429 Too Many Requests

An important aspect of a direct composite restoration is aesthetics. Choosing the right opacity, chroma and value is an absolute necessity for natural-looking results. However, working with a composite with built-in light diffusion technology will make life much easier. Due to this technology, a composite can blend seamlessly with the adjacent tooth structure.

What is light diffusion?

Simply put, light diffusion refers to a material’s ability to scatter and reflect light rays in many different angles. Composites without a form of light diffusion technology are less forgiving and that’s why preparation borders are still often visible through the composite. Alternately, a composite can be so opaque that the filling often stands out from the tooth tissue. With aesthetic composites, the ability to diffuse light in all directions, in a way that emulates these natural teeth, is crucial to their success. With the help of Kuraray Noritake Dental’s Light Diffusion (LD) technology—which incorporates light diffusion particle fillers to augment the opacity of restorations—our CLEARFIL MAJESTY family of composites can do just this.

The CLEARFIL MAJESTY family

Both CLEARFIL MAJESTY ES-2 Premium and Classic, as well as CLEARFIL MAJESTY ES Flow, faithfully reproduce the diffusive properties of tooth structure. This means that they show a higher level of light diffusion in the more opaque shades (dentin) and a lower level in the more translucent ones.

The actual effect of our LD technology can be clearly seen in the following images. On the laminated Light Diffusion Card there are three discs, each made of a composite material less than 1mm thick. The composite on the left (the CLEARFIL MAJESTY Esthetic) is the most translucent of the three when the card is placed directly on top of another surface—this composite best allows the text to be read through it. However, increasing the distance from the text by inserting a pair of two-euro coins underneath the card reverses this outcome—thanks to the light diffusion properties of CLEARFIL MAJESTY Esthetic, it is the only composite through which the text can no longer be read.

When put into practice, the end result is simple: this light diffusion helps create a restoration that merges effortlessly with the surrounding natural dentition. 

Kuraray Noritake highlights KATANA Zirconia Block at Berlin symposium

Berlin, Germany: Kuraray Noritake Dental invited dental professionals from across Europe on January 26 to a symposium dedicated to the KATANA Zirconia Block, the newest addition to its famed KATANA Zirconia range. Held in the Lecture Hall Ruin of the stunning Berlin Museum of Medical History, the symposium brought together leading experts to discuss their research and clinical experiences with the material so far.

Prof. Florian Beuer, Chairman of the Department of Prosthodontics at the Charité University of Medicine in Berlin, welcomed the attendees and guided them through the history and development of zirconia as a dental restoration material. Beuer emphasised the vast difference between the first generation of zirconia, which was relatively opaque and prone to chipping and fracturing, and the highly translucent, mechanically superior zirconia of today. “Today, zirconia is truly applicable for digital workflows,” he stated, highlighting that its ability to be used for single-unit restoration and minimally invasive dentistry “truly helps to save the existing tooth structure”.

The morning’s other sessions focused on material research regarding the mechanical and aesthetic properties of the KATANA Zirconia Block. Prof. Marc Schmitter discussed the mechanical properties and fracture toughness of occlusal veneers made with the block in comparison to lithium disilicate, whilst the University of Bologna’s Prof. Paolo Baldissara highlighted the use of Kuraray Noritake’s multilayered zirconia technology, which allows it to effectively mimic the shade gradation of natural teeth. Prof. Cees Kleverlaan also presented his work on tooth enamel erosion, concluding that restorations made with ceramics such as zirconia generally lead to far lower wear rates than those made with materials with large, hard particles and low filler loads.

After a hearty lunch that featured falafel and currywurst – a Berlin sausage-based specialty – a variety of highly renowned experts in dentistry took to the stage to present their clinical experiences with the KATANA Zirconia Block. President of the ISCD (International Society of Computerized Dentistry) Dr. Klaus Wiedhahn went through his experiences integrating the block into his CEREC-based digital workflow, stating that “with the KATANA Zirconia Block, aesthetics are no longer a weak point”.

Drs Nicola Scotti, Rodolphe Acker and Hendrik Zellerhoff then presented their own clinical experiences with this new product in Italy, France and Germany, respectively. Each dentist commented on how the speed with which the block can be milled and sintered with the CEREC system allowed them to see how full-contour zirconia restorations can now be considered to be a true chairside solution. “Thanks to this block, you can create something really amazing without much effort,” said Scotti, who only began using it in April 2018 but was soon impressed with the block’s aesthetic qualities and ease of cementation with PANAVIA V5.

Dr. Alessandro Devigus and MDt. Daniele Rondoni, two active members of the European Academy of Esthetic Dentistry, capped off the symposium by discussing the possibilities of the KATANA Zirconia Block for restorations in the aesthetic zone. Both dentists emphasised the importance of fluorescence in this regard and showed, through a number of clinical cases, that the block’s excellent translucency and impressive shade selection make it ideal for this purpose.

Overall, the symposium effectively demonstrated the potential of Kuraray Noritake Dental’s KATANA Zirconia Block as a material for single-visit chairside restorative dentistry.

NOW 18 Minutes Sintering using the CEREC SpeedFire

KATANA™ Zirconia Block, the innovative multi-layered zirconia block^*1, can be used with Dentsply Sirona's CEREC system^*2. Now the 18 minutes sintering program^*3 is developed and installed into CEREC SpeedFire. New sintering technology makes it possible to fabricate full zirconia restoration in approx. 35 minutes.

An ideal composite material should satisfy three basic requirements: function, aesthetics and biocompatibility. A member of the CLEARFIL MAJESTY family, Kuraray Noritake Dental’s CLEARFIL MAJESTY™ ES Flow combines excellent handling, polishability and mechanical strength to provide a solution for all cavity classes. This universal flowable composite employs silane and filler technologies to maximise both its procedural and aesthetic outcomes, allowing dentists to create long-lasting restorations with reduced chairside time.

A new standard for flowable composites

Traditionally, a composite’s flowability has been inversely related to its filler content. When flowable composites were first introduced in the mid-1990s, their lower viscosity was enabled by a filler level much lower than that of conventional composites. This, however, meant that these flowables fared poorly in a clinical setting, demonstrating inferior mechanical properties when compared to traditional hybrid composites.

With CLEARFIL MAJESTY™ ES Flow, dentists can now use a flowable composite with mechanical properties comparable to those of conventional alternatives. Thanks to Kuraray Noritake Dental’s silane technology, millions of submicron filler particles fit into the composite, reliably adhering to the resin and maintaining long-term stability. CLEARFIL MAJESTY™ ES Flow possesses a scientifically tested flexural strength of over 150 MPa, similar to that of a universal nano hybrid composite, making it suitable for use in Class I and II restorations.

Aesthetic restorations

However, the small, durable particles of CLEARFIL MAJESTY™ ES Flow provide more than just mechanical reliability. Special cluster fillers provide a light diffusion effect that is similar to that of natural teeth, meaning that the material blends effortlessly with the existing tooth structure. Unlike other flowables, CLEARFIL MAJESTY™ ES Flow is glossy immediately after curing. This gloss can be improved with remarkable simplicity—simply wipe the cured resin with an ethanol-moistened gauze or cotton roll to produce a smooth surface that is proven to maintain its gloss over time.

Ideal handling

CLEARFIL MAJESTY™ ES Flow’s low viscosity monomers ensure that it has excellent handling characteristics, promising better sculpting for the dentist. The flowable composite does not stick to the needle tip or to any instruments, only adhering to the area to which it is applied, while the proprietary design of the syringe itself minimises air bubbles when dispensing. Once dispensed, the paste possesses great consistency with its non-slumping formula, ensuring that it can maintain its shape. A truly universal composite, CLEARFIL MAJESTY™ ES Flow allows dentists to create highly aesthetic restorations with ease.

Obtain results in four simple steps

Creating aesthetic and durable restorations has never been more achievable. Simply prepare the cavity and apply bonding, dispense and sculpt the CLEARFIL MAJESTY™ ES Flow, light-cure and, finally, polish. It’s as easy as that.

This year marks the 40th year of Kuraray's entry into the commercial dental products market. This edition of the BOND is fully dedicated to celebrating our unique position in modern dentistry.

We post the BOND here for your convenience; Enjoy!

BOND | VOLUME 4 | 06/2018

Previous versions:

BOND | VOLUME 3 | 10/2017

BOND | VOLUME 2 | 04/2017

BOND | VOLUME 1 | 12/2016

DENTAL ADVISOR SIX-MONTH PROGRESS REPORT

Summary
Over a six-month period, 96 restorations were placed. The clinical performance at the time of placement was excellent for esthetics, handling, ease of adjustment, and ease of finish/polish. There were no reports of post-operative sensitivity or debonding. Based on the placement period, CLEARFIL Universal Bond Quick with CLEARFIL MAJESTY ES Flow received a clinical performance rating of 100%.

Description:

CLEARFIL MAJESTY ES Flow is a light-cured, universal flowable composite.

It contains submicron fillers that are treated with a proprietary silane

coupling agent to provide for low shrinkage and high mechanical

properties. The submicron fillers and high filler load provide for esthetics.

CLEARFIL Universal Bond Quick is a single-bottle, universal bonding agent

that contains a novel rapid bond technology and releases fluoride. It is

compatible with total-, self- and selective-etch techniques and with light-,

self- and dual-cured materials (with CLEARFIL DC Activator).

Clinical Evaluation Protocol (Six Months):

A total of 96 CLEARFIL Universal Bond Quick with CLEARFIL MAJESTY ES

Flow restorations were placed in 44 molars, 26 premolars and 26 anterior

teeth (Figure 1). The classification of restorations was recorded as 44 Class

I, 7 Class II, 1 Class III, 30 Class V, and 14 Class VI restorations (Figure 2).

Kuraray Noritake Dental Inc.

Results at Six Months:

There were no reports of post-operative sensitivity for CLEARFIL Universal

Bond Quick with CLEARFIL MAJESTY ES Flow. All 96 restorations received

excellent ratings of five for esthetics, handling, ease of adjustment, and

ease of finish/polish (Figure 3). No debonding was observed.

All restorations were evaluated at placement in the following areas: lack
of post-operative sensitivity, esthetics, handling, ease of adjustment, and
ease of finish/polish. Restorations were evaluated on a 1-5 rating scale:
1 = poor, 2 = fair, 3 = good, 4 = very good, 5 = excellent.

Consultants’ Comments
• “I love flowables - CLEARFIL MAJESTY ES Flow is in a class of its own.”
• “I use CLEARFIL MAJESTY ES Flow regularly in areas of incipient decay
- flows well, very esthetic and polishes easily.”
• “CLEARFIL MAJESTY ES Flow is my go-to flowable to repair small chips
in anterior teeth. It blends seamlessly with the tooth.”
• “Great to use in abfraction areas in conjunction with CLEARFIL
Universal Bond Quick. CLEARFIL MAJESTY ES Flow bonds well and is
very easy to finish and polish. Patients love the outcome.”

“The multi-layered aspect of KATANA Zirconia is excellent”

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.

PANAVIA and KATANA: The perfect combination

Scientific research has demonstrated that, when bonding zirconia, optimal bond values can only be achieved with resin cements—specifically, MDP monomer-based resin cements. With PANAVIA V5, we offer a dual-cure resin cement with dentine bond strengths equal to our gold standard light-cure bonding agent CLEARFIL SE BOND, even when used in self-cure mode. Through our KATANA Zirconia range, Kuraray Noritake Dental presents a ceramic material for restorative procedures that has excellent translucency and shade options. Together, PANAVIA V5 and KATANA Zirconia make an ideal team for durable and reliable indirect restorations.

PANAVIA V5

In 1983, Kuraray introduced its patented MDP monomer in PANAVIA EX cement. With its clinically proven adhesion, our PANAVIA family has set the industry standard for adhesion for over 30 years. As the newest addition to the PANAVIA cement line, PANAVIA V5 provides strong bonding not just to zirconia but to hydroxyapatite and metals as well. Unlike other dual-cure resin cements, PANAVIA V5 offers improved bond strength to all tooth structures. Simple to use and with predictable results, PANAVIA V5 is unique in its user friendliness and procedural consistency. 

KATANA Zirconia

Our KATANA Zirconia discs are processed using a proprietary zirconia powder, allowing it to have as natural a translucency and colour as possible. The KATANA range consists of several options designed for full-contour zirconia prostheses, from single crown to full arch: KATANA Zirconia UTML (Ultra Translucent Multi Layered), STML (Super Translucent Multi Layered), ML (Multi Layered) and HT (High Translucent). The multilayered build-up of KATANA Zirconia STML provides a translucency and chroma that gradually decrease from the cervical to incisal regions, just like natural dentition. KATANA Zirconia UTML is perfect for anterior restorations, such as veneers, owing to its natural translucency and colour gradient. With a flexural strength considerably higher than that of lithium disilicate, KATANA Zirconia has the mechanical and aesthetic properties to achieve well-balanced restorations between natural teeth in the anterior zone.

An ideal team

PANAVIA V5 provides a strong and durable bond between KATANA Zirconia-based restorations and the tooth structure. PANAVIA V5 resin cement offers optimal margins and predictable restorations. Always use PANAVIA V5 Tooth Primer for the pretreatment of the tooth and CLEARFIL CERAMIC PRIMER PLUS for the priming of the restoration.

“We’re thrilled by the possibilities presented from the combination of PANAVIA V5 and KATANA Zirconia,” said Mitsuru Takei, Head of Technical Services at Kuraray Europe. “Together, they make achieving natural-looking restorations easier than ever.”

TEETHMATE DESENSITIZER: A natural solution for sensitive teeth

Kuraray Noritake Dental’s TEETHMATE DESENSITIZER is designed to provide an immediate and long-lasting solution for dentine sensitivity. Owing to a specially modified powder free of potential irritants like methacrylates and colophony resins, TEETHMATE DESENSITIZER is biocompatible and harmless to tissue. The first desensitiser to form hydroxyapatite, TEETHMATE DESENSITIZER possesses a neutral taste that will please patients. Since its introduction in 2013, dentists have hailed the product for its safe tubule sealing and for providing patients with immediate relief.

TEETHMATE DESENSITIZER consists of a powder, composed mainly of calcium phosphate, and a liquid, whose chief component is water. The powder and liquid simply need to be mixed. After the paste has been applied with a superfine brush to the affected area for 30 seconds, the material sets into hydroxyapatite, providing an instant reduction of hypersensitivity by sealing the dentinal tubules and microcracks in the enamel.

Hydroxyapatite: The human body’s strongest mineral

The presence of hydroxyapatite encourages tooth remineralisation, protecting teeth against hypersensitivity and after professional tooth cleaning. TEETHMATE DESENSITIZER is composed of two different calcium phosphates that react under water to form hydroxyapatite. Since Kuraray Noritake Dental’s technology ensures the right calcium–phosphate ion ratio with a suitable pH level, the newly formed hydroxyapatite acts as if it were the patient’s own, crystallising so that it can neatly seal dentinal tubules and enamel cracks.

Suitable for most sensitivity issues

TEETHMATE DESENSITIZER has a wide range of indications, from whitening-related dentine sensitivity to the treatment of dentine exposed by periodontitis, abraded by harsh toothbrushing, or prepared for fillings and/or restorations.

TEETHMATE DESENSITIZER is an invisible and durable form of treatment. When applied, it occludes open dentinal tubules without leaving a film on the tooth. It is fast and easy to use—simply mix the powder and liquid, apply with a rubbing motion to the sensitive region for 30 seconds and rinse lightly with water. No air blowing or light curing is required, as the calcium phosphates in the substance harden on their own, providing patients with fast relief from sensitivity-related pain.

Proven effectiveness

In a survey conducted by Kuraray Noritake Dental, Japanese dentists were asked to rate the effectiveness of TEETHMATE DESENSITIZER. Of the 285 respondents, 92 per cent said that they were satisfied with the product’s effectiveness.

No impact on bond strength

TEETHMATE DESENSITIZER has been clinically proven not to reduce the bond strength of adhesives or cements when it is used prior to their application. This is a considerable advantage for dentists using etch and rinse adhesives, for instance, as they can apply TEETHMATE DESENSITIZER without any concerns about potentially deleterious effects on restorations. A smart, invisible and durable form of dentine sensitivity treatment, TEETHMATE DESENSITIZER promises to satisfy both dentists and patients.