompozīta materiāliem: tie saturēja tās pašas pildvielas un sveķu matricu, bet pildvielu saturs bija samazināts. Līdz ar to tiem bija zemāka viskozitāte, kā rezultātā uzlabojās materiāla plūstamība vieglākai modelēšanai un pielāgošanai kavitātes sienām, bet pasliktinājās materiāla fizikālās un mehāniskās īpašības. Šo faktoru dēļ, plūstošie kompozīta materiāli tika izmantoti tikai kā noderīgs papildinājums jau esošajam kompozīta materiālu klāstam. Tos plaši izmantoja V klases kavitāšu restaurācijām un kā laineri lielām I un II klases kavitātēm.

Lai paplašinātu sākotnēji ierobežoto indikāciju klāstu, Kuraray Noritake Dental nolēma koncentrēties uz plūstošo kompozīta materiālu mehānisko un fizikālo īpašību uzlabošanu, izstrādājot pilnīgi jaunu produktu klāstu: CLEARFIL MAJESTY^TM ES Flow universālo plūstošo kompozītu. Lai gan tā priekštecim – CLEARFIL MAJESTY^TM Flow – ir lielāks pildvielu daudzums un līdzīgas mehāniskās īpašības, termins “universāls” norāda, ka šie jaunie materiāli ir pielietojami patiešām universāli. To potenciālās indikācijas, salīdzinot ar kādreizējo plūstošo kompozīta materiālu indikāciju diapazonu, ir ļoti plašas. Neatkarīgi no tā, vai zobārstam ir nepieciešams laineris vai materiāls lielas II klases kavitātes restaurācijai, CLEARFIL MAJESTY^TM ES Flow ir ideāla izvēle.

Trīs plūstamības pakāpes

Tā kā Kuraray Noritake Dental vēlējās radīt produktu, kas ir piemērots jebkurai klīniskajai situācijai, CLEARFIL MAJESTY^TM ES Flow ir pieejams trijās dažādās plūstamības pakāpēs.

Augstas plūstamības materiāls CLEARFIL MAJESTY^TM ES Flow High (ar zaļu etiķeti) ir paredzēts lietošanai kā laineris, vai arī nelielu nepilnību aizpildīšanai un nelielu bojājumu atjaunošanai, kas ļauj veidot minimāli invazīvas kavitātes. 

Vidējas plūstamības variants CLEARFIL MAJESTY^TM ES Flow Low (ar zilu etiķeti) ir universālākais materiāls no šīs sērijas, un to var izmantot lielākajai daļai indikāciju.

Zemākās jeb super zemas plūstamības opcija ir CLEARFIL MAJESTY^TM ES Flow Super Low (ar sarkanu etiķeti). To var izmantot lielāku sānu zobu kavitāšu restaurācijām un inleju vai onleju cementēšanai.

Profesionāļu starpā novērtēts produkts

Tas, ka šis materiāls zobārstu rokās darbojas labi, tika apstiprināts neatkarīgajā izdevumā Dental Advisor. 2019. gada janvāra–februāra numurā (36. sējums, 1. numurs) CLEARFIL MAJESTYT^M ES Flow ieguva Dental Advisor's Top Product Award balvu piekto gadu pēc kārtas. Ziņojumā tas tika aprakstīts kā “Universāls plūstošais materiāls ar augstu pildvielu saturu”, un tieši tā tas arī ir!

CLEARFIL MAJESTY ES Flow jau piekto gadu pēc kārtas ir ieguvis Dental Advisor’s Top Product Award balvu.

Atšķirībā no agrīnās paaudzes plūstamajiem materiāliem, CLEARFIL MAJESTY^TM ES Flow ir augsts pildvielu saturs un lieces izturība, kas ir pat lielāka nekā lielākajai daļai no citiem plaši izmantotajiem kompozīta materiāliem.

Tā kā universālajam plūstošajam kompozītA materiālam ir tik daudz pozitīvu īpašību, zobārstiem varētu rasties kārdinājums līdz šim izmantoto blīvējamo kompozīta materiālu aizstāt ar CLEARFIL MAJESTY^TM ES Flow. Lielākajai daļai indikāciju tas patiešām ir iespējams. Tie, kas to arī izdarīs, atklās, ka materiāla lietošana un modelēšana pa taisno no šļirces darbojas ļoti labi un novērš nepieciešamību pēc papildus instrumenta.

Unikālas tehnoloģijas

Kas padara šo materiālu tik unikālu? Iespējams, ka tā ir esošo un jauno tehnoloģiju kombinācija, kā rezultātā tiek iegūtas izcilas mehāniskās īpašības, augsts estētiskais potenciāls un lieliskas apstrādes īpašības. Kuraray Noritake unikālā gaismas difūzijas tehnoloģija, kas ir izmantota estētisko CLEARFIL MAJESTY^TM ES-2 kompozīta materiālu klāstā, tiek izmantota arī CLEARFIL MAJESTY^TM ES Flow ražošanas procesā. Apvienojumā ar patentēto filleru tehnoloģiju, šī inovatīvā tehnoloģija ir atbildīga par to, ka no CLEARFIL MAJESTY^TM ES Flow izgatavotās restaurācijas gandrīz nevainojami integrējas apkārtējā zoba struktūrā.

Trešais svarīgais materiāla komponents ir silāna tehnoloģija. CLEARFIL MAJESTY^TM ES Flow izmantotais garās ķēdes silāns nodrošina optimālu pildvielu daļiņu mitrināmības spēju. Tas ir galvenais iemesls, kāpēc pildvielu procentuālo daudzumu ir iespējams palielināt līdz tik augstam līmenim. Pēc polimerizācijas stiprā saite starp pildvielām un sintētiskajiem sveķiem, ko rada silāns, rada ilgstošu adhēziju. Tāpēc arī materiāla ūdens absorbcija ir ārkārtīgi zema. Šī īpašība ir labi pazīstama jebkuram Kuraray Noritake kompozīta materiālu lietotājam.

Unikālā CLEARFIL MAJESTY^TM ES Flow sastāva dēļ, tam ir lieliska pulējamība un ilgstoša spīduma noturība. Pulēšana neprasa piepūli. Vien noslaukot ar spirta salvetīti tiek iegūts skaists spīdums.

Ar visām šīm priekšrocībām apvienotām vienā produktā, CLEARFIL MAJESTY^TM ES Flow piedāvā nepārspējamu komfortu darbā pie kompozīta materiālu restaurācijām. Kuraray Noritake Dental lepojas ar savām tehnoloģiskajām inovācijām un izmanto tās, lai sniegtu lietotājam bezgalīgas iespējas darbā ar universālu plūstošu kompozīta materiālu.

Conventional Cementation Vs. Adhesive Luting

Proper luting of indirect restoration is critical in achieving long-term success as it highly influences the retention of the restoration.

With the availability of different types of cements, the decision of choosing the suitable luting agent and method can be confusing for the practitioner. Especially with the wide use of contemporary restorative materials such as new generations of highly translucent zirconia as well as reinforced-composites, it is important to take into consideration that the properties of such materials differ highly from metal or earlier generations of zirconia.

Subsequently, the choice of the luting agent must be appropriate to achieve satisfying results and long-term success. Therefore, the aim of this online seminar is to provide insights for the clinicians on choosing the correct luting agent that can help achieve satisfactory results for the dentist as well as the patients.

Dr Adham Elsayed

• PhD degree in Prosthodontics and Implantology from the University of Kiel, Germany
• Certified Specialist in Prosthodontics, German Society for Prosthetic Dentistry and Biomaterials (DGPro)
• Certified Specialist in Implantology, German Society for Implant Dentistry (DGI)
• Clinical & Scientific Manager DACH, Kuraray Europe GmbH

Case by Francesco Ferretti and Marco Nicastro

Aesthetic restoration of anterior teeth using KATANA™ UTML Full anatomical crowns, with vestibular stratification and BOPT*¹.

^{*1 Biologically Oriented Preparation Technique}

Initial situation

Final result

Shows excellent aesthetic properties of KATANA™ UTML and the perfect integration in harmony with pink tissues.

Figure 1. The patient requested a solution for an aesthetic problem due to unnatural look of old restorations and black triangles coming from past history of periodontitis. The resulting retraction of the tissues had left the margins of the prosthesis clearly visible, and the loss of the papilla peaks, together with the numerous black spaces between the crowns, required a complex therapeutic approach.

Figure 2. The treatment plan for the periodontal problems con-sisted of a non-surgical approach, with scaling and root planing, and the replacement of the previously fixed prostheses to recondition the marginal tissues and facilitate the restoration of a new, aesthetically pleasing gingival architecture.

Figure 3. From a functional point of view, we decided to reduce the deep frontal bite to restore a correct overjet-overbite ratio. This reduction was also important from an aesthetic point of view, as it allowed us to shape the various elements correctly.

Figure 4. We usually remove old prostheses before beginning a periodontal treatment, and make a first, provisional restoration to create an environment in which the soft tissues can heal. If we have to work beyond the cement enamel joint (CEJ), we prefer a vertical preparation for posts, and the purpose of the provisional restoration is to condition the marginal tissues using Dr. Loi’s BOPT.

Figure 5. For the BOPT, the vertical preparation of the post has a finish line that extends inside the gingival sulcus. The temporary conditioning of the tissues induced by the provisional prosthesis allows us to modify the level of the gingival parables to a certain extent.

Figure 6. The image on the left shows the clinical healing of the tissues one month after the initial periodontal treatment. The role of the provisional restoration, appropriately realigned, is clear. The conditioning of the tissue has been achieved by means of the provisional restoration, which has modified the level and shape of the marginal tissue. Once filled with correctly fitted crowns, the interproximal spaces will be further reduced after the definitive restoration.

Figure 7. The correct management of the provisional restoration is crucial for the healing of the tissues. The placement of a provisional restoration before the periodontal therapy has allowed us to create the right environment for complete healing. At the same time, the vertical preparation has allowed us to gradually condition the marginal gingival tissue by shortening or lengthening the provisional restoration as necessary.

Figure 8. One of the advantages of a vertical preparation is that taking the final impression is easy, because the absence of a horizontal finish line greatly simplifies the procedure. On the other hand, the BOPT also requires the taking of an impression of the sub-gingival portion of the preparation. The dental technician will have to decide marginal shape of restorations according to the position of the gingival line in consultation of the clinician, and based on the tests conducted with the provisional restoration.

Figure 9. After the casting of the model, we prepared the gingival area to accommodate an ideal configuration of gingival parables.

Figure 10. After making a wax model, we assessed whether the height of the gingival zenith level could be further corrected. This photo shows that gingival level of 21 was not yet ideal, so we stretched it distally.

Figure 11. Once the wax model was complete, we extracted the element from the model and evaluated its protrusion. It was only after joining the gingival protrusion to the arbitrary margin of the preparation that we proceeded to a scan and milled the crowns.

Figure 12. The restoration was carried out with Katana™ UTML zirconia based on the new formulation of cubic zirconium oxide. This ultra tralucent material was chosen because we were working with light and non-discolored posts.

Figure 13. We finished the crowns on a positional impression to help to improve the gingival adaptation; we had some dispersion of the tissues in the first precision impression due to the use of retractors. We finished the crowns with CZR FC Paste Stain colours and glaze.

Figure 14. The surface colours and the slight contrast created are highlighted in this black-and-white image taken with a blue filter.

Figure 15. In this translucent image, we can see the natural translucent effect of KATANA™ UTML and invisible fusion between abutments and crowns.

Figure 16. Clinical image one year after cementation made with PANAVIA V5; this shows the good clinical condition of the marginal tissue, with no signs of inflammation or bleeding. The BOPT allowed us to optimise the level of the gingiva without resorting to periodontal surgery, while the shape of the new crowns has made it possible to close all interproximal spaces for an optimally aesthetic result.

Figure 17. The brightness of the restorations (thanks to the use of a particularly translucent zirconia) combined with the shape of the incisors, has greatly im-proved the aesthetic of the restoration, even though the condition initially appeared to be particularly unfavourable.

Figure 18. Compared to the previous prostheses, the incisal reduction allowed not only for the optimisation of the functional phase by reducing the overbite, but also made it possible to achieve a more natural aesthetic, with the contour of the incisal margins following that of the lower lip.

Dentists:

FRANCESCO FERRETTI

Born in Rome on 15th March 1957, Francesco Ferretti gets his degree as dental technician at the Institute “Edmondo de Amicis”, in Rome. In 1980, he starts working and, from 1987 to 1994, he cooperates with IVOCLAR VIVADENT giving consulting as ceramist. In 1992 he starts working exclusively with Prof. Mario MARTIGNONI.

• After one year cooperation with Prof. Martignoni, he starts working with the ORAL DESIGN CENTER founded in Rome by Mr. Willi Geller, and becomes a partner, improving prosthesis esthetics.
• Is registered outside the course of dentistry at the University of Rome Tor Vergata.
• In 2001, he founds ESTECH DENTAL STUDIOS, in cooperation with Pentron for technical training and consulting.
• He has published articles and studies in Italian and American magazines. He is interested in Metal Free techniques.
• Winner of the 2004 Polcan Aiop.
• He is a member of: ANTLO LAZIO ( National Association of Lab Owners) with the president of the Lazio region 2013-2014.
• National cultural manager ANTLO 2017-2020.
• Teacher of prosthetics perfectioning at the University of Chieti for the year 2002, he has been re-confirmed for the year 2003, 2004, 2005 to deal with Metal Free.
• Teacher of prosthetics perfectioning at the University of Naples 2006.
• He has participated as a speaker at numerous conferences in Italy. ESCD member has participated as a speaker at ten in Florence 2009 and Turin 2013.

MARCO NICASTRO

Marco Nicastro takes a degree in “Odontoiatria e Protesi Dentaria (Dentistry and Dental Prosthesis) at the University of Rome “ La Sapienza in 1989. Since the beginning he is interested in prosthesis restoration dentistry and aesthetic problems.

• From 1990 to 1996 he attends Prof. Martignoni’s studio, where he develops his prosthesis knowledge.
• From 1993 to 1998 he cooperates as lecturer with the Oral Design Centre in Rome, directed by Mr. Ferretti and Mr. Felli, giving lectures and courses about aesthetic restoration either in Italy or in foreign countries. In the same period he enlarges his experience in aesthetics, attending training courses at the University of Geneva, in Switzerland.
• Since 1993 he has been cooperating with Mr. Francesco Ferretti in the organization of Courses and Conferences, paying particular attention to metal free methodology.
• Vice President of the European Society of Cosmetic Dentistry (ESCD).
• Founding member and active member of Gimnasium interdisciplinary CAD-CAM (GICC).
• Active member of the Italian Society of Conservative Dentistry (SIDOC).
• Partner of the Italian Academy of Prosthetic Dentistry (AIOP).
• President of Like Mine Dental Education in Rome since 2001.
• He won, with Francesco Ferretti, the Polcan award of the Italian Accademy of Prosthetic Dentistry in 2004.

With so many different adhesives, cements, and restorative materials available on the dental market, it seems difficult to decide which products are best suited to fulfill the individual requirements. A direct comparison obtained through testing of all products in the dental office is simply impossible due to the great number of available solutions. Laboratory investigations provide information about specific product properties, but usually cannot create the overall picture. Moreover, the results of different tests are barely comparable due to variations in test conditions. Clinical study results are very useful as they shed light on clinical (long-term) performance of selected materials, but they are usually published years after a product’s launch. Hence, they are not available in the early stages. A great source of information are practice-based evaluations, as they support potential users in identifying high-quality dental materials.

One of the institutions conducting and publishing practice-based clinical evaluations and product performance tests is the US-based DENTAL ADVISOR. Once per year, the dental materials and equipment with the best performance receive a Top Product or Preferred Product Award. The list of winners is published online (www.dentaladvisor.com) and in the January-February issue of the DENTAL ADVISOR. In 2021, numerous products from Kuraray Noritake Dental Inc. were among the award winners.

Top Product Awards

CLEARFIL™ SE Protect received a Top Product Award in the category Direct Restoratives, Bonding Agent: Self-Etch. The self-etch adhesive is based on the formulation of the gold standard two-step self-etch adhesive CLEARFIL™ SE BOND but contains an extra MDPB monomer offering an antibacterial cavity-cleansing effect and fluoride for long-term fluoride release. The honoring of the DENTAL ADVISOR is based on a material test carried out by 13 DENTAL ADVISOR consultants and editors in their dental offices for six weeks. Due to its excellent performance, the antibacterial self-etch adhesive received a 98 percent clinical rating.

For the sixth year in a row, the Top Product Award in the category Direct Restoratives, Composite: Highly Filled Flowable went to CLEARFIL MAJESTY™ ES Flow.

The universal flowable composite that also became the Editor’s Choice comes in three different levels of flowability, from high to super low*. This enables the user to choose the right viscosity for every clinical situation – with the high flowability variant being the perfect choice for cavity lining and as a resin coat in IDS procedures, and the super low flowability option being specifically suited for direct veneer procedures and even for build-up of posterior cusps etc. The universal flowable composite was tested by 29 consultants of the DENTAL ADVISOR in more than 900 clinical applications. The evaluated properties – placement/handling, aesthetics, viscosity and polishability – were rated “excellent”. This led to a recommendation rate of 100 percent and a 98 percent overall clinical rating.

^{*DENTAL ADVISOR evaluated only the standard level of flowability (Low), because other two variants are not available in US.}

A product that earned recognition from the Dental Advisor for the seventh time already is TEETHMATE™ DESENSITIZER for hypersensitivity treatment.

The product that won a Top Product Award this year was designed to create hydroxyapatite (HAp), which is able to occlude open dentinal tubules and enamel cracks. This leads to a significant reduction of hypersensitivities when applied to exposed, mechanically treated or freshly prepared dentin. When used in the context of restorative treatment, TEETHMATE™ DESENSITIZER does not have a negative effect on the bond strength of dental adhesives or cements. A six-month clinical evaluation conducted by the DENTAL ADVISOR involving 27 patients with gingival recession-related hypersensitivity revealed that the use of the product is very effective in providing immediate and even long-term (six-months) hypersensitivity relief. This resulted in an excellent rating with a score of 96 percent.

In the category Self-Adhesive Cement, an additional Top Product Award went to PANAVIA™ SA Cement Plus. The dual-cure self-adhesive resin cement stands out due to its ease of use, favorable viscosity and an easy excess removal feature after tack-curing.

Preferred Products

Among the 2021 Preferred Products that also received an Editor’s Choice label is PANAVIA™ SA Cement Universal. The Top Product Award winning self-adhesive universal resin cement from 2020 contains the unique LCSi monomer. This monomer is a silane coupling agent, which has a unique long carbon chain in its molecule. This carbon chain establishes a durable, chemical bond with porcelain, lithium disilicate and composite resin without the need for a separate silane containing primer. The other key technology present in the formulation is the original MDP monomer, which ensures chemical reactiveness with zirconia, dentin and enamel. Together, the technologies ensure that PANAVIA™ SA Cement Universal produces a strong and durable bond with virtually every restorative material without the need for a separate primer. Its handling characteristics, aesthetics and gingival friendliness received very good to excellent ratings from 31 clinical evaluators, who used the cement in 516 applications. The result of the overall clinical rating was 96 percent.

Moreover, CLEARFIL™ Universal Bond Quick was honored as a Preferred Product by the Dental Advisor consultants for the second consecutive year.

The universal bonding agent may be applied using the self-etch technique or – together with K-ETCHANT syringe – in the selective enamel etch or total-etch technique. Containing our rapid bond technology – a combination of the original MDP monomer with innovative hydrophilic amide monomers – the adhesive works instantly and without the need for extended exposure times, application of multiple layers or extensive rubbing into the tooth structure. The fast and easy application procedure was one of the main reasons for the consultants of the DENTAL ADVISOR to select CLEARFIL™ Universal Bond Quick as a Preferred Product and Editor’s Choice with a 98 percent score in a clinical evaluation.

Finally, CLEARFIL™ CERAMIC PRIMER PLUS became a Preferred Product in 2019, 2020 and 2021, and an Editor’s Choice in 2021. It contains the original MDP monomer and a silane monomer, which ensure excellent bond strength to all kinds of restorative materials, i.e., to silica-based ceramics, zirconia, composites and even metals. Users benefit from procedural simplicity as the product is just applied and dried to the bonding surface after the recommended pretreatment. In a clinical evaluation, the product received a recommendation rate of 96 percent and a 96 percent overall score from the DENTAL ADVISOR consultants.

Conclusion

Most of the Kuraray Noritake Dental products that received an award this year are based on resin technologies, one of our key competencies. In the 1980s, we developed the original MDP monomer, a functional monomer, which is an essential component of any adhesive product we introduced down to the present day, including the award-winning CLEARFIL™ SE Protect, PANAVIA™ SA Cement Universal, CLEARFIL™ Universal Bond Quick and CLEARFIL™ CERAMIC PRIMER PLUS. This is only one of our many areas of expertise. We also provide users with preventive products and a whole range of restorative materials – from composite filling materials like CLEARFIL MAJESTY™ ES Flow to dental ceramics like KATANA™ Zirconia UTML, STML and HTML. We see the winning of the awards as a positive proof of a reliable product performance that supports dental practitioners in reaching their own goals.

Interview with Dr Imad Ghandour

In recent years, zirconia has emerged as the preferred choice for dentists who wish to perform restorative procedures with a reliable and metal-free material. With the recent development of multi-layered aesthetic high-translucency options, zirconia’s popularity has further increased. In comparison to the opaque whiteness of older generations of zirconia, these newer versions have an enhanced appearance and functionality that makes them suitable for natural-looking anterior restorations.

Kuraray Noritake Dental’s KATANA Zirconia disc range is made with a proprietary zirconia powder - processed in-house - that gives it its natural appearance. Suitable for zirconia prostheses, from single crown to full arch, it is an ideal option for restorations in both the anterior and posterior regions. We spoke with Dr Imad Ghandour, a prosthodontist with a strong scientific background and a private practice in Le Cannet in France, about his experiences with the KATANA Zirconia range in restorative procedures.

Dr Ghandour, when did you first start using zirconia as a material for your restorations?

In 1998, when I was still sintering manually, I began using zirconia alumina. It was nice to have an alternative to metal alloys that was much more aesthetic. From 2003, however, I started with VITA blocks, but only for frameworks - I would still build up with ceramics. Now, with so much of dentistry being digitally focused, there is a need for a material that can be milled without changing anything in the morphology of the teeth. Why? Because we need to be able to reproduce the treatment plan as accurately as possible. Simply put, the KATANA Zirconia range solves this need for me.

With respect to dentistry being digitally focused, how has this changed the role of the dentist regarding performing restorative procedures?

Well, it is clear that we have entered the age of digital dentistry. Around 80 per cent of restorations are conducted via CAD/CAM systems and without dentists even touching the materials themselves. There are great advances being made in the technologies that are available for everyday use in dental practices worldwide, and many of them can be used to assist dentists performing restorative procedures. It is important, though, to keep in mind that these technological advancements alone will not lead to better results - they should supplement the requisite hands-on skills and techniques that all dentists must first learn. With this base of fundamentals, we can then use digital dentistry to make restorative procedures more predictable and reproducible. Of course, to ensure the best results in restorative procedures, dentists also need to use the materials that have the best aesthetic and mechanical properties.

For how long have you been using Kuraray Noritake Dental’s KATANA Zirconia range, and what has your experience been?

I have been using KATANA Zirconia for a little bit more than one year. In that time, I have primarily used the KATANA Zirconia STML (Super Translucent Multi Layered) line and have been pleasantly surprised by how natural-looking the restorations I have made with the material are. For example, when I sinter a crown made of Katana Zirconia STML, I am amazed at how much the sintered material is reminiscent of a pearl - it truly brings to mind the idea of one’s teeth being one’s pearly whites.

When using KATANA, how do you ensure that you select the correct shade to achieve a natural look?

Firstly, no one - not a dentist nor a dental technician - can be absolutely certain that the shade and chroma of the restoration that is in one’s hand will be the same once it is in position in the oral cavity. This is due to the complexities of the oral environment - the pinkness of the gingivae, for one, can have a large impact on how the restoration appears, often making it seem far duller than it does in the light of a dental laboratory. This can cause dental practitioners to compensate and make prostheses that appear far brighter than they will when they are in place.

With a product like KATANA and its related glazing materials, however, I can create crowns and other restorations that have an optimal fluorescence and translucency and are able to maintain their shading better than any other ceramic material I have used. I am able to select a shade with the confidence that it will look exactly the same once placed inside the mouth, with its chroma remaining unabsorbed by the gingiva. Achieving a natural look, then, depends on choosing a shade that is as close to that of the surrounding dentition as possible. Since KATANA Zirconia UTML (Ultra Translucent Multi Layered) is available in 16 standard shades and a further four enamel shades, there is no shortage of options in this regard.

How does the multi-layered technology of KATANA Zirconia help you to achieve optimal and natural-looking aesthetic results?

Well, firstly, the layering of the material is designed to replicate the colour and translucency progression of natural teeth, which allows for restorations to blend in as much as possible. This multi-layered technology has also proved itself to be very handy when I am sintering crowns made of KATANA Zirconia. Simply put, if one sinters a crown quickly, it will be a little more opaque. If one sinters it at a higher temperature and quite slowly, it will be much more translucent. The multi-layered aspect of KATANA Zirconia is excellent in that it gives me the ability to make restorations more or less translucent depending on what is required.