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In January 2019, Kuraray Noritake Dental proudly hosted a symposium dedicated to the KATANA™ Zirconia Block. Dental professionals from across Europe gathered in Berlin to hear a number of experts detail their research into, and clinical experiences with, this all-zirconia solution. Among those presenting were Dr Alessandro Devigus and master dental technician Daniele Rondoni, both active members of the European Academy of Esthetic Dentistry.

Devigus and Rondoni’s presentation was focused on discussing the possibilities of the KATANA™ Zirconia Block for restorations in the aesthetic zone. Devigus, who is the founder and president of the Swiss society for computer-aided dentistry (SGcZ), spoke of the dual meaning of the word ‘digital’—though it refers to numbers, it also can be used to describe something performed with one’s digits, or fingers. Digital dentistry, he explained, thus combines the reliability of computer-aided design and manufacturing with the creativity and aesthetic possibilities of handcrafted restorations. “This combination of hands and machine is, simply put, what defines digital dentistry,” Devigus said.

The evolution of KATANA™

Rondoni highlighted the evolution of Kuraray Noritake Dental’s work, particularly with zirconia. Having been an international instructor for the company for many years, he spoke of witnessing the development of the KATANA™ family into a solution that can truly replicate the appearance of natural dentition. “Thanks to the multilayered nature of this material, we can obtain a mimetic effect in regards to the optical properties of a natural tooth,” he explained, and described how these multiple layers effectively reproduce the shade gradation of teeth and work to create a three-dimensional effect.

Fluorescence is crucial

Both presenters emphasised the importance of fluorescence for the aesthetic qualities of dental restorations. “My concern was always that, with zirconia, there was no fluorescence,” Devigus admitted. This fear was easily allayed, however, with the use of Kuraray’s Cerabien™ ZR FC Paste Stain, a product optimised for full-zirconia restorations.

A true chair side solution

To demonstrate their experiences with the KATANA™ Zirconia Block, the two presenters then showed a number of clinical cases that they had worked on together in Devigus’ dental practice in Bülach in Switzerland. Devigus praised the speed sintering that is made possible through the block’s integration with Dentsply Sirona’s CEREC system, saying that, “For me, if a material can be used to complete a restoration in less than two hours, then it is truly a chair side material. You cannot expect a patient to sit there and wait there for four hours in your dental practice—but this is not a concern with the KATANA™ Zirconia Block.

The KATANA™ Zirconia family of multi-layered CAD/CAM blanks has a new member: KATANA™ Zirconia YML (yttria multi-layered). Based on Kuraray Noritake Dental Inc. (KND) proprietary multi-layer technology, this new material offers multiple layers with different levels of chroma and translucency PLUS different concentrations of yttria in a single blank. We talked to two experts from Kuraray Noritake Dental’s Research & Development Department in Japan, Atsushi Matsumoto and Yuta Tajima, about the new product and its specific features.

Mr. Matsumoto, Mr. Tajima, KND already offers a broad range of zirconia materials covering virtually every indication. Why did you decide to start developing yet another dental zirconia?

The KATANA™ Zirconia series has indeed received high praise and great feedback from the market. Users particularly appreciate the remarkably high strength of HTML, the well-balanced aesthetic and strength properties of STML, and also the high translucency of UTML. Although there has been a large increase of zirconia materials in the dental market recently, we have received many requests from our customers for a more universal material that offers the excellent properties of all variants of KATANA™ Zirconia in one product. This product should allow them to fabricate all kinds of restorations from a single disc, from single crowns to full bridges, while maintaining high aesthetic and mechanical properties for both anterior and posterior restorations. As the developer of the KATANA™ Zirconia series, the invention of KATANA™ Zirconia YML is our response to these desires expressed by our customers.

What is the main difference between KATANA™ Zirconia YML and the other available products of the KATANA™ Zirconia Multi-Layered Series?

All layers of KATANA™ Zirconia UTML, STML and HTML are produced from the same basic powder composition and therefore offer the same strength throughout the whole blank. Depending on the case specific requirements, users need to select the most suitable type of material, either a high-strength zirconia or a highly translucent variant. KATANA™ Zirconia YML is an all-in-one zirconia suitable for all cases: It consists of a high-translucency enamel layer, an intermediate layer offering well-balanced strength, translucency and colour, and a high-strength body layer. The raw materials used for this product are developed and produced by KND exclusively for YML. This is another milestone in advanced product development KATANA™ Zirconia.

We have received many requests from our customers
for a more universal material.

In general, the currently available zirconia materials with an integrated strength gradient do not have a very positive image in the eyes of many dental technicians and specialists, due to the fact that in the incisal area, the materials seem to be insufficiently strengthened. This can lead to fractures when it comes to long-span restorations, especially if they are inadequately positioned within the blank. How carefully did KND focus on these problems and how did they try to solve them in order to stand out from the competition?

The current yttria-based multi-layer products on the market are facing complicated limitations in connector position in large cases, such as full-arch restorations, due to the lack of an ideal combination of aesthetics and strength. To overcome this challenge, KND developed well-balanced raw materials of high strength and high aesthetics, and by including these raw materials in the intermediate layer between the enamel and body layers. The result is that even for long-span restorations, it is very simple to position the connectors thanks to its excellent balance between high strength and high aesthetic properties. Due to these unique attributes incorporated in our new product, the risk of deformation and breakage is avoided.

Another problem is the often clearly visible line between the different layers containing different amounts of yttrium oxide, which can be seen at a more detailed inspection after sintering. How did you address this issue?

At KND, we achieved both, adequate translucency gradation and invisible transition lines, even for zirconia layers with different yttria content. This has been accomplished thanks to our multi-layer zirconia manufacturing technology refined over many years, which includes mixing the appropriate amount of each layer's boundary to intentionally avoid transition lines. In addition, the newly developed interlayer raw materials and a newly designed sintering schedule were the keys to success.

How is it possible to have a sintering protocol that works for different zirconia components within the KATANA™ Zirconia YML blank and allows for the shortest sintering times ever?

The amount of shrinkage during sintering is determined by different factors such as the number and quantity of additives (yttria, alumina etc.) it contains. If the shrinkage ratio of each layer is different, transition lines are likely to appear between the layers, which might produce tensions in the material structure. The newly developed raw material for KATANA™ Zirconia YML enables us to control and unify the shrinkage ratio for all layers, even for raw materials with different yttria contents.

The use of proprietary raw materials produced in-house with excellent properties suitable for high-speed sintering was the main precondition that allowed for the development KND’s high-speed sintering schedule (54 min for restorations up to 3-unit bridges), which is available for all products of the KATANA™ Zirconia multi-layered series. This option improves the efficiency of the dental technician’s work and simplifies the workflow.

Are there any differences in milling and adjusting KATANA™ Zirconia YML compared to competitor products?

All KATANA™ Zirconia products from KND have an appropriate hardness with less chipping during the milling process thanks to the raw materials manufactured and refined in-house. Also, after the sintering procedure, it offers excellent chipping resistance, especially during very challenging marginal adjustments.

Is there anything else that sets KATANA™ Zirconia YML apart from other products with an integrated strength gradient?

Yes, KATANA™ Zirconia YML offers reduced sintering deformation, thanks to in-house developed raw materials, based on proprietary technology to control shrinkage rate. Moreover, we offer a wide range of shades (14), which is another important aspect (apart from the material’s well-balanced aesthetic properties and absence of transition lines) for the creation of lifelike restorations. Finally, since three out of four layers meet the conditions for an ISO class 5 classification, there are few restrictions on the design variation of the prosthesis.

Why should a dental technician consider using KATANA™ Zirconia YML instead of any other dental zirconia (in your opinion)?

Atsushi Matsumoto:

It is now possible for dental technicians to produce strong and aesthetic restorations with just one material, KATANA™ Zirconia YML. This allows for a reduced inventory, while working time is significantly shortened due to the possibility of high-speed sintering.

Yuta Tajima:

To my mind, the most convincing properties are excellent firing accuracy due to well-balanced material properties across all layers, the wide range of shades available and the great design flexibility even when designing long-span bridges. Last but not least, the trusted quality of the KATANA™ brand and the label “Made in Japan” are reasons to opt for this new product.

All blanks from the KATANA™ Zirconia Series stand out from other dental zirconia materials due to their particularly fine-grained, densely pressed microstructure, which is the basis for a superior surface quality, edge stability and the resulting accuracy of fit. What is the secret behind this exceptionally high blank quality?

Since we do not know the correlation between marginal stability properties (chipping, etc.) and material compositions, structures etc., it is very difficult to answer this question. It may depend on the structures of the zirconia crystals, the raw material itself, the correct strength level after pre-sintering or any other minor factor during the manufacturing process of the disc. All these factors together, of course, are important.

We are using pigments developed by KND, which have an excellent colour stability without fading even after the final sintering procedure.

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

A clear advantage of the KATANA™ Zirconia series, much praised by KND's Key Opinion Leaders, is its colour stability and shade match to the "VITA classical shade guide". Can you explain the importance of an in-house conducted addition of additives and color pigments in form of metal oxides to satisfy the user and distinguish KATANA™ Zirconia from competitors’ products?

We are using pigments developed by KND, which have an excellent colour stability without fading even after the final sintering procedure. The particle size is appropriately controlled. In addition, our professional "colour mixing" staff, reflecting the opinions of clinically experienced dental technicians both inside and outside the company, have achieved a pigment mixture that shows only a slight change in shade even in cases with different thicknesses.

What is your vision with regard to future developments in dental zirconia?

Since the introduction of zirconia on the dental market, many significant material advances have been achieved. Today, there are high-strength, low light-transmitting zirconia materials up to high light- transmitting, low strength zirconia materials available on the market. Furthermore, there are now also high light-transmitting, low strength zirconia materials in mixed systems (YML series) offered. Our foremost goal is to develop the ultimate zirconia in near future, combining both high strength and high light transmission, which breaks the general expectation of a compromise between strength and translucency within zirconia materials.

An interview with Dr. Tomohiro Takagaki, DDS, PhD by Dr. Jorge Espigares, DDS, PhD

Due to its increased usability, one-step universal adhesives are becoming more popular and are the choice of many clinicians all around the world. Nonetheless, some studies have shown lower performance for one-step universal adhesives than previous generations.

Dr. Jorge Espigares, DDS, PhD, Planning and Development Department at Kuraray Noritake Dental Inc., interviewed Dr. Tomohiro Takagaki, DDS, PhD, lecturer and former assistant professor at Tokyo Medical and Dental University (TMDU), pioneer in the field adhesive dentistry, author of many publications, and currently lecturing at Asahi University, Japan.

Dr. Takagaki, in your opinion, what are the most important factors for a good and durable adhesion?

Dr. Takagaki: Good resin infiltration (penetration) and good polymerization are essential factors for good bonding. This is the basic concept for the formation of the hybrid layer. Additionally, there are other important factors such as low water sorption for bonding durability and the demineralization depth, which should be the same as the depth that the resin is capable of penetrating to.

Nowadays, the trend seems to be one-step universal adhesives. Do you believe that this reduction in steps has brought any limitations compared to previous generations?

Dr. Takagaki: Traditionally, one-bottle adhesives are too hydrophilic. This hydrophilicity also brings high water sorption, therefore the durability of the interface is compromised. At TMDU, we did not accept one-step bonding agents in clinical usage based on results we obtained in our research in that area.

Water sorption/solubility of different bonding agents.
Data provided by Tokyo Medical and Dental University.

What do you think of the new MDP-Amide chemistry (included in CLEARFIL™ Universal Bond Quick) for overcoming such limitations?

Dr. Takagaki: The MDP monomer has proved through research to be the best monomer for adhesion to tooth substrate. Nowadays, many manufacturers include MDP. Although the MDP purity and performance differs from Kuraray Noritake’s original one, in one-step bonding agents only MDP is not enough. The differential factor is the amide monomer that provides the desired high penetration and low water sorption.

You and your work at TMDU are very well known in the field of adhesive dentistry. Did your research show results that would support the above mentioned statements?

Dr. Takagaki: In our research results, we observed indeed a lower water sorption compared to previous one-step generations. Actually, we were surprised to see water sorption levels equivalent to the two step bonding agent gold standard: CLEARFIL™ SE BOND. (1. Graph). The amide monomer behaves as hydrophilic before the polymerization and as hydrophobic after, which is the desired situation for one bottle self-etching systems.

Would you recommend, therefore, the usage of universal bonding agents in daily practice?

Dr. Takagaki: Yes, but as mentioned, the MDP-amide chemistry is essential. It is noteworthy that another company is also using an amide monomer. However, our results at TMDU indicate that the performance in terms of penetration is not that good. Actually, we still saw lesion formation with that other company’s amide. Kuraray Noritake’s MDP-amide chemistry is the only one that avoids lesion formation (2. SEM images). In addition, CLEARFIL™ Universal Bond Quick releases fluoride that helps protecting the interface degradation and its “no waiting time” makes it ideal for challenging conditions as pediatric and/or geriatric patients.

Let’s get out of the laboratory, according to your clinical experience is there any extra advice that you could provide for a reliable adhesion?

Dr. Takagaki: One important point that sometimes is missed is to properly air-dry the solvent for at least 5 seconds after the bond application. I also recommend selective enamel etch for achieving aesthetic margins, even if all universal bonding agents allow self-etching. Finally, I would like to talk about simplicity. We dentists tend to shorten the necessary time and sometimes the rubbing time is not respected. With CLEARFIL™ Universal Bond Quick, our research showed not significant difference in bond strength with rubbing time (3. Graph). Therefore, it reduces the risk of error, allowing consistent results. I believe that simplicity is required so the fact that CLEARFIL™ Universal Bond Quick and PANAVIA™ SA Cement Universal can cover direct and indirect restorations, is ideal for daily practice. CLEARFIL™ Universal Bond Quick achieves what I am looking for in my practice: easy, quick and reliable.

Although the amount of available universal adhesives market is large, key properties like the ones above-mentioned may help in the complicated process of selecting a one-step adhesive that offers the best performance, simplicity, consistency and predictable results.

Bond strength upon rubbing time. Data courtesy of Tokyo Medical and Dental University.

PROVEN SCIENCE AND ARTISTRY LEAD TO QUALITY

Kuraray Noritake Dental enables the unique in-house production of raw materials. In contrast to our competitors, who source their raw materials externally (well known: Tosoh Cooperation), Kuraray Noritake Dental distinguishes itself by its unique in-house production of zirconia raw materials. Many years of expertise in manufacturing the company’s own powder have brought the material quality of KATANA™ to completely new dimensions, not only by controlling the degree of purity and particle sizes, but also by creating an optimal balance of binders, color pigments, stabilizers and other ingredients.

“WE CONTROL EVERY DETAIL.”

KATANA™ Zirconia STML NW with CERABIEN™ ZR FC Paste Stain
Sergio R. Arias DDS, MS Sung Bin Im, MDC, CDT

NEW SINTERING SCHEDULE

In addition to the new sintering programs, the traditional KATANA™ sintering programs can also be used, if desired.

The Function that becomes aesthetics

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

Click here to read. Enjoy!

Start Reading: BOND | SPECIAL EDITION | 6/2021

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BOND | VOLUME 7 | 10/2020

Case by Dr. Matthieu Gilli

Fig. 1. A 25 years old female patient was dissatisfied with the aesthetics of the existing composite filling in tooth 21.

Fig. 2. Shade determination of the cervical and middle third of the tooth. By using small amounts of different shades of CLEARFIL MAJESTY™ ES-2 Premium Dentin.

Fig. 3. Contrast increase allows for:

- a better picture of dentinal structure
- dentin shade selection with more accuracy

Fig. 4. Two spheres of two different Premium Enamel shades are put at the incisal edge and the photo turned to black and white to optimise the evaluation of the translucency.

Fig. 5. To allow for the creation of a suitable palatal index, a large isolation field is necessary.

Fig. 6. Since the shape of the existing restoration is still correct the putty index can be made directly in the mouth.

Fig. 7. To improve both adhesion and optical integration, a bevel of 2 mm, 45° has been made as recommended by XU et al. (Eur J Oral Sci 2012).

Fig. 8. Selective enamel etching with 30% phosphoric acid for 30 sec. followed by rinsing and drying.

Fig. 9.

Left: Self-etch primer on dentin followed by bonding with CLEARFIL™ SE Bond.
Middle: 20 sec., 1000 mW/cm2 polymerisation of the bonding.
Right: Completed adhesive procedure with CLEARFIL™ SE Bond.

Fig. 10. Palatal shell made of A1E shade with the aid of the palatal putty index.

Fig. 11. Proximal matrix in place.

Fig. 12. Dentin replaced with CLEARFIL MAJESTY™ ES-2 PREMIUM A2D.

Fig. 13. To create the incisal halo, a small amount of A1D has been applied at the incisal edge.

Fig. 14. A tiny amount of CLEARFIL MAJESTY™ ES-2 Premium Translucent Blue is placed between the mamelons to create translucency.

Fig. 15. A white spot is created with a white opaque staining material to complete internal characterisation.

Fig. 16. A small amount of CLEARFIL MAJESTY™ ES-2 PREMIUM A1E is applied as a final covering layer.

Fig. 17. Secondary anatomy is marked with a pencil as a polishing area guide.

Fig. 18. 2 week follow-up.

FINAL SITUATION

Dentist:

DR. MATTHIEU GILLI

Dr. Matthieu Gilli graduated in 2014 as a dentist from the Université Catholique de Louvain, Brussels. Currently he is completing his PhD study in Service of conservative dentistry, at the same university.

Dr Max Andrup, a 2010 graduate of Umeå University, currently runs a private practice in the city of Hudiksvall in Sweden, where he maintains a passion for restorative dentistry with a biomimetic approach. In this interview, he discusses the future of restorative dentistry and explains why he relies on Kuraray Noritake Dental’s products for his daily workflow.

Dr Andrup, could you please tell us a bit about your dental career to this point?

For the first few years of my career, I pursued a residency as an oral and maxillofacial surgeon. For various reasons, I ended up buying my own practice instead, and I couldn’t be happier with that decision! It allows me to take my time with patients and focus on delivering high-quality treatment together with co-workers with whom I really enjoy working.

How did your passion for restorative dentistry develop?

I have always enjoyed bringing patients’ dentition back to a functional and aesthetic state. I’m not sure why exactly, but I started looking for dental accounts on social media to broaden my horizons and to see how others solved challenging clinical situations. This was a turning point for my career, as I found so much inspiration and learnt a great deal from what others shared.

Do you have a dental philosophy? If so, what are its guiding principles?

Knowing that many people don’t really like going to the dentist, my goal in my practice has always been not just to provide excellent oral care but also to offer a comfortable and relaxing experience. My ultimate goal is that no patient should feel anxious about his or her visit. The patients don’t necessarily have to look forward to their visits, but they shouldn’t be something over which they lose sleep.

When were you first introduced to Kuraray Noritake Dental's portfolio of products?

About three years ago, I found these Instagram accounts talking about gold standard adhesives and biomimetic restorative dentistry. This piqued my interest, and I started to read many scientific papers in order to understand why some adhesives worked better than others, why certain composites are preferable when replacing deep dentine, and so on. Products from one particular company kept coming up: Kuraray Noritake Dental. I had never worked with their products before but, convinced as a result of what I’d read and seen, I ordered a starter pack with CLEARFIL™ SE Protect adhesive, CLEARFIL MAJESTY™ Flow and CLEARFIL™ AP-X and haven’t looked back since!

Which Kuraray Noritake Dental products do you use on a daily basis in your workflow and why?

The one product I couldn’t survive without is the CLEARFIL™ SE Protect adhesive. It brings a level of research and clinical backing that gives me a feeling of confidence when conducting restorative dentistry. It contains the MDPB monomer, which results in lower levels of bond degradation. If you want to achieve a bond strength to dentine in the range of 40-50 MPa* it all starts with the right dentine bonding agent, and CLEARFIL™ SE Protect is just that.

*depending on testing method

What do you think will be trends, or points of emphasis, in restorative dentistry moving forward?

Unfortunately, I believe that the trend in the field of dentistry will continue to move towards simplification regarding bulk-fill restoratives and one-step adhesives. I can understand why-simple procedures are faster, and many clinicians have very limited time. The truth is, however, that developing a strong bond to dentine takes time, and you need to have an understanding of how the materials work to make the bond last.

In the past few years, new technologies have emerged that make it easier to study what happens in the bottom of a cavity when placing bulk-fill restoratives and, as expected, the contraction stress from the polymerisation process forms gaps in the cavity floor. This results in postoperative sensitivity and eventually a degraded bond. Getting a strong and durable bond to dentine starts with a gold standard adhesive like CLEARFIL™ SE Protect, but if you don’t respect the hybrid layer and place bulk fill over it, it will most likely fail.

By Prof. Dr. Florian Beuer

Zirconia has been the most popular all-ceramic material in dentistry for more than two decades. While the earlier generations of zirconia had to be veneered with porcelain to achieve acceptable aesthetics, recent developments showed higher translucency, allowing them to be used as full-contour restorations with partial veneering on the buccal aspects. However, the higher translucency was paid off by reduced mechanical stability.

In the past, we had to decide whether we want high stability or high translucency. With the introduction of the new KATANA™ Zirconia YML, both characteristics are combined in one disc. Analogue to previous multi-layer materials, the graded translucency is now combined with graded mechanical strength. The three apical layers (body 1 to body 3) consist of high strength zirconia with a flexural strength of 1000 MPa, while the enamel layer shows a flexural strength of 750 MPa. Thanks to this combination, aesthetics can be achieved much easier with higher buffers for mechanical stress. On the other hand, there is the potential to reduce thickness of the restoration and save tooth tissue during preparation.

At the KATANA™ Zirconia YML symposium (www.kuraraysymposium.info) on July 3^rd, we will look at the developments of zirconia in the last years and point out the significance of monolithic restorations, their strengths and the crucial issues in the treatment protocol. Join us!

Dentist:

PROF. DR. FLORIAN BEUER

Professor and Chair, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité – Universitätsmedizin Berlin, Germany.

The fact that different zirconia materials are used depending on the indication is both a blessing and a curse: Blessing because it allows dental technicians to achieve the best possible outcomes in every situation, and curse because the approach requires a extensive inventory and a lot of decisions. For those who prefer to take a more efficient route without compromising the outcomes, KATANA™ Zirconia YML is the new go-to solution. With its strong core and translucent outer layer, this new generation of multi-layered zirconia offers the properties needed for a broad indication range and easily obtained aesthetics.

KATANA™ Zirconia YML is the reinvention of the original multi-layer technology developed by Kuraray Noritake Dental Inc. (Kuraray Noritake Dental) more than a decade ago. It features new raw materials of different yttria concentrations integrated into the well-liked four-layer colour structure. The result is a disc with a well-balanced combination of chroma, translucency and flexural strength gradation.

As all body layers have a flexural strength of at least 1,000 MPa, the new zirconia fulfills the requirements for a broad range of indications even including monolithic long-span restorations. With its proven colour gradient and super-high translucency enamel layer, the aesthetic potiential is so high that it is often sufficient to opt for a monolithic design of the desired restorations and a time-saving finishing procedure such as polishing or ultra-micro layering with liquid ceramics (e.g. CERABIEN™ ZR FC Paste Stain).

The different layers in the blank are perfectly adjusted to each other through an in-house production procedure which ensures easy positioning of the restorations within the blank, a seamless multi-layer structure required for flawless aesthetics, a precise fit and predictable long-term behaviour.

The advanced fabrication and material composition comes with another advantage: A 54-minute high-speed sintering procedure is available for single-tooth restorations and bridges with up to three units. The optical and mechanical properties of the restorations are comparable to those after the alternative 90-minute or seven-hour sintering cycle.

KATANA™ Zirconia YML will be available July 1^st 2021. To celebrate the launch of the new member to our KATANA™ Zirconia family, we invite you to join us for a virtual kick-off symposium on July 3^rd, 2021 at 10:00 CET. We will show you how aesthetic outcomes are achieved with minimal effort, how design flexibility puts you in control and how the pace of procedures is accelerated without compromising quality.

Registration and further information: www.kuraraysymposium.info

Download brochure:

Discover the next step in the evolution of multi-layered zirconia!

Let us introduce you to KATANA™ Zirconia YML, the next step in the evolution of multi-layered zirconia! The material of superlatives will take center stage at the KATANA™ Zirconia YML Virtual Kick-Off Symposium on July 3, 2021. Renowned experts from the scientific and practical field will share important facts and first-hand information on the unique allrounder and its ability to empower dental laboratories.

Celebrating the launch of the new member to our KATANA™ Zirconia family, we will show you how aesthetic outcomes are achieved with minimal effort, how design flexibility puts you in control and how the pace of procedures is accelerated without compromising quality.

Hence, participation is highly recommended for everyone striving for more: more safety, more reliability, more simplicity and, ultimately, more time.

Registration and further information: www.kuraraysymposium.info

Case by Dr. Jorge F. Zapata, DDS

When replacing amalgam restorations, we often see that the remaining tooth structure is severely stained. Nevertheless, a defect-oriented preparation is preferable over a procedure that involves the removal of healthy, but stained dentin as well. Long-lasting direct restorations with a natural look are obtained by using the universal adhesive CLEARFIL™ Universal Bond Quick, CLEARFIL MAJESTY™ Flow as a cavity liner, CLEARFIL MAJESTY™ ES-2 Premium Dentin to mask the stained areas and a final layer of CLEARFIL MAJESTY™ ES-2 Universal. The following case example confirms that this product combination leads to a nice optical integration.

Fig. 1 Pre-operative image: Maxillary second premolar and first molar with amalgam restorations in need of replacement.

Fig. 2 Situation after removal of the existing amalgam restorations.

Fig. 3 Immediate treatment outcome.

Dentist:

DR. JORGE F. ZAPATA, DDS

Wouldn’t it be great to have a single dental material indicated for the treatment of all kinds of hypersensitivities? A product that effectively and durably occludes exposed dentinal tubules caused by gingival recession, dental erosion or excessive toothbrushing, but also works in the context of professional tooth cleaning, scaling and root planning, tooth whitening or restorative procedures? The fact that Kuraray Noritake Dental Inc.’s TEETHMATE™ DESENSITIZER is ideally suited for all those indications by providing lasting hypersensitivity relief is surely one of the reasons for its winning of a Dental Advisor award for the seventh consecutive year.

Designed to crystallize hydroxyapatite (HAp) from the ground up, TEETHMATE™ DESENSITIZER reliably seals exposed dentinal tubules and enamel cracks.

Consisting of natural calcium and phosphate, the product may even be applied to freshly prepared tooth structure without negatively affecting the bond strength of subsequently utilized dental adhesives or cements.

The consultants of the Dental Advisor conducted a six-month clinical study to be able to evaluate the performance of TEETHMATE™ DESENSITIZER. They selected 27 patients with hypersensitivity issues in their dental practices. Thermal testing with cold air was used to identify the affected teeth, 54 of which were included in the evaluation. For the initial assessment, patients were asked to evaluate their level and frequency of hypersensitivity per tooth on a five-point scale (1 = severe, persistent sensitivity to 5 = no sensitivity). Subsequently, TEETHMATE™ DESENSITIZER was applied according to the instructions for use. Sensitivity was evaluated again immediately after the treatment and 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. This indicates that the product is very effective in providing immediate and even long-term hypersensitivity relief.

Hence, it is not surprising that TEETHMATE™ DESENSITIZER has been among the winners of the Dental Advisor’s Top Product Award every year between 2015 and 2021.

Study results that confirm the material’s effectiveness in reducing pre- and post-operative sensitivity in the context of tooth whitening¹ and indirect restoration procedures² are also available, so that users can count on a reliable performance in a wide range of indications.

References

1. Mehta D, Jyothi S, Moogi P, Finger WJ, Sasaki K. Novel treatment of in-office tooth bleaching sensitivity: A randomized, placebo-controlled clinical study. J Esthet Restor Dent. 2018 May;30(3):254-258.
2. Shetty R, Bhat AN, Mehta D, Finger WJ. Effect of a Calcium Phosphate Desensitizer on Pre- and Postcementation Sensitivity of Teeth Prepared for Full-Coverage Restorations: A Randomized, Placebo-Controlled Clinical Study. Int J Prosthodont. 2017 Jan/Feb;30(1):38-42.