100 years ago, the Association of the German Dental Industry (VDDI) organized its first dental show. Now, the show that became the world’s leading dental trade fair is just about to take place for the 40^th time – and Kuraray Noritake Dental Inc. is going to be part of it. At the company’s booth in Hall 11.3 (Stand E010), visitors are invited to discover new opportunities related to countless innovative products and their benefits – by chatting with the warm-hearted and knowledgeable team or by watching one of the lectures and hands-on demonstrations given by numerous internationally renowned experts.

Among the products worth a closer look are universal excellence solutions. These universally applicable, highly intuitive materials may be used to streamline clinical workflows by reducing the number of required components and work steps. Prominent examples are a universal composite with very few universal shades, a universal adhesive suitable for every etching technique and a universal resin cement working as a single-component solution even on silica-based ceramics.

Dental practitioners with a particular interest in prosthodontics should stop at the desk focusing on indirect restorative workflows. Here, they will find the PANAVIA™ family of resin cements and its three popular members, which are able to cover virtually every need. Moreover, CAD/CAM blocks for chairside processing and KATANA™ Cleaner, a cleaning solution providing for optimal bonding conditions on every surface will be presented here.

The bread and butter of many dental offices is placing direct restorations. However, the patient- and situation-specific demands may vary widely and may require very different types of materials – even within the class of composites. That is why Kuraray Noritake Dental offers various types of restoratives – all with excellent mechanical properties and innovative technologies such as Light Diffusion. They are part of the CLEARFIL MAJESTY™ series, showcased at the booth together with the well-known and researched CLEARFIL adhesives.

Minimally invasive restoration designs and excellent aesthetic despite a high degree of automation have found their way into dental technology. The materials required to realize these patient-centred concepts are found at a dedicated counter of the Kuraray Noritake booth. New in the portfolio: Esthetic Colorant that enables dental technicians to create characteristic shade effects on pre-sintered KATANA™ Zirconia!

A special highlight for dentists and dental technicians will be the lectures and hands-on demonstrations hosted by internationally renowned speakers. They will take place from Wednesday, March 15 to Saturday, March 18, 2023, at the Kuraray Noritake booth. The full programme and additional information about what to expect from Kuraray Noritake Dental in Cologne is available online at www.kuraraynoritake.eu. For those who are unable to attend in person, the presentations will also be broadcasted online.

A particularly chromatic cervical area, pronounced mamelons and translucencies in the incisal area: every natural tooth has its characteristic optical features stemming from its inner structure. Unfortunately, imitating these specific effects by merely adding stains or liquid ceramics to the surface of a monolithic restoration is quite hard to achieve. For this reason, Kuraray Noritake Dental Inc. introduces Esthetic Colorant for “KATANA™ Zirconia” – a set of easy-to-use shading liquids diffusing into the zirconia structure and enabling imitation of variety of internal shade structures. It is an excellent choice for creating initial characteristics of the restoration before the sintering procedure, and by doing so laying groundwork for the final fast and easy individualization.

Esthetic Colorant has been specifically developed for the “KATANA™ Zirconia” Multi-Layered Series to complement the effects obtained from the materials’ multi-layered colour structure. The system consists of twelve shading liquids, which have been optimised to maintain the original flexural strength of the “KATANA™ Zirconia” restoration. After milling, the liquids are applied to the clean surface of a monolithic or anatomically reduced restoration with a metal-free brush, preferably with our Liquid Brush Pen. The Esthetic Colorant then diffuses into the zirconia, and the desired inner shade effects are fixed and revealed after the final sintering procedure. Finishing can be accomplished through a variety of techniques including polishing, glazing and micro-layering.

The compact Esthetic Colorant line-up facilitates inventory management, while the typical effects of natural teeth can be reproduced in a predictable way. Using the new Liquid Brush Pen for Esthetic Colorant, the application procedure is streamlined, as the dental technician is given full control over the amount of shading liquid applied.

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

2023 IS A YEAR OF RABBIT, BUT DID YOU KNOW THAT...

• Rabbits’ eyes are on the sides of their head, meaning they can see almost all the way around them.
• A rabbit’s best feature? Their long ears! Growing up to 10 centimeters in length, rabbits can turn their ears by 180 degrees, keeping a careful listen out for predators.
• A rabbit’s teeth never stop growing! Instead, they’re gradually worn down as the rabbit chews on grasses, wildflowers and vegetables.*

*We at Kuraray Noritake Dental wonder - does this make a rabbit the ideal patient?

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.