429 Too Many Requests

A discoloured abutment tooth, a metal post or tooth-coloured gum areas: It is not always possible to meet the target tooth or gum shade with a pre-shaded zirconia framework. Porcelain layering on a differently coloured base, however, is likely to deliver unexpected outcomes. The “CERABIEN™ ZR” Shade Base line-up has been developed and recently extended by Kuraray Noritake Dental Inc. for those who would like to avoid surprises and provide for a favourable framework colour, right from the start of porcelain layering. The five new opaque shades deliver approximately five times higher opacity than conventional “CERABIEN™ ZR” Shade Base porcelains, and can mask the base colour much more effectively for even more lifelike restorations.

The “CERABIEN™ ZR” Shade Base opaque shade line-up consists of three shades that reproduce tooth colour: Opaque White as a bleaching shade, Opaque Light as an A2 shade, and Opaque Dark as an A3.5 shade. They may be mixed or applied as delivered to the zirconia framework in thin layers to mask severely discoloured or metal areas. In most situations with a severely discoloured base, a precise matching of the target shade is achieved by applying an opaque shade as a first layer and a target-coloured “CERABIEN™ ZR” Shade Base as a second layer.

The other two new opaque shades – “CERABIEN™ ZR” Opaque Light Tissue and Opaque Dark Tissue – are used in a similar way to create a pink-opaque base in the gum areas of tooth-coloured zirconia frameworks (e.g. made of KATANA™ Zirconia Multi-Layered discs), which is perfect for reproducing gingival colour. Applied as a thin coating, the opaque tissue shades neutralise the tooth colour and their moderate reflection improves the colour effect of the subsequently applied tissue porcelains.

With their high masking ability, the new opaque shades make it even easier to adjust zirconia framework colours for highly aesthetic porcelain layering – no matter whether the base colour of a tissue or tooth area needs to be optimized.

Testimonial article by Dr. Michael Teitelbaum, DMD, MAGD, FACD

A self-adhesive resin cement that contains MDP and LCSi monomers, allowing it to adhere to virtually every material without the need for a separate primer.

Ready to say goodbye to complicated bonding procedures, Dr. Michael Teitelbaum said hello to simplicity with Kuraray Noritake Dental Inc.‘s PANAVIA™ SA Cement Universal, a versatile cementation solution that simplifies his restorative workflow without sacrificing long-term bond strength. “PANAVIA™ is a name I’ve known and trusted since my prosthodontic program over 30 years ago,” shared Dr. Teitelbaum, who said PANAVIA™ SA Cement Universal allows him to confidently cement restorations because of its long-term reliability.

ALL-IN-ONE CEMENTATION SOLUTION

A self-adhesive resin cement that eliminates the need for a separate primer, PANAVIA™ SA Cement Universal contains a unique LCSi monomer that delivers a strong, durable chemical bond to porcelain, lithium disilicate, and composite resin, while a MDP monomer chemically reacts with zirconia, dentin, and enamel. “When I find myself cementing zirconia, my go-to cement is PANAVIA SA™ Cement Universal because it contains MDP, the magic ingredient that lets it actually bond to zirconia,” Dr. Teitelbaum explained. Thanks to a single-step bonding formula, PANAVIA™ SA Cement Universal is an easy-to-use, all-in-one cementation solution, and the material is available in both automix and handmix options. “One of the nice things about PANAVIA™ SA Cement Universal is if you’re in a hurry, maybe doing multiple units or working alone, you can use the automixing syringe tip and inject it into each crown,” said Dr. Teitelbaum. “Or if you’re naturally fast, like my assistant of over 20 years, you can hand mix the cement and load it directly into the crowns.”

“My go-to cement is PANAVIA™ SA Cement Universal because it contains MDP, the magic ingredient that lets it actually bond to zirconia.”

- Michael Teitelbaum, DMD, MAGD, FACD –

VERSATILE AND EASY TO USE

PANAVIA™ SA Cement Universal adheres to virtually all restorative materials without the need for a separate primer, silane, or etchant, simplifying the cementation workflow for clinicians and saving time for patients. “I have a patient who not only gags but makes more saliva than the Colorado River,” joked Dr. Teitelbaum. “It was nearly impossible [with other cements] to keep No. 31 dry long enough to sandblast, etch, prime, mix cement, load the crown and seat it. PANAVIA™ SA Cement Universal was the only cement I could get to work for him.” After the restoration is placed, any excess cement is easy to clean up after a quick 2 to 5 second light cure. “Once you’ve fully seated the crown, you can wave the curing light over the margins for a couple of seconds to just start the set. The excess material easily pops off while still in the rubbery phase,” said Dr. Teitelbaum. PANAVIA™ SA Cement Universal comes in 3 shades, universal (A2), translucent and white, which Dr. Teitelbaum says are suitable for most situations. “For translucent restorations, like inlays where the margins might be visible, I prefer a translucent or universal shade cement,” he said. “But where I may need to see the cement again someday, like an opaque crown or post, I prefer straight white.” Suitable for crowns, bridges, inlays/onlays, posts, and adhesion bridges, PANAVIA™ SA Cement Universal is a versatile cementation solution for virtually every material.

Dentist:

MICHAEL TEITELBAUM
DMD, MAGD, FACD

Case by Richard Young DDS, San Bernardino, CA

Easy procedure, reliable outcome: that is what most dental practitioners may wish for when placing indirect restorations. The following clinical case example is used to demonstrate an easy, but highly successful clinical protocol for the luting of a lithium disilicate crown.

Fig. 1. Lithium disilicate crown after etching of the intaglio surface with hydrofluoric acid and try-in.

Fig. 2a. Application of KATANA™ Cleaner into the crown for a complete removal of contaminants such as proteins from blood and saliva, which may compromise the performance of any resin cement system.

OR Fig. 2b. Alternatively, KATANA™ Cleaner is applied into a mixing well.

Fig. 3. Application of KATANA™ Cleaner to the restoration.

Fig. 4. KATANA™ Cleaner is applied to the prepared tooth structure in the same way (rubbing for ten seconds followed by rinsing and drying).

Fig. 5. Application of PANAVIA™ SA Cement Universal into the cleaned crown.

Fig. 6. The cement contains a unique silane coupling agent – the LCSi monomer - for a strong and reliable bond to lithium disilicate and other restorative materials like glass ceramics and hybrid ceramics.

   The Silane is activated in the mixing tip by Original MDP.

Fig. 7. Easy clean-up after two to five seconds of tack-curing.

Fig. 8. The excess resin cement is in its gel-state and removed in one piece with an explorer.

FINAL SITUATION

Fig. 9. Treatment outcome immediately after crown placement.

Dentist:

RICHARD YOUNG DDS

Case and images courtesy of Richard Young DDS, San Bernardino, CA

Is it possible to reduce the number of different cements used in a dental office? In most cases, it is. Kuraray Noritake Dental Inc. is convinced that one or two resin cement systems are usually enough to cover every indication and every need for general cementation. The selection of products may be different depending on personal preferences and the focus on specific dental treatments.

That is why the company offers three high-quality resin cements, with which it is possible to meet the needs and desires of every dentist and patient. One product is available for those who would like to keep it as simple as possible while taking advantage of the multiple benefits resin cements offer over conventional cements. Another system is designed for those who demand highest possible bond strength and aesthetics. And finally, a light-curing system has been developed as a specialized solution for veneer cementation.

In order to facilitate decision making, this article provides in-depth information on each of the three systems and their specific strengths.

The everyday cement

Keeping cementation simple and efficient is possible by minimizing the number of work steps and components and solving existing challenges. The self-adhesive dual-cure resin cement PANAVIA™ SA Cement Universal has been designed for these purposes. The challenge of removing sticky excess cement is overcome by a formulation that allows for very easy excess clean-up.

Components are reduced as the product incorporates Kuraray Noritake Dental Inc.’s Original MDP Monomer and original silane coupling agent, the LCSi Monomer, for a strong and durable bond. While MDP establishes a strong and long-lasting chemical bond to enamel, dentin, metal and zirconia, LCSi is responsible for bonding to resin composite, porcelain and silica-type ceramics (like lithium disilicate), eliminating the need for separate primers.

This means that a single component is needed, which streamlines the procedure, leading to time savings and a minimized potential for errors. Due to its properties, PANAVIA™ SA Cement Universal is ideal for everyday procedures such as the permanent cementation of crowns and bridges made of zirconia, lithium disilicate, hybrid ceramic or even metal.

The strong and aesthetic allrounder

For those who place importance on achieving the highest possible bond strength and aesthetics, PANAVIA™ V5 is the solution. The reliable dual-cure cementation system consisting of a tooth primer, a cement paste and a ceramic primer produces the highest bond strength and aesthetics from the PANAVIA™ cement range.

Therefore, it is an excellent choice for a whole range of indirect restorations and for post-and-core procedures. As the well-aligned components are always combined and applied in the same way, standardization is supported, leading to predictable outcomes.

The veneer specialist

When fulfilling such demanding tasks as cementing veneers, every dental practitioner needs time. Especially when placing multiple veneers at once for the best aesthetic outcomes, having to race against the setting time is counterproductive. For this reason, Kuraray Noritake Dental Inc. developed PANAVIA™ Veneer LC, a light-curing resin cement system with an extended working time of 200 seconds* on the primer, which allows users to initiate polymerization whenever they are ready for it.

PANAVIA™ Veneer LC also offers a well-aligned paste viscosity and consistency for easy dispensing and seating, and comes in four highly colour-stable shades for long-lasting aesthetics. Finally, the system provides for easy excess removal after tack-curing and an excellent bond strength over time.

** Working time: sensitivity to light (8000 lux, ISO 4049)

Meeting expectations

The three products mentioned are precisely what is needed to cover every personal preference and specific indication. They are based on Kuraray Noritake Dental Inc.’s long-standing expertise in the development of adhesive resin cements. The first product from the PANAVIA™ brand was introduced in the 1980s and since then, the company never stopped improving the portfolio by combining existing technologies like the original MDP Monomer with newly developed ones, such as the LCSi Monomer and the Touch Cure Technology. All this ultimately resulted in the current lean portfolio of easy-to-use and highly aesthetic resin cements that provide top-level bond strength.

The prerequisite for adhesive luting is a reliable bond between the tooth and the restorative material. The quality of the bond depends on the resin cement and its correct application. The state of the bonding surface also plays a decisive role. The surfaces of the tooth and restoration must be conditioned and clean. We spoke with Dr. Adham Elsayed.

All-ceramic restorations require adhesive luting. Is this true for all restorative materials (zirconia, lithium disilicate, hybrid ceramics, etc.)?

Yes and no, several factors must be taken into account. The first important factor are the material properties, especially the flexural strength. Fortunately, clear guidelines based on scientific studies are available. As a guideline, all materials with a flexural strength of less than 350 MPa should be placed with an adhesively luted. Correct adhesive luting stabilizes the restoration and tooth structure. Restorative materials of higher strength (e.g. reinforced glass-ceramics, lithium disilicate ceramics, zirconia, etc.) can be cemented with conventional methods. However, some studies indicate that an adhesive luting can improve the overall stability, whereas others show no significant difference.

Another factor guiding the decision for or against adhesive luting is the preparation design. For crowns and bridges, the decisive factor is whether the operator has been able to adhere to the preparation guidelines (minimum abutment height of 4 mm and maximum convergence of 15 degrees)1-5 in order to create the required retention and resistance form for conventional cementation. Minimally invasive restorations, such as resin-bonded fixed dental prothesis (FDPs), veneers and inlay FDPs, are based on a non-retentive preparation design. In such cases, only adhesive luting can ensure adequate retention.

Aesthetics is another important factor. Besides the restorative material, the luting material also has a major impact on the optical outcome. For highly translucent ceramics in particular, it is recommended to resort to adhesive luting. While conventional cements are usually only available as opaque materials, resin composites come in different colours with higher colour stability (PANAVIA V5 or PANAVIA SA Universal).

How should the surface be pre-treated or conditioned for adhesive luting?

Pre-treatment of the surface depends on the structure or microstructure of the ceramic. Silicate ceramics (e.g. glass ceramics) have a glass phase and can be etched. Etching increases the surface area, thus preparing it for adhesive luting. In contrast, oxide ceramics like zirconia as well as composites have no or neglectable amount of glass phase. They cannot be etched. Their surface is conditioned by air-abrasion (with aluminium oxide). This is the only current method which is scientifically proven for achieving a dependable bond with these materials.

How important is correct cleaning of the tooth and restoration surface for the quality of the bond?

The restoration surface must be decontaminated immediately prior to luting. Contamination must be removed thoroughly. Rinsing with water or alcohol has been shown to be insufficient. Therefore, cleaning solutions such as KATANA Cleaner have been developed.

Rub it in, rinse and dry—that's all—for optimal bonding procedures. Unlike other cleaning products, which have to be rubbed in for longer and are only suitable for extraoral use due to their high pH value, KATANA Cleaner is applied within 10 sec. and is suitable for both intraoral and extraoral use.

Any contamination is detrimental for the adhesive bond. At try-in of the restoration, for example, its surface becomes contaminated. Saliva, possibly blood, etc. accumulate and the proteins contained act to isolate all subsequently applied components (e.g. the primer). Any contamination must therefore be thoroughly removed prior to the bonding procedure. This is also the case for direct adhesive restorations. KATANA Cleaner offers a simple and quick way to accomplish this task.

What makes KATANA Cleaner so interesting for the user?

The special features of KATANA Cleaner are its integrated MDP salt and mild pH-value. Let's look at the function of the MDP salt. Rubbed in (for 10 seconds), the cleaner causes the contaminant particles (e.g. remnants from the work process, proteins from saliva, blood, etc.) to adhere to the MDP salt, like a magnet. The contamination is flushed out of the surface by rinsing with water. This ability is attributable to the MDP salt and makes KATANA Cleaner interesting and easy to use. In addition, the pH-value allows us to use the cleaning solution both intraorally and extra-orally, which is another special feature. We generally recommend the use of KATANA Cleaner—for both direct and indirect restorations. Thanks to the universal applicability of the cleaning solution, only one material is needed, while the time required is extremely low. Even for bonding abutments on a titanium base, cleaning with KATANA Cleaner is recommendable as it provides for an ideal basis (before applying the primer). In this case, contamination (e.g. finger grease, residues of the air abrasive) could also act as an insulator and impair the quality of the bond.

References:

1. Ladha K, Verma M. Conventional and contemporary luting cements: an overview. J Indian Prosthodont Soc. 2010;10(2):79-88.
2. Edelhoff D, Özcan M. To what extent does the longevity of fixed dental prostheses depend on the function of the cement? Working Group 4 materials: cementation. Clin Oral Implants Res. 2007;18 Suppl 3:193-204.
3. Güth JF, Stawarczyk B, Edelhoff D, Liebermann A. Zirconia and its novel compositions: What do clinicians need to know? Quintessence Int. 2019;50(7):512-20.
4. Smith CT, Gary JJ, Conkin JE, Franks HL. Effective taper criterion for the full veneer crown preparation in preclinical prosthodontics. J Prosthodont. 1999;8(3):196-200.
5. Uy JN, Neo JC, Chan SH. The effect of tooth and foundation restoration heights on the load fatigue performance of cast crowns. J Prosthet Dent. 2010;104(5):318-24.

How to condition ceramic surfaces prior to their cementation? And what are the parameters guiding the decision for adhesive, self-adhesive or conventional systems? Dr. Gerard Chiche and Prof. Dr. Markus B. Blatz know the answers. In this lecture, they shared exactly the knowledge needed to achieve predictable results.

October 7^th, 2022 marked the 10^th anniversary of the dental divisions of Kuraray and Noritake becoming Kuraray Noritake Dental Inc. For this celebration, ten internationally renowned experts shared their scientific, technical and clinical know-how in the virtual symposium titled “Up to now and from now on: From innovation to simplification”.

We prepared and uploaded the recording of this fifth and final lecture so you can watch it at your convenience.

Are you looking for an easy to use solution for your clinical workflows?

In this short video Swiss dentist Dr. Alessandro Devigus shares his experience using dual curing and self-adhesive cement PANAVIA SA Cement Universal.

Is it possible to simplify direct restorative procedures without compromising the outcomes? In many situations, it is – provided that the right materials and techniques are selected. In this lecture Dr. Nicola Scotti and Prof. Lorenzo Breschi focused on the single-shade technique, discussing its capabilities and limitations.

October 7^th, 2022 marked the 10^th anniversary of the dental divisions of Kuraray and Noritake becoming Kuraray Noritake Dental Inc. For this celebration, ten internationally renowned experts shared their scientific, technical and clinical know-how in the virtual symposium titled “Up to now and from now on: From innovation to simplification”.

We prepared and uploaded the recording of this fourth lecture so you can watch it at your convenience.

CLEARFIL MAJESTY™ ES-2 Universal and CLEARFIL™ Universal Bond Quick have helped me create long-lasting and aesthetic composite restorations with little to no sensitivity for my patients.­

- Donald Jetter, DMD –

Despite getting its start in the early 1900s manufacturing semi-synthetic fibers (former company of Kuraray Co., Ltd.), today, Kuraray Noritake Dental Inc. is known to clinicians as a restorative powerhouse—especially to those who have relied on its advanced material science for years to achieve consistently successful restorations. One reason for Kuraray’s success is the company’s introduction of adhesive monomers to dentistry nearly 4 decades ago. Years of careful research ultimately led to the development of the MDP monomer, whose molecular structure yields greater adhesion and a stronger chemical bond to enamel, dentin, metal, and zirconia. It is the foundation of all products in Kuraray’s CLEARFIL™ and PANAVIA™ product lines, and likely what has led teams of clinicians to crown several of these materials as DPS* Best Products.

CLEARFIL™: A STRONG BOND & AESTHETIC FILL

For restorative dentists, building a strong restoration calls for an artful combination of technique and materials. To satisfy the latter, Donald Jetter, DMD, relies on CLEARFIL™ adhesives and composites. “We have been using Kuraray’s CLEARFIL™ composites and bonding materials in our practice for a very long time now,” he shared. “Our dental supply rep first suggested the material to us as a cost-effective alternative to the composite we were previously using, and that she always received positive feedback from other doctors who had tried it. I reluctantly ordered some and have never looked back.”

After using CLEARFIL MAJESTY™ ES-2 in the A2 shade for several years with success, Dr. Jetter was excited to try out CLEARFIL MAJESTY™ ES-2 Universal, a single-shade composite for posterior restorations. It uses Light Diffusion Technology to mirror the way tooth structure distorts light, resulting in a virtually seamless blend between the restoration and surrounding dentition. Additionally, enamel-like translucency allows for easy polishing to a high gloss. “The new universal shade seems just a bit lighter than the A2 shade but works well to match adjacent tooth structure,” said Dr. Jetter. “I tried another universal shade product that came out prior to CLEARFIL MAJESTY™ ES-2 Universal, but I experienced material failure with it, and it did not handle as well as Kuraray’s material.”

CLEARFIL MAJESTY™ ES-2 Universal pairs well with CLEARFIL™ Universal Bond Quick, a single-bottle adhesive that houses both the original MDP monomer and AMIDE-based chemistry, which rapidly permeates dentin and enamel to eliminate waiting time and dramatically reduce water absorption. Together, the two monomers provide a unique Rapid Bond Technology. Dr. Jetter and his team has been using CLEARFIL™ Universal Bond Quick since it first came to market, after successfully using its predecessor, CLEARFIL™ Universal Bond, for many years. “I like these products because they are single-bottle, fluoride-releasing, universal adhesives with low odor that help achieve less postop sensitivity,” he shared. “I would highly recommend CLEARFIL MAJESTY™ ES-2 Universal and CLEARFIL™ Universal Bond Quick to other dentists, as they’ve helped me create long-lasting and aesthetic composite restorations with little to no sensitivity for my patients.”

PANAVIA™ SA Cement Universal: CEMENTATION SIMPLIFIED

Designed to remove both primer and silane from the cementation procedure, PANAVIA™ SA Cement Universal contains not one, but two monomers: the original MDP monomer and the LCSi monomer, which allows for a strong bond to porcelain, lithium disilicate, and composite resin. “In my 12 years of clinical practice, I have tried using a variety of different cements and what I find myself gravitating toward is the versatile powerhouse of Kuraray’s PANAVIA™, which makes sense since Kuraray revolutionized bonding by introducing the MDP monomer to the world,” said Bilyana Tesic, DDS, who practices in Monterey, CA. After using earlier generations of PANAVIA™ cements, which required mixing several bottles together before application, Dr. Tesic was excited when PANAVIA™ SA Cement Universal changed all that. “PANAVIA™ SA Cement Universal simplified this process into a single step delivered via automix dispenser. Voilà! One cement to rule them all.” Dr. Tesic has been using PANAVIA™ SA Cement Universal for the past two years, and what she appreciates most about the material is its versatility. “It is a self-adhesive, radiopaque, dual-cure resin cement that bonds to enamel, dentin, composite, semi-precious and precious metal, porcelain, fiber posts, and zirconia. It’s easy to dispense and even easier to clean up. Fast setting time, no need to refrigerate, and no postop sensitivity. That all adds up to no headache. I recommend it to anyone looking to simplify their cementation protocols without losing any bond strength.”

PANAVIA™ V5: 'V' IS FOR VERSATILITY

The strongest dentin bonding cement that Kuraray has ever developed, PANAVIA™ V5 simplifies cementation of crowns, bridges, inlays, onlays, veneers, and posts and cores. PANAVIA™ V5’s MDP-based Tooth Primer offers high bond strength in the self-cure mode thanks to unique catalyst technology, while a 1-bottle surface treatment applies to all indirect restorations. “I loved being able to cement a metal post-and-core and ceramic crown all at the same time with the same product,” said Dr. J. Jerald Boseman, who took part in the DPS product review of PANAVIA™ V5. He added that the cement was easier to use, had a longer set time, and was less technique-sensitive than similar products. Available in 5 shades–White, Brown, Universal, Clear, and Opaque–with corresponding try-in pastes, PANAVIA™ V5 offers easy removal of excess cement after light-curing. Just one drop creates a durable bond to hydroxyapatite, metals, composites, and zirconia. “So far, the retention has been good with excellent handling properties,” shared J. Michael Heider, DDS, who has also used previous generations of PANAVIA™ products. “I’m glad to see the best characteristics of PANAVIA™ are being improved further.”

How to select the best zirconia for a specific case? In this lecture, popular master ceramists RDT Aki Yoshida and DT Nondas Vlachopoulos presented their success strategies. They focused on the selection of the best suitable type of zirconia and finishing technique depending on the indication and on patient-specific needs.

October 7^th, 2022 marked the 10^th anniversary of the dental divisions of Kuraray and Noritake becoming Kuraray Noritake Dental Inc. For this celebration, ten internationally renowned experts shared their scientific, technical and clinical know-how in the virtual symposium titled “Up to now and from now on: From innovation to simplification”.

We prepared and uploaded the recording of this third lecture so you can watch it at your convenience.