429 Too Many Requests

The impact of a material switch in the dental laboratory

Switching to a different type of zirconium is not something you do lightly. Was the leap to KATANA™ Zirconia worth it? Three dental lab owners share their experience!

Not all zirconium oxide materials are created equal. Dental technicians worldwide recognise that zirconium oxide discs vary significantly in quality depending on their composition and manufacturing process. The most noticeable differences lie in their mechanical and optical properties, both of which are determined during production. At first glance, zirconium oxide products from leading manufacturers may seem similar. However, —sometimes invisible—differences can exist. Achieving the highest quality requires the use of premium raw materials, advanced cleaning and pressing techniques, and precise pre-sintering methods. These factors help ensure superior results while minimizing the risk of remakes. Selecting a high-quality zirconium oxide product is crucial, particularly when working with complex structures or specialised processing techniques. The right choice can significantly impact the final outcome and durability of dental restorations.

We had a conversation with three decision makers of Norwegian dental laboratories to learn more about their reasons to switch to the KATANA™ Zirconia Multi Layered Series (Kuraray Noritake Dental Inc.) and their path to success with these materials. Espen Rørstad is the owner and general manager of Vestfold Dental in Tønsberg, Lucas Andvik the general manager of Cicero Dental AS in Trondheim and Hilsen Egil Berg the general manager of dental technology at Berg Dental in Askim. They are happy to share their experience and practical tips and tricks.

Time for change

The reasons to start testing alternative zirconium oxide materials were different: Espen Rørstad, who has been a dental technician for 24 years, was looking for improvements in strength and aesthetics: “Nowadays, zirconium materials are evolving quickly, and specifically those blanks with multi-layered colour, translucency and flexural strength attracted my attention. I first tested a material from another leading manufacturer. Then, I received a single disc of KATANA™ Zirconia YML. I was immediately impressed by the homogeneous, densely pressed material and its optical properties. Ever since my first trial case with KATANA™ YML, I have not used any other zirconium oxide again.”

Choosing the right material

Hilsen Egil Berg uses KATANA™ Zirconia YML for most indications, and KATANA™ Zirconia HTML Plus for large reconstructions of ten or more units. The design is predominantly monolithic with a small (vestibular) cutback. The approach of Espen Rørstad is similar. He also uses KATANA™ Zirconia YML on a regular basis for reconstructions with up to ten units, even on implants in combination with Ti-bases. “For larger-span restorations, I most frequently opt for KATANA™ Zirconia HTML Plus or, occasionally KATANA™ Zirconia HT combined with a traditional layering approach”. Lucas Andvik uses all four types of multi-layered zirconia from Kuraray Noritake Dental Inc. (KATANA™ Zirconia UTML, STML, HTML Plus and YML) to have the best of all worlds.

Establishing workflows

Switching materials always means investing time and effort until processes run smoothly and predictably. According to Espen Rørstad, it did not take long with KATANA™ Zirconia to get the parameters right and obtain high-quality results. According to him, a factor that is critical for good outcomes with KATANA™ Zirconia YML is positioning of the restoration in the disc. “Proper positioning is key to success – long-span reconstructions are only stable if positioned according to the manufacturer’s recommendations. The learning curve is quite steep and we have no issues with fractures,” he says. Lucas Andvik slightly adjusted his production procedure to provide for great outcomes: “Initially, we tried to position our restorations in blanks of the heights we had used before, and this turned out to be quite challenging. In order to have enough space for the connectors and be able to position long-span restorations in the middle of the disc as recommended, we started utilising higher blanks. With this strategy, the initial challenges were a thing of the past.”

What makes KATANA™ Zirconia different

KATANA™ Zirconia is engineered with precision at every step of the production process, from raw powder production to disc pressing, every step is tightly controlled for consistency and quality. It’s the result of decades of expertise in ceramics and full in-house control. Every disc reflects that precision and expertise, offering you high quality zirconium oxide with outstanding features;

• Dual gradient structure (YML): A seamless transition in both translucency and strength.
• High green-state stability: Thin margins, no chipping. Fewer sprues, smoother carving, and optimal material use.
• Targeted yttria balance: Optical translucency where needed, strength where it matters, each layer is purposefully composed.
• Speed sintering: 54-minute cycles delivering consistent aesthetics and mechanical performance.
• Optimized density and CTE: Uniform density and a stable coefficient of thermal expansion in all layers ensure minimized sintering deformation and high fitting accuracy.

Easy carving

One of the practical benefits of using KATANA™ Zirconia is the fact that it is perfectly suitable for carving. Lucas Andvik states: “Carving is easier with KATANA™ Zirconia than with other materials. It is even possible to go close to the margins without increasing the fracture risk. Other materials seem to be much less dense and softer, which may result in marginal fractures. Carving is really a feature that transformed our inhouse production procedure and contributes to great outcomes.” Espen Rørstad and Hilsen Egil Berg agree that carving feels great with this material, while the former also stresses that the overall aesthetics when using the carving technique are very well received by partners from dental offices.

Mastering the sintering process for optimal results

A procedure known as a critical step in the production procedure is the sintering. Virtually every leading manufacturer of hightranslucency zirconium oxide advises users to calibrate furnaces and check the achieved temperatures on a regular basis to provide for optimal outcomes. The actual sintering protocols recommended for each material, however, are very different. Kuraray Noritake Dental Inc. offers three sintering programms valid for all four materials of the KATANA™ Zirconia Multi-Layered series: The standard sevenhour programme is available for all kinds of prostheses, while the high-speed 54-minute and 90 minute programmes are suitable for restorations with up to three units. For KATANA™ Zirconia Blocks, even18-minute sintering is possible. Lucas Andvik uses the seven-hour programme for over-night sintering of all large restorations, and speed sintering for single-tooth restorations and small bridgeworks during the day. With his new furnace, he simply adopted the recommended protocols. Espen Rørstad modified the protocols slightly for his furnace and regards speed sintering as a great option for rush cases. Hilsen Egil Berg prefers over-night sintering. He reports: “It is really important to have a high-quality, modern furnace, calibrate it regularly and follow the manufacturer’s instructions. My recommendation for everyone experiencing issues is to pay extra attention to warming up and cooling down properly. That way, you achieve the highest possible strength and aesthetics, including an absolutely smooth transition between the different layers in the blank.”

Micro-layering: A game changer for finishing

In all three dental laboratories, the integration of KATANA™ Zirconia has led to a shift towards higher-efficiency finishing approaches. Espen Rørstad reports: “The switch to KATANA™ Zirconia enabled us to increase the amount of monolithic and micro cut-back zirconium oxide restorations from around 40 to 80 percent. In the anterior area, we use a minimal vestibular cutback and micro-layering, while the restorations are purely monolithic and only minimally pre coloured in the posterior area. Classical layering is only delivered on special request.” Hilsen Egil Berg states: “We completely stopped using traditional porcelain layering approaches and prefer micro-layering instead – especially in combination with KATANA™ Zirconia YML. The aesthetic outcomes are so good that a cosmetic dentist recently called me and asked if I had used lithium disilicate instead of zirconium.” Lucas Andvik also likes to add a little bit of porcelain: “We moved away from a full cutback to micro-layering approaches, using the same porcelain system for lithium disilicate and zirconium oxide,” he says. In subgingival areas, he often just polishes the restorations for highest biocompatibility, a concept that is very well received by dental practitioners.

Happy with the results?

Hilsen Egil Berg concludes: “Once you have implemented the workflow and set all parameters, working with KATANA™ Zirconia is really great. My staff likes its handling during carving, the efficient workflows and predictable results. Although sometimes the product may be more expensive than other brands’ zirconium oxide, the total economy is a lot better: We do no longer face any issues with fractures and remakes, and due to the homogeneous material structure, the service life of our milling tools is extended, while, at the same time, the edge stability of the milled restorations is increased. The blanks are so homogeneous that I am able to sinter long-span restorations without a lateral support!”

The conclusion of Lucas Andvik is similarly good: "everyone in my laboratory working with KATANA™ Zirconia is more than satisfied. My co-founder, Katharina, has tested many different materials on behalf of notable manufacturers and has never seen anything that compares to KATANA™. All the technicians that work with KATANA™ here consider it to the most versatile and aesthetic we have ever utilized. I think that all four variants are super nice to work with. My personal recommendation is to attend one of the courses offered by Kuraray Noritake Dental Inc. The instructors are super knowledgeable and we got a completely new conception of zirconium oxide as well as practical advice that was really useful for our daily work.”

Espen Rørstad is sure that “in terms of aesthetics, KATANA™ Zirconia is the best zirconium oxide tested, and I really tested a lot in the past decades! I am happy with the material, the interaction with the Kuraray Noritake Dental team and the support offered. My team is also happy with the material, but even more important is the positive feedback of my customers: One of them requested a specific zirconium all the time, and when we switched, we did not tell him immediately. Now he knows and is very happy with what he gets.” Espen is sure that economically, KATANA™ Zirconia YML is even able to compete with cheap zirconium oxide brands, as the production procedure is much more efficient and the results are predictable.

Switching zirconium oxide materials is a significant investment in both time and resources, but for many dental laboratories, the results speak for themselves. The experiences shared by these Norwegian technicians demonstrate that KATANA™ Zirconia offers a balance of aesthetics, strength, and efficiency. While adapting to new workflows takes effort, the improved outcomes, fewer remakes, and enhanced handling make the transition worthwhile. For those considering the switch, thorough testing and training are key to ensuring a smooth and successful integration.

PRACTICAL IMPLEMENTATION TIPS

• Review and adjust milling, sintering, and finishing protocols to match the manufacturer’s recommendations.
• Train technicians on best practices for positioning restorations within the blank to ensure strength and aesthetics.
• Optimise material selection for different cases
• Regularly calibrate sintering furnaces and check temperature accuracy to avoid issues like fractures or compromised aesthetics.
• Work closely with the supplier for technical support and guidance when setting up new workflows.

Case by MDT Andreas Chatzimpatzakis and DDS Manousos Pissadakis

ONE SOLUTION, MULTIPLE NEEDS COVERED

The treatment of young patients with a dental condition that affects the appearance of multiple teeth – like enamel hypomineralisation or hyperplasia – is particularly challenging for the restorative team. Dental practitioners and technicians need to be aware of the fact that the condition often involves a life-long disease burden, which typically goes hand in hand with an immense treatment need and increasingly invasive measures required with advancing age. It is their task to make the situation as bearable as possible for patients by delivering treatment that is very well aligned to their specific aesthetic, functional and financial needs, both in the short and long term.

Whenever all-ceramic restorations seem most appropriate, material and technique selection are particularly important: Protection of the affected teeth from extrinsic influences, the saving of sound tooth structure and the safeguarding of the long-term stability of the restorations are key to success. Depending on the aesthetic expectations of the patient, veneers made of zirconia or lithium disilicate, produced with a minimal vestibular cutback and finished using the micro-layering technique, are a great option. A prime example of an innovative porcelain system specifically developed for this technique is CERABIEN™ MiLai (Kuraray Noritake Dental Inc.). It includes a collection of internal stains and porcelains that fire at just 740 °C. With this low firing temperature and a coefficient of thermal expansion between 9.5~11.0×10-6/K (50 °C – 500 °C), this product is ideal for use with lithium disilicate and zirconia. In addition, it offers impressive aesthetic capabilities: Depending on the specific needs of each case, users can adjust the level of complexity and number of bakes.

CASE EXAMPLE

In the present case of a young female patient with hypomineralisation, it was decided to follow a straightforward approach to restore the maxillary teeth for the time being. For this purpose, we produced a wax-up and transferred it into the patient’s mouth in the form of a mock-up. Following guided tooth structure removal trough this mock-up, an impression was taken. The restorations were designed in full contour, pressed using lithium disilicate-based press ingots (Amber® Press LTW3, HASS Corp.) and cut back slightly in the vestibular area (reduction: 0.3 mm). The selected micro-layering system was applied according to the internal stain technique. The following CERABIEN™ MiLai Internal Stains were used: A little Red in the cervical, and Mamelon 2, Incisal Blue 1 and White in the incisal third. What followed was build-up with CERABIEN™ MiLai Porcelains Tx incisally and LTx proximally; some whitish lines were created with Value Liner 1. Then, I applied a mixture of E2 and ELT1 in the middle and LT1 in the cervical area. After the bake, the restorations were treated with green stones, sandpaper and rubber wheels to pre polish the surface. After glazing with CERABIEN™ ZR FC Paste Stain Clear Glaze, final polishing was carried out.

The whole treatment procedure including tooth preparation, shade determination, veneer production and adhesive cementation is illustrated below.

Fig. 1. Portrait of the patient prior to treatment.

Fig. 2. Enamel defects in the maxilla and mandible.

Fig. 3. Initial clinical situation in the maxilla with whitish-brown discolouration and composite restorations in need of replacement.

Fig. 4. Mock-up in the patient’s mouth.

Fig. 5. Labial reduction through the mock-up: The depth of tooth preparation is controlled by using a depth guide and by marking the created depth grooves with a colour marker.

Fig. 6. Silicon index used to check the space created for the veneers.

Fig. 7. Prepared teeth ready for impression taking and temporization.

Fig. 8. Shade determination for the veneers.

Fig. 9. Pressed lithium-disilicate restorations on the model.

Fig. 10. Appearance of the restorations after internal staining.

Fig. 11. Appearance of the teeth after build-up with CERABIEN™ MiLai Porcelain.

Fig. 12. Final restorations on the model.

Fig. 13. Adhesive cementation procedure carried out for two teeth at once: Isolated teeth and a perfectly dry working field.

Fig. 14. Etching of the tooth structure with phosphoric etchant (K-ETCHANT Syringe, Kuraray Noritake Dental Inc.).

Fig. 15. PANAVIA™ V5 Tooth Primer (Kuraray Noritake Dental Inc.) applied to the etched tooth surfaces.

Fig. 16. Veneers – pre-treated with hydrofluoric acid and CLEARFIL™ Ceramic Primer Plus – filled with PANAVIA™ V5 Paste (Both from Kuraray Noritake Dental Inc.) and placed in the patient’s mouth.

Fig. 17. Restorations after excess removal.

Fig. 18. All eight restorations in place.

Fig. 19. Treatment outcome after two weeks.

Fig. 20. Portrait of the patient taken two weeks after treatment.

CONCLUSION

Repeated dental treatment, increasing invasiveness of the measures, often resulting in early tooth loss: To break the vicious cycle in young patients with enamel defects, it is important to carefully evaluate the treatment need and select the appropriate solutions. As dental technicians, we can contribute to long-term treatment success by using high quality materials and production techniques that allow us to create restorations that last.

The presented material combination and the micro-layering technique are very well suited as they offer the required mechanical and optical properties for high aesthetics and durability. Plus, the risk of complications is low due to the high biocompatibility and the layer of porcelain limited to non-load-bearing areas.

Dental technicians:

ANDREAS CHATZIMPATZAKIS

Andreas graduated from the Dental Technology Institute (TEI) of Athens in 1999. During his studies he followed a program at the Helsinki Polytechnic Department of Dental Technique, where he trained on implant superstructures and all ceramic prosthetic restorations. As of 2000, he is running the ACH Dental Laboratory in Athens, Greece, specialized on refractory veneers, zirconia and long span implant prosthesis. In 2017 Andreas visited Japan where he trained under the guidance of Hitoshi Aoshima, Naoto Yuasa and Kazunabu Yamanda and become International Trainer for Kuraray Noritake Dental Inc..

MANOUSOS PISSADAKIS

Dr. Manousos Pissadakis is a graduate of the National Kapodistrian University Dental School, Athens, Greece. He completed the Master of Science curriculum in Prosthodontics at the School of Dentistry of the Aristotle University of Thessaloniki, Greece. He also holds the ITI Certificate in Implant Dentistry – Foundation and Intermediate Level (ITI Curriculum, ITI section Greece and Cyprus). He has presented at numerous prestigious international conferences, focusing on subjects such as aesthetics, implant dentistry and prosthodontics.

ACHIEVE CONSISTENT, NATURAL-LOOKING RESTORATIONS WITH CONFIDENCE

Shade selection is one of the most critical steps in restorative dentistry — and one of the most challenging. The KATANA™ Zirconia Shade Selection Guide provides practical, evidence-based recommendations to help clinicians and technicians achieve predictable, lifelike results every time.

Inside, you’ll find clear guidance on how abutment color, restoration thickness, milling and sintering conditions, and finishing methods influence the final shade outcome. Backed by Kuraray Noritake Dental’s expertise, this guide is designed to simplify your decision-making, minimize remakes, and support optimal aesthetics across different workflows.

Download now and equip your practice or lab with proven strategies for shade selection success.

High-quality dental zirconia is crucial in prosthodontic treatments to ensure patient satisfaction and long-term success. The use of high-quality zirconia helps in achieving perfectly fitting restorations that are both aesthetically pleasing and durable, minimizing the need for remakes and extra appointments. Low-quality zirconia, however, can lead to various issues such as poor optical properties, improper fit, and inferior biocompatibility, which may go undetected until they cause clinical problems like gingival recession or early restoration failure. Therefore, selecting high-quality zirconia with the right composition, followed by correct processing, is essential for optimal outcomes in dental restorations.

THE DEVELOPMENT OF DENTAL ZIRCONIA

In the late 1990s, the first CAD/CAM-fabricated Zirconia coping was launched as an alternative to the non-aesthetic metal substructure, providing a strong and more aesthetic framework for porcelain-fused restorations. More recent developments in zirconium oxide have led to a shift from full-baked to monolithic use. This has largely overcome mechanical complications such as chipping and delamination and at the same time avoiding the need for the preparation of much of the tooth structure. Leading to prosthetic restorations that retain as much of the structure as possible.

Dental zirconia has traditionally been manufactured mainly from the tetragonal zirconia crystals with a minor proportion of approximately 3 mol% yttria stabilizer (3Y-TZP); this type is extremely strong but has low translucency.¹ By increasing the amount of yttria added to zirconia to around 5 mol%, the translucency is significantly improved because of the presence of a higher amount of zirconia crystals in the cubic form. This zirconia material is often referred at as 5Y-partially stabilized zirconia (5Y-PSZ). However, this increase in translucency comes at the cost of a decrease in mechanical strength.² The introduction of multi-layered zirconia by Kuraray Noritake Dental Inc. marked a significant advancement in zirconia technology, paving the way for highly aesthetic monolithic restorations. The development of a more aesthetic zirconia resulted in a steep decline of metal-ceramic usage in favour of ceramic prostheses. Nevertheless, there are still concerns about the quality of zirconium oxide prostheses. Not only about adhesiveness, but also about fit and processing. Several clinical reports show outcomes with high success rates up to 97% over more than 15 years.² However, there are also reports showing catastrophic failures of zirconia dental restorations. Let’s look at a very important root cause of these failures; the processing procedure.

ALTHOUGH ALL ZIRCONIA BLANKS MAY LOOK SIMILAR, QUALITY AND PROPERTIES CAN DIFFER WIDELY AS THEY ARE AFFECTED BY:

✓ The quality of the raw materials

✓ Raw material processing

✓ Blank pressing

✓ Pre-sintering

OVERVIEW OF POTENTIAL PROBLEMS AND CLINICAL CONSEQUENCES FOR PATIENTS

ROOT CAUSES OF ZIRCONIA FAILURES

Failures in zirconia restorations can often be traced back to the processing procedures used before the materials reach dental clinics. Most dental manufacturers source their zirconia powder from third-party suppliers, giving them limited control over the quality of the material they receive. Zirconia milling blank manufacturers typically press the raw powders, into disks around 100 mm in diameter, which are then pre-sintered to add mechanical stability. The exact formulations of these blanks are often proprietary and not disclosed. Variations during the disc pressing process can introduce air voids and impurities, negatively impacting the quality of the final restorations.² Dental laboratories further process these blanks by milling them into final shapes based on the 3D profiles provided and then sinter them at temperatures above 1,400°C to achieve the desired final phase. Each blank is designed with an enlargement factor to account for shrinkage during sintering. However, detailed processing procedures, such as milling and finishing, are often typically unavailable. As a result, the exact chemical composition, microstructure, and processing of zirconia materials for dental applications varies significantly depending on the manufacturer and laboratory involved. These variations make the production of zirconia restorations a complex and often unpredictable process.

Kuraray Noritake Dental Inc. is one of the few manufacturers handling the entire dental zirconia production process, including raw material processing, in-house. This end-to-end control allows us to ensure exceptional product quality across all materials. A core principle of Kuraray Noritake is the of a higher amount of zirconia crystals in the cubic form. This zirconia material is often referred at as 5Y-partially stabilized zirconia (5Y-PSZ). However, this increase in translucency comes at the cost of a decrease in mechanical strength.² The introduction of multi-layered zirconia by Kuraray Noritake Dental Inc. marked a significant advancement in zirconia technology, paving the way for highly aesthetic monolithic restorations. The development of a more aesthetic zirconia resulted in a steep decline of metal-ceramic usage in favour of ceramic prostheses. Nevertheless, there are still concerns about the quality of zirconium oxide prostheses. Not only about adhesiveness, but also about fit and processing. Several clinical reports show outcomes with high success rates up to 97% over more than 15 years.² However, there are also reports showing catastrophic failures of zirconia dental restorations. Let’s look at a very important root cause of these failures; the processing procedure. seamless integration of quality performance and ease of use, backed by a strong commitment to providing the right materials and support. As the producer of KATANA™ Zirconia, Kuraray Noritake’s meticulous oversight at every stage of production guarantees consistent quality, enabling us to confidently stand behind the excellence of our products.

KATANA™ PRODUCTION

All our zirconia offerings begin their journey to the dental lab in our Japanese facility where raw zirconia ore is processed to a high quality raw powder. Several delicate treatments are done as next steps, including the addition of several fine-tuned essential components like stabilisers and binders. Kuraray Noritake Dental Inc. benefits from in-house production of the raw materials required for dental zirconia. This provides the perfect base on which to use our multi-layering technology and add any other elements needed to create superior quality and purity of the formulation as well as a precise alignment of the desired properties.

From powder to blank pressing, Kuraray Noritake Dental Inc. uses a unique and highly meticulous pressing process that provides for absolute uniform pressing distributions. Every detail is carefully calculated, managed, and controlled. This phase of the process takes several days, underscoring our goal to achieve the most aesthetic product. The results are uniform mechanical and optical properties, outstanding margin stability, high surface quality and a very controlled sintering deformation. By removing the variables for the dental lab, KATANA™ Zirconia provides a reliable material that will give you the same result, every single time.

In the final stage of production, as our KATANA™ Zirconia blanks are prepared for packaging, each disc undergoes a meticulous manual quality check. This last, hands-on inspection ensures that every KATANA™ Zirconia disc meets the highest standards of excellence that we promise. By giving each disc this personal  attention, we guarantee that the quality and performance of our products consistently exceed expectations, reflecting our unwavering commitment to perfection in every detail.

Kuraray Noritake Dental Inc’s state-of-the-art production facilities enable us to create highly stable pre-sintered blanks with precisely the right rigidity to withstand all kinds of milling. This stability makes KATANA™ Zirconia a product that can be fully used without braking in situations where a large part of the disc already has been milled. Something that frequently occurs with lower quality products that are less strong in green-state. This highly stable quality also makes it possible to shorten the sinter time on KATANA™ Zirconia discs up to 54 minutes for single tooth restorations and bridges with up to three units.

NATURAL COLOUR GRADIENT

Kuraray Noritake is well aware of the importance of varying levels of chroma and translucency in various parts of a natural tooth. Our aim has been to mimic this effect even without the use of porcelain layering. In areas where the dentin core is revealed, a tooth is highly chromatic and rather opaque. In contrast, those parts of a tooth mainly composed of enamel – such as the incisal edge - are highly translucent and have a low chroma. Our patented KATANA™ Zirconia multi-layered technology has been developed to precisely imitate this gradient in chroma and translucency and shows a virtually seamless transition between layers, resulting in a tooth-like appearance without the need for porcelain layering. The four types of multi-layered KATANA™ Zirconia (UTML, STML, YML* and HTML PLUS) have a four-layer colour grading structure. The optical outcome is revealed immediately after sintering.

THE LATEST DEVELOPMENT IN ZIRCONIA

Our commitment to quality performance and ease of use is at the heart of everything we do. In line with these core values, we have pushed the boundaries of dental zirconia technology with our latest innovation: KATANA™ Zirconia YML for flawless aesthetics combined with high strength. In this revolutionary design we developed a multi-layered zirconia with additional flexural-strength and smooth translucency gradation; KATANA™ Zirconia YML.

Furthermore, all KATANA™ Zirconia YML discs are designed using ratios rather than fixed measurements of different layers in the multi-layered structure, this means that regardless of the disc’s thickness, there is always a consistent ratio of 35% of raw material that constitutes the translucent enamel zone. Hence, discs with an increased height, which are typically used to produce larger restorations, will always offer sufficient space in the enamel zone, while smaller discs are optimized for smaller restorations.

THE DESIGN CHOICES MADE ON KATANA™ ZIRCONIA YML GREATLY ENHANCES THE ADVANTAGES FOR THE LAB TECHNICIAN

✓ The ratio design offers design flexibility due to strategic layering.

✓ The accurate reflection of colour and translucency reduce the need for extensive finishing.

✓ Stable CTE throughout the disc allowing to produce high precision full arch restorations.

✓ Uniform, void free and high green-state stability for higher nesting flexibility thus higher output.

✓ Relatively high hardness in the green state, for easy green-state modification and fine tuning without the risk of fracturing or chipping.

✓ The hardness also allows for milling thinner restorations including sharp margins, thereby improving marginal fit.

✓ The part of a prosthesis from the body layer of KATANA™ Zirconia YML can be adjusted thinner than that of other high translucency zirconia, resulting in higher translucency in the body part.

MARGINAL STABILITY AND ENHANCED FITTING ACCURACY

KATANA™ Zirconia YML shows sharp margins and less chipping , thereby leading to better marginal fit. Thinner restorations show that this good result in sharp margin supports the use of KATANA™ Zirconia YML.

Even if the restoration margins have been milled to a very thin profile, they still show smooth margins without any chipping.

EVERYTHING THE LAB NEEDS

Kuraray Noritake offers four different types of multi-layered dental zirconia to cover every indication as well as a single-layer HT option to produce frameworks and long-span bridges. In the below chart you can view the range of recommended applications for all KATANA™ Zirconia Multi-layer discs.

CONCLUSION

The choice of dental zirconia significantly impacts the success of dental restorations, translating directly into daily practice for the lab technician. High-quality zirconia, such as that produced by Kuraray Noritake Dental Inc., ensures less cracking and chipping during the manufacturing process, reducing the likelihood of costly redoes due to fit or colour deviations. Superior quality of the zirconia powder, like those in KATANA™ Zirconia, allows for speed sintering, accelerating production without compromising the integrity of the restorations. Additionally, the advanced multi-layered zirconia designs, like Kuraray Noritake’s, reduce the need for extensive porcelain layering to achieve aesthetic results, streamlining the process, and enhancing efficiency.

Kuraray Noritake’s stringent quality control, with its end-to-end in-house production, guarantees consistent and reliable zirconia products. The all-rounder KATANA™ Zirconia YML, designed using precise ratios rather than fixed measurements, offers greater flexibility in design and nesting, ensuring consistent quality across varying restoration sizes. By selecting high-quality zirconia with meticulous quality control, dental labs can achieve optimal outcomes in both performance and aesthetics, ultimately benefiting both technicians, dentists, and patients.

REFERENCES

1. Yarahmadi M., Roa J.J., Zhang J., Cabezas L., Ortiz-Membrado L., Llanes L., Fargas G.; Micromechanical properties of Yttria-doped zirconia ceramics. Journal of the European Ceramic Society, Volume 43, Issue 7, July 2023, Pages 2884-2893.
2. Liao, Y., PhDa, Gruber, M. BSEa ; Lukic H., BSEa; McLees J., CDTb ; Chen S., PhDc ; Boghosian A., DDSd ; Megremis S., MS, PhDa; Survey of the mechanical and physical behaviors of yttria-stabilized zirconia from multiple dental laboratories. Journal Reprint Line (2023) 2, 100018

HOW TO OPTIMIZE ALL-CERAMIC RESTORATION BOTH AESTHETIC AND MECHANICAL?

A homogeneous porcelain structure, a strong bond between framework and veneering layer and a natural play of colours: All those characteristics of a high-quality all-ceramic restoration are not only strongly dependent on manual skills of the dental technician, but also on ideal firing conditions.

Only with a well maintained and properly functioning furnace and the right protocols, it is possible to obtain consistently great results in terms of aesthetics and function.

This is true for all kinds of all-ceramic restorations consisting of a framework and a veneering layer: It applies to full layering with a classical anatomical framework design and a relatively thick layer of porcelain, as well as to various cut-back designs finished using the modern micro-layering technique. A material that belongs to the latter category of porcelains and is becoming increasingly popular among dental technicians worldwide is CERABIEN™ MiLai (Kuraray Noritake Dental Inc.). The set of low-fusing porcelains and internal stains has been specifically developed for micro-layering, and works well with different variants of lithium disilicate and zirconia.

While the firing parameters provided by manufacturers like Kuraray Noritake Dental serve as reliable and thoroughly tested guidelines, experienced technicians often explore beyond these standards to achieve the highest possible aesthetic and functional outcomes.

This is precisely what MDT Nondas Vlachopoulos has done with CERABIEN MiLai. A distinguished expert in porcelain layering, he uses this material in his own dental laboratory “AestheticLab” in Athens and during his trainings. Drawing on his deep understanding of ceramic behaviour and extensive experience with a variety of furnaces, he has developed a refined protocol tailored to his lab conditions and artistic goals.

CERABIEN MiLai Baking Schedule by MDT Nondas Vlachopoulos.

His adjustments — such as overbaking the wash layer for structural homogeneity, adding vacuum during internal staining to avoid opacity, or fine-tuning temperatures depending on the ceramic zone (tissue vs. enamel) — are all examples of how small changes can lead to noticeable improvements in both aesthetics and function. Such expert refinements are only possible due to the exceptional flexibility of CERABIEN MiLai, enabled by its unique synthetic feldspar matrix. This advanced material composition offers excellent thermal stability and responsiveness, making it ideal for both standard use and high-level customization. Several leading technicians, including Alek Aronin, have independently followed similar approaches — confirming that Nondas’ schedule reflects a broader best practice among top users.

The above baking schedule has been validated on the furnaces Nondas Vlachopoulos uses in his laboratory on a daily basis – AUSTROMAT™ 624 (Dekema) and checked also in Programat® P510 (Ivoclar Vivadent). He truly recommends using this baking schedule independent of the ambient conditions and the furnace used: “As a hands-on course instructor at the International Dental Exhibition and Conference (IDEX) Istanbul 2025 on May 9, I used a local furnace for the first time. With the aid of my protocols, baking CERABIEN MiLai restorations in this type of furnace the outcome was as if have been fired my laboratory.”

According to Nondas Vlachopoulos, getting started with the new schedule is easy: “Just follow the IFU of your materials and equipment, enter the parameters and that’s it.” He recommends to conduct a trial bake first, before moving on to real patient cases.

For more information on how to maximize the potential of your furnace and material, have a look at our firing guide!

Dentist:

NONDAS VLACHOPOULOS

Nondas Vlachopoulos was born in Toronto, Canada, and graduated from the School of Dental Technology in 1985. He earned a BSc (Hons) from the Technological Educational Institution of Athens in 1989 and founded AestheticLab in Athens in 1990. An expert in aesthetic all-ceramic and implant restorations, Nondas is an international member of the American Academy of Cosmetic Dentistry, an editorial reviewer for the Journal of the AACD, and a member of the Hellenic Academy of Esthetic Dentistry. In 2024, he received the Kenneth D. Rudd Award from the American Prosthodontic Society.

He collaborates with the Department of Prosthodontics at the Eastman Institute for Oral Health (University of Rochester, USA),  and has worked with the Dental School of the National and Kapodistrian University of Athens. Since 2015, he contributes to the postgraduate MSc program in Dental Biomaterials.

Nondas is a global lecturer and hands-on educator, presenting in the USA, South America, Europe, Asia, Australia, and the Middle East. He has published in both Greek and international dental journals and serves as an opinion leader for Noritake Dental and MPF Brush Co. in Greece.

Case by Dt. Koray Kendir, DDS, Turkey (İzmir)

LAYERED COMPOSITE TECHNIQUE WITH A1D AND A1E SHADES

Single-shade composite layering techniques are becoming increasingly popular among dental practitioners due to their simplicity. Used in combination with modern composite materials that offer improved optical properties, these techniques lead to aesthetic outcomes in many clinical situations. However, when it comes to restoring anterior teeth with pronounced enamel translucencies and a vivid internal colour structure, playing with two shades and opacities of composite may be the better option.

Luckily, a dual-shade technique does not have to be complicated, either: With CLEARFIL MAJESTY™ ES-2 Premium (Kuraray Noritake Dental Inc.), dental practitioners have a material at their disposal that supports simplified procedures and predictable outcomes as well. It comes with fixed shade combinations of Dentin and Enamel, each of which covers three VITA shades. Consequently, the need for complicated shade schemes and colour combination formulas is eliminated.

The following case reveals how to use it in the context of an anterior restoration procedure.

STEP 1 – ISOLATION AND INITIAL EVALUATION

Rubber dam isolation was performed to provide for optimal moisture control and field visibility. Initial photographs were taken to document the preoperative condition. The defects on teeth #22 (mesial), #21 (distal), #11 (distal), and #12 (mesial, FDI notation) were evaluated under dry conditions.

STEP 2 – SHADE SELECTION

Shade selection was performed under rubber dam isolation using CLEARFIL MAJESTY™ ES-2 Premium Shade Guide (Kuraray Noritake Dental Inc.). The selected shades were A1D (dentin) and A1E (enamel) from CLEARFIL MAJESTY™ ES-2 Premium, providing optimal blending with the surrounding natural teeth.

STEP 3 – CAVITY PREPARATION

After completing the shade selection, carious tissue was thoroughly removed from teeth #22, #21, #11, and #12. Conservative Class III cavity were prepared with a focus on maintaining maximum enamel support and preserving tooth structure. Palatal and buccal views were documented to demonstrate the cavity extension and cleanliness of the preparation.

STEP 4 – ETCHING

Selective etching was performed using K-ETCHANT Syringe (Kuraray Noritake Dental Inc.) on the enamel margins of the prepared cavities. Adjacent teeth were protected using PTFE tape to prevent unintended etching. This step provides for optimal micromechanical retention and enhances the bond strength of the adhesive system.

STEP 5 – ADHESIVE APPLICATION

CLEARFIL™ SE BOND 2 (Kuraray Noritake Dental Inc.) was used as the adhesive system. Following the manufacturer’s protocol, the primer was first applied to all cavity surfaces, left undisturbed for 20 seconds to allow adequate penetration, and then gently dried with air. The bond was then applied, air-thinned, and light cured. This two-step self-etch adhesive provides reliable adhesion and long-term stability in direct restorations.

STEP 6 – LIGHT POLYMERIZATION

Following the adhesive application, each surface was light-cured using a high power LED curing unit. The tip of the curing device was positioned as close as possible to the bonding surfaces to enable optimal polymerization of the adhesive layer.

STEP 7 – COMPOSITE RESTORATION AND FINISHING

The restorations were completed using a multilayering approach. Palatal shells were initially built with A1E (enamel shade) to establish the outline form. The dentin body was reconstructed with A1D, followed by a final enamel layer (A1E) to achieve natural translucency and surface texture. After finishing the contouring, polishing was performed to achieve a lifelike gloss and seamless integration with the surrounding dentition.

Dentist:

KORAY KENDIR

Dt. Koray Kendir is a graduate of Hacettepe University Faculty of Dentistry and the co-founder of a private dental clinic in İzmir. He specializes in digital dentistry, smile design, and computer-aided restorative treatments. Known for his innovative approach, Dr. Kendir is a frequent speaker at national dental congresses and serves as an advisor to several dental companies.

Business Development Representative UK

Team Member – Dental Market (North of England) 
Are you an energetic team player with a passion for dentistry? Kuraray Noritake Dental is looking for a new chairside Team Member Business Development Representative to join our fast-growing team in the North of England!

About Kuraray Noritake Dental

Kuraray Noritake Dental is a global leader in the dental sector, specializing in high-quality materials for dentists and dental technicians. Our innovative products help dental professionals deliver the best care to their patients. With headquarters in Tokyo, Japan, and our Northern European office in IJmuiden, we serve the Benelux, Nordics, Baltic States, United Kingdom, and Ireland. As a subsidiary of Kuraray Inc., a multinational with an annual turnover of over €4 billion and more than 8,300 employees, we combine the advantages of a large organization with the personal culture of a smaller company.

What will you do?

• Support our team at dental events, trade shows, and on-site activities (including occasional weekends);
• Work closely with colleagues in a dynamic, ambitious, and international environment;
• Help increase the visibility of Kuraray Noritake Dental and our innovative products in the dental market;
• Maintain and develop relationships with dental practices, depots, universities, and key opinion leaders;
• Represent Kuraray Noritake Dental at exhibitions, symposia, and conferences;
• Analyze market trends and customer needs;
• Provide hands-on support and training to partners and customers.

What are we looking for?

• Based in the North of England
• Willingness to travel and occasionally work weekends;
• At least 2 years of experience in the dental market;
• Strong communication and interpersonal skills;
• Creative, curious, and proactive attitude;
• Ability to work independently and as part of a fast-paced, growing team;
• Structured approach to work and high level of initiative;
• Entrepreneurial spirit and strategic thinking;
• Presentation skills and willingness to invest in learning;
• Experience with CRM systems is an advantage.

Why join us?

• Be part of a diverse, ambitious, and award-winning team in the dental industry;
• Extensive training program and full marketing/technical support;
• Opportunities for career progression as we continue to grow;
• Competitive salary based on experience, company car, phone, computer, bonus scheme, and solid training opportunities;
• Work from your home office.

Interested?

To apply for the "Business Development Representative UK" vacancy, email your CV and application letter to Fiona Bell at Fiona.Bell@kuraray.com. For details, call +447730219605. We look forward to welcoming our new colleague!

Acquisition in response to this advertisement will not be appreciated!

Case by Andreas Chatzimpatzakis

Many modern, tooth-coloured dental materials enable us to achieve more with less. By using high-strength ceramics with a multi-layered colour structure and natural translucency, for example, the path to the desired outcomes involves fewer components, smaller layers and a reduced number of bakes. A possible streamlined procedure is illustrated below. The main materials used were KATANA™ Zirconia HTML PLUS for the screw-retained implant-supported superstructure and CERABIEN™ MiLai (both Kuraray Noritake Dental Inc.) for vestibular micro-layering.

Fig. 1. Zirconia-based screw-retained implant-supported prosthesis after milling and carving to obtain a natural surface texture.

Fig. 2. Restoration after sintering. To intensify the colour characteristic of the multi-layered blanks, the surface was treated with Esthetic Colorant (mainly in the incisal area and the gum parts).

Fig. 3. Appearance after the application of CERABIEN™ MiLai SS Fluoro.

Fig. 4. Restoration after the application of CERABIEN™ MiLai internal stains. They add some natural shading effects to the tooth and gum areas.

Fig. 5. Restoration on the model after micro-layering. In the cervical area, CERABIEN™ MiLai LT1 was mainly used, while the middle and incisal areas were individualized with E2 and Tx, the latter adding a seamless gradient in translucency. For the gingiva, the choice fell on the tissue porcelains 1, 5 and 6.

Fig. 6. Finished restoration on the model.

Fig. 7. The micro-layer of porcelain has a brilliant effect.

Fig. 8. The lifelike appearance is due to a smart combination of surface texturing …

Fig. 9. … and micro-layering with a comprehensive set of internal stains plus porcelains.

CONFIDENCE AND CONTROL

Full ceramic layering can produce beautiful results, but can be quite complex and time-consuming. In times with limited availability of skilled personnel and high-performance materials being offered, it may be a valuable strategy to opt for micro-layering with CERABIEN™ MiLai whenever appropriate. The system provides precise control over the layering and shading procedure, so that highly aesthetic and functional outcomes are easily and confidently obtained.

Dental technician:

ANDREAS CHATZIMPATZAKIS

Andreas graduated from the Dental Technology Institute (TEI) of Athens in 1999. During his studies he followed a program at the Helsinki Polytechnic Department of Dental Technique, where he trained on implant superstructures and all ceramic prosthetic restorations. As of 2000, he is running the ACH Dental Laboratory in Athens, Greece, specialized on refractory veneers, zirconia and long span implant prosthesis. In 2017 Andreas visited Japan where he trained under the guidance of Hitoshi Aoshima, Naoto Yuasa and Kazunabu Yamanda and become International Trainer for Kuraray Noritake Dental Inc..

TEETHMATE™ DESENSITIZER RECOGNIZED AS TOP PRODUCT YET AGAIN

Dental Advisor has recognized TEETHMATE™ DESENSITIZER as a Top Product in the category of Hygiene – Desensitizer yet again. This year’s recognition – the eleventh in a row (2015 – 2025) – was announced in the January/February 2025 issue of the publication. TEETHMATE™ DESENSITIZER allows an effective non-invasive approach to the treatment of hypersensitivity – a painful condition that generally occurs when dentinal tubules are exposed – when used as directed by dental professionals.

HOW IT WORKS

TEETHMATE™ DESENSITIZER is designed to crystalize hydroxyapatite (HAp), a mineral that is naturally found in enamel and dentin, and is the human body’s strongest material. When applied to exposed, mechanically treated, or freshly prepared dentin, the calcium phosphate-based mixture blocks the exposed tubules and provides immediate pain relief. During setting, HAp is formed, providing for long-term prevention of hypersensitivity. Further, when used in the context of restorative treatment, TEETHMATE™ DESENSITIZER does not have a negative effect on the bond strength of subsequently utilized dental adhesives or cements.

BENEFITS IN A NUTSHELL

TEETHMATE™ DESENSITIZER is a versatile solution providing hypersensitivity relief independent of the cause. It is perfectly suited for

• Treatment of dentin exposed by toothbrush abrasion, gingival recession, periodontal disease and/or acid erosion.
• Treatment of dentin after mechanical tooth cleaning, scaling and/or root planing.
• Treatment of the tooth surface before and after bleaching.
• Treatment of prepared dentin for fillings and/or prosthetic restorations.

The use of the product is also beneficial as it is

• Easy to mix and apply.
• Proven to be effective.
• Tissue-friendly and highly biocompatible.

OUTSTANDING CLINICAL PERFORMANCE RATING: 96 PERCENT

In a clinical evaluation, the Dental Advisor consultants found TEETHMATE™ DESENSITIZER effective in providing hypersensitivity relief immediately following and for up to six months after application. The study evaluated 27 patients diagnosed with gingival recession-related hypersensitivity, which was diagnosed using thermal testing with cold air. For the initial assessment, patients were asked to evaluate their level and frequency of hypersensitivity per tooth on a five-point scale. They were questioned about their level of sensitivity immediately after TEETHMATE™ DESENSITIZER was applied, according to the instructions for use, and again six months later. At baseline, 91 percent of the patients stated that they had no or only mild, sporadic sensitivity, which was still the case for 85 percent after six months.

Among the consultants’ comments were

• “TEETHMATE DESENSITIZER is easy to apply and seems to provide consistent relief.”
• "At six months, the majority of patients continue to experience marked improvement from their preoperative sensitivity or no sensitivity at all."

As a result, the product received a clinical performance rating of 96 percent.

ABOUT DENTAL ADVISOR

The Top Product and Preferred Product Awards from Dental Advisor, a US-based organization, were initiated to help busy practitioners navigate the variety of new dental solutions available, particularly for less invasive techniques and standardized procedures. These awards aim to identify products that improve outcomes consistently. Dental Advisor conducts clinical evaluations and product performance tests shortly after a product’s launch and publishes annual results online to help practitioners identify high-quality dental materials suited to their specific needs.

For more information, visit Dental Advisor at: www.dentaladvisor.com

Interview with Dr. Ludivine Facon

Individual prophylaxis, early defect detection and treatment, minimally invasive restorative techniques: In her joint dental practice in Anstaing, France, Dr. Ludivine Facon does everything in  her power to keep her patients’ teeth healthy for their lifetime. When we met her at the International Dental Show in Cologne, where she was a speaker for Kuraray Noritake Dental Inc., we asked her to share information about her treatment philosophy and how flowable injection fits into her overall approach.

Your treatment philosophy seems to be minimally invasive. Would you please tell us a bit more about it?

Ever since I started treating patients, my priority has always been to preserve the dental tissues and to be as minimally invasive as possible when restoration is required. My interest in prevention started with my thesis in 2000, which focused on oral health prevention in Quebec, Canada, a country where prophylactic care is an integral part of dental treatment. I have always been highly interested in individual prophylaxis, which naturally led me to focus on minimally invasive treatments. My goal is to stay as low as possible on the therapeutic gradient, always thinking about the long-term benefits for the patient.

What are the benefits of this approach for your practice?

Integrating prophylaxis for every patient into my practice allows me to work with excellent surface conditions for bonding. The oral environment is sanitized before applying conservative restorations, and carious lesion removal is kept to a minimum.

When defects – be it a carious lesion or severe tooth wear – are present, I use the following instruments and materials that allow for truly minimally invasive interventions:

• Rondoflex 50-micron sandblaster to roughen the surface,
• Micro diamond burs to remove what is necessary,
• Layered composites for single-tooth restorations,
• Injected composites when multiple teeth are involved.

Case predestined for composite injection, as multiple teeth in the maxilla need to be treated (smile makeover).

What dental materials do you use for your restorative procedures?

I am a hands-on dentist, and in my daily practice, I strictly follow surface preparation and bonding protocols recommended for CLEARFIL™ Universal Bond Quick 2 (Kuraray Noritake Dental Inc.). In addition, I use high-quality composites from Kuraray Noritake Dental Inc. For layering, CLEARFIL MAJESTY™ ES-2 Premium Enamel and Dentin are my got-to solution, while I use CLEARFIL MAJESTY™ ES Flow Low for injection.

What are the benefits of a conservative approach for your patients?

Patients appreciate the fact that my treatment approach is as conservative as possible while still allowing for easy reintervention if necessary, preserving as much healthy dental tissue as possible. Another significant advantage is the moderate cost, which makes the treatment more accessible.

How does composite injection fit into this philosophy?

This technique allows for an easy reconstruction of multiple teeth by transferring a wax-up designed in the lab into the mouth via an injection of modern flowable composite into a transparent silicone index. Patients like this technique because it is aesthetic, reliable, reproducible and minimally invasive. A major advantage is that it allows for touch-ups and repairs, making it a reassuring solution. In some cases, no tooth preparation is needed at all—we simply add material, making the whole treatment truly non-invasive.

Why do you think this technique is promising?

It is a trendy and promising technique because:

• It is non-invasive --> preserves tissues --> aligns with minimally invasive dentistry.
• It is predictable --> due to the index, the technique is reproducible.
• It is easier than traditional layering --> saves chair time and improves patient comfort.
• It is cost-effective --> a cheaper alternative to ceramic veneers.
• It allows for repairs at any time, making it a reassuring option.

How did you proceed before knowing this technique?

In the anterior region, I used traditional composite layering with a wax-up and a palatal silicone index. It allowed me to rebuild the palatal wall and provide for precise incisal edge placement. In the posterior region, I used inlays, onlays, or overlays made of lab-processed reinforced composite or lithium disilicate.

Transparent silicone index with injection hole used to inject the flowable composite and restore the tooth to its planned shape.

What made you start using the new technique?

There has been an explosion in demand for smile enhancements, especially among young adults. The composite injection technique is an appealing alternative for reshaping smiles in young patients with intact teeth but unsatisfactory size or shape. It is less invasive than veneers, which have gained popularity due to social media trends, but often require significant tooth preparation.

How did you proceed in the beginning?

I first discovered the technique in a specialized journal in 2019, then trained myself using online tutorials. Of course, there were some trial-and-error moments, but it is a very accessible technique—even for beginners. To achieve optimal results, I believe that proper case selection and treatment planning are key. One of the most important preconditions for aesthetic outcomes is that the patient’s teeth have a simple shade structure. If the shade structure of the teeth is complex or the required restoration is large, it is better to layer the dentin before injecting the enamel. Moreover, it is essential to produce two models in the wax-up phase, not just one: An “intermediate wax-up model” with every other tooth featuring the wax-up, while the remaining teeth remain unmodified. The second is a “full wax-up model” with all teeth reshaped.

Considering these aspects, it is possible to obtain great outcomes quite quickly. The learning curve is steep, however – as with every new technique to be implemented – you need to step out of your comfort zone.

Apart from CLEARFIL™ Universal Bond Quick 2 and CLEARFIL MAJESTY™ ES Flow Low you already mentioned, what instruments and materials do you use?

For treatment planning including the wax-up, I use digital technology via Smilecloud, but a traditional wax-up works just as well. The production of the silicone index is the most delicate part when doing it in-house. I recommend using EXACLEAR (GC), the only truly effective transparent silicone currently available. Adjacent teeth are isolated with PTFE tape. Finishing instruments that have proven their worth are:

• Scalpel Blade No. 12,
• 3M™ Sof-Lex™ Contouring and Polishing Discs (Solventum),
• Red-ring fine diamond burs,
• TWIST™ DIA for Composite polishers (Kuraray Noritake Dental Inc.).

Intermediate wax-up model: One tooth with wax-up followed by one tooth without.

Full wax-up model.

Do you believe that the quality of the outcome is affected by the composite material you use?

Absolutely! New high-filled flowable composites, like CLEARFIL MAJESTY™ ES Flow Low, offer excellent mechanical properties and polishability, making them very promising.

Highly aesthetic treatment outcome after injection of CLEARFIL MAJESTY™ ES Flow Low.

What material characteristics impact overall quality?

First of all, the optical properties or shade matching ability of the material are crucial. I like the fact that I can select from a variety of shades when using CLEARFIL MAJESTY™ ES Flow. Once the right shade is selected and the thickness of the injected layer does not exceed 1 mm, the optical properties of the restorations may be expected to be exceptional.

Moreover, we need a material with great flow properties (fluid, but not too runny), which is virtually void-free. I prefer using low viscosity flowable composites like CLEARFIL MAJESTY™ ES Flow Low (two other flowabilities – HIGH and SUPER LOW – are also available). The physical properties (mechanical strength) and polishability plus polish retention are also important. They are usually excellent with premium flowable composites.

What are your most important clinical tips and tricks?

For beginners:

• Press firmly on the cervical area of the silicone index to reduce excess material upon removal.
• Finish the proximal area thoroughly before moving to the next injection step. This way, you provide for perfect key positioning for the following teeth.

If you follow the protocol, the technique is very beginner friendly!

What is your opinion about the emerging hybrid "layering & injection" technique?

This hybrid technique complicates the original injection technique, which is meant to simplify composite restorations. However, it is very useful in cases where aesthetic complexity requires layering. For maximum mimicry with this technique, I would love to have injectable composites in an enamel shade at my disposal.

Would you please share your final thoughts with us?

Take your time planning! Observe, document, take photos, use digital tools! Less is more.

Dr. Facon, thank you very much!

Dentist:

LUDIVINE FACON

Dr. Ludivine Facon graduated from the University of Lille, where she developed a solid foundation in dentistry. Passionate about periodontology and dental aesthetics, Dr. Facon pursued specialized training to refine her skills in these fields. In 2007, she completed clinical periodontology training at the Charon Clinic, followed by individual dental prophylaxis training with Michel Blique in 2008. From 2013 to 2014, she attended the long cycle program at the Académie du Sourire in Aix-en-Provence, enhancing her expertise in dental aesthetics. Dr. Facon continued to build on her knowledge with international training, including at the International Institute of Periodontology in Montreal in 2015, and a veneer training course at the GAD Center in Bordeaux the same year. In 2016, she further advanced in mucogingival surgery at the Académie de Parodontologie in Aix-en-Provence. Always keeping up with the latest developments, she participated in the CIDAE training in Brussels in 2022. More recently, in 2024, Dr. Facon completed a course in composite layering and injection, led by Guillaume Piskorski, the French specialist in injected composite technique, in Lille. With extensive expertise, Dr. Facon is also an educator in direct aesthetic composites, having taught at the University of Lille in 2020, 2022, 2023, and 2024.