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From Production
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Skills toto Scientific
Scientific Knowledge,
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andand Onward
Onward toto Fusion
Fusion with
with Medical
Medical Science
Science

TMR-Z Fill 10.

Product Report
Composite Resin: In Pursuit of Sustained Fluoride Release,High Strength and Operability

YAMAKIN CO., LTD.

Head Office: 3-7 Sanadayama-cho Tennoji-ku Osaka 543-0015, Japan
Biological Science Safety Laboratory:
Laboratory in the Department of Oral and Maxillofacial Surgery, Kochi Medical School, Kochi University
Kohasu, Oko-cho, Nankoku-shi, Kochi 783-8505, JAPANBranch Office: Tokyo, Osaka, Sendai, Nagoya, Fukuoka, JAPAN
P: +81-887-55-0281 F: +81-887-55-0053
E: contact@yamakin-gold.co.jp

EditedEdited by
by YAMAKIN
YAMAKIN Ph.D.
Ph.D. GroupGroup

https://www.yamakin-global.com
INTERNATIONAL20200617

Index
1. Introduction ・・・・・・・・・・・・・・・・・・・・・・・・・ 2
2. Basic Points about Composite Resin for Dental Filling ・・ 3
2.1 What is composite resin? ・・・・・・・・・・・・・・・・・・・・・ 3
2.2 Photo radical polymerization reaction mechanism by photosensitizer ・・・・・・ 4
2.3 Initiating reaction and light irradiator ・・・・・・・・・・・・・・・・・ 6
2.4 Expanding the scope of applications ・・・・・・・・・・・・・・・・・ 7
3. Concept of TMR-Z Fill 10. ・・・・・・・・・・・・・・・・・ 8
3.1 Making full use of filler technology ・・・・・・・・・・・・・・・・
8
3.2 Innovation through the TMR Series ・・・・・・・・・・・・・・・・・ 9
4. Features of “TMR- Z Fill 10.” ・・・・・・・・・・・・・・・ 11
11
12
4.3 Color tone ・・・・・・・・・・・・・・・・・・・・・・・・・・・ 14
4.4 Sustained fluoride release property ・・・・・・・・・・・・・・・・・・ 15
4.5 Biological safety・・・・・・・・・・・・・・・・・・・・・・・・・ 18
4.1 Mechanical strength ・・・・・・・・・・・・・・・・・・・・・・・
4.2 Operability ・・・・・・・・・・・・・・・・・・・・・・・・・・

5. Clinical Cases ・・・・・・・・・・・・・・・・・・・・・・・・ 21
6. Conclusion ・・・・・・・・・・・・・・・・・・・・・・・・・・ 23

Supervision
YAMAKIN Ph.D. Group
Teruo Anraku (Ph.D. in Engineering)
Hiroyuki Itoigawa (Ph.D. in Science)
Takahiro Kato (Ph.D. in Engineering)Takeshi Sakamoto (Ph.D. in Pharmacy)
Yuji Sato (Ph.D. in enterpreneur engineering)
Hidekazu Tanaka (Ph.D. in Engineering)
Ritaro Matsuura (Ph.D. in Agriculture)
Masatoshi Yamazoe (Ph.D. in Dentistry)
Hirohisa Yamamoto(Ph.D. in entrepreneur engineering)
Advisor of YAMAKIN Ph.D. Group
Bunichiro Yamada (Ph.D. in Engineering)
What is the YAMAKIN Ph.D. Group?
This is a group of experts in various specialized fields who combine their knowledge, experience andtechnical expertise to act as a prime mover in the continuous generation of innovation.

TMR-Z Fill 10. Product Report
Kato, T., Ph.D. in Engineering, Executive Officer, Head Researcher, Development Department
Matsuura, R., Ph.D. in Agriculture, Senior Chief Researcher, Biological Science and Safety Laboratory
Sakamoto, T., Ph.D. in Pharmacy, Chief Researcher, Organic Material Development Section
Mizuta, Y., Master of Engineering, Project Leader, Organic Material Development Section

1. Introduction

CO., LTD. (referred to as YAMAKIN) has undertaken product development with the focus on "sustained
fluoride release" and "strength" for the required tasks.
As a result, we are now offering a new composite resin in our line-up. "TMR-Z Fill 10." appropriately
combines sustained fluoride release property and the YAMAKIN technology "Ceramics Cluster Filler,"
which is employed for both the hybrid composite resin "TWiNY" and the resin block series for CAD/
CAM. In this way, under the concept of achieving both high strength that can be used for occlusal
surfaces and sustained fluoride release, this product has been realized by putting various technologies forresin material together, with special consideration for the particularly required qualities of operability
and color tone.

Restorative treatment for dental caries using composite resin is a method that achieves the treatment ofhealthy dentin with the least possible grinding or machining. Also, since composite resin is an effective
filling material for easily adjusting the color tone to surrounding natural teeth, it is a material thatsatisfies the demand over recent years for the "restoration of white teeth."

In this product report, "TMR-Z Fill 10." will be introduced from various angles. We hope that you will beinterested in this product and avail of its outstanding features in future dental treatments.

Moreover, composite resin is an organic-inorganic complex material consisting of monomers which are
made into macromolecules by curing, and inorganic fillers surface-treated with a silane coupling agent. It
has become used for a wide range of cases in dental treatment thanks to a combination of its relatively
low price among controlled medical devices and the spread of the concept of MI (Minimal Intervention)
treatment in recent years. Composite resins with such characteristics include a universal type, which has
excellent formability, and a flowable type with high flowability. In recent years, the flowable type whicheasily fills a wide range of cavities, is used more frequently.

2. Basic Points about Composite Resin for Dental Filling

Although this kind of composite resin has the above characteristics, there are issues regarding its
strength compared to metal and ceramic materials. This is especially true since the concept of MI
treatment has been refined. MI treatment is now used not only for treating small caries on the dentine
surface layer, but also for repairing the crown of the molar. Thus, high strength which can withstandocclusion is required of composite resins.
Furthermore, in addition to having the requisite strength, composite resin needs to be comprehensively
excellent from the viewpoints of durability, operability, color tone, and sustained fluoride release, among
other qualities. Especially for operability, rheology(formability and fluidity) which does not place aburden on the operator is required, and for color tone,
it is desirable that the color tone of natural teeth canbe easily reproduced. Sustained fluoride release has
been proposed for the prevention of secondary caries,and sustained release and rechargeability are
considered effective.
In responding to such demands, it is difficult to satisfy
all the requirements. For example, a dental material
with a sustained fluoride release property may suffer adecrease in strength and color tone depending on thesustained release process of fluoride ions. YAMAKIN―2―

2.1 What is composite resin?
Composite resin is an organic-inorganic complex material, which consists monomer matrix as anorganic component, a filler containing glass as an inorganic component as the main component, and amaterial composed of these interfaces.
A monomer is an organic material with a property of polymerization and conversion into polymer resin.
In dental materials in particular, it is often a mixture of crosslinkable (meth) acrylate monomers in manycases. The nature of polymerization, whereby a monomer with flowability becomes a solid polymer, isrelevant to important core functions of composite resin. That is, while the monomer has the property thata shape can be given freely before polymerization, it takes on its characteristic function of maintaining
shape after polymerization.
Urethane dimethacrylate (UDMA) and triethylene glycol dimethacrylate (TEGDMA), which are employedwidely for dental restorations, are shown in Figure 1.
In addition to these, various monomers are used, and a predetermined viscosity and a polymerization
shrinkage rate have been fixed by mixing monomers and monomers with different properties.
O
O
O

O

O

H
N

N
H

O

O

O
UDMA

O
O
O

TMR-Z Fill 10.

O
3

TEGDMA

Figure 1. Monomers employed as dental materials―3―

Particulate alumina or zirconia is used for the inorganic filler, and when it is combinedwith a monomer, it
becomes an uncured composite resin. By mixing the fillers, the matrix can be given mechanical properties
such as flexural strength and hardness. Fillers used in dental materials include inorganic fillers of submicron to several-micron diameters, nano-sized colloidal silica, and organic composite fillers prepared bymixing monomer in advance with nanofiller and polymerizing them, and then pulverizing them. Thesefillers have various properties and particle diameters. Changing the components and shapes used for the
inorganic filler increases the range of functions such as improvement of abrasiveness and operability,
impartation of sustained fluoride release, and the like. Furthermore, the operability of the paste isadjusted by using these fillers in combination (Figure 2).

polymerization progresses and the density of the polymer network structure increases, and it does notdissolve in solvent of small molecular weight.
In other words, monomer can be cured in an extremely short time by the chain reaction.
Radical polymerization is one of patterns in a chain reaction like this. It provides a wider range ofmonomers and applicable reaction conditions than other patterns of polymerization reaction.
Radical polymerization is the most appropriate method to instantly cure a dental material containing
monomer in the oral cavity under high humidity. This is a polymerization reaction frequently used for
dental materials.
(In a short time)

Before the reaction

Mixture of polymer (insoluble) and monomer

Figure 3 Chain reaction (Radical polymerization)
Amorphous inorganic filler of micronsize of 1 to 10 μm, Spherical nanofiller of 10-100 nm

Spherical inorganic filler of submicronsize of 200-300 nm, Organic complex
filler of 20-30 μm containing submicron
filler of 200-300 nm

Spherical inorganic filler of micron sizeof 0.5-1 μm, Organic complex filler of
10-50 μm contain nano filler of 10-30
nm

Figure 2 Image of Fillers being mixed
As shown in the above images, each monomer and inorganic filler plays an important role. However, sufficient strength and durability will not be obtained unless they are firmly combine strongly at the interfaces.
This is because destruction occurs at the interface between the matrix and the filler in the event of considering destruction or fracture of the complex material. Many monomers are lipophilic, and the surface of
the inorganic filler is hydrophilic, so their affinity is not high. A method used to solve this point is a silane
coupling treatment; the inorganic filler subjected to the coupling treatment is modified so as to have alipophilic surface and to have high affinity with the monomer. As a result, mixing inorganic filler highlyis possible, and after polymerizing and curing, it firmly bonds with the polymer matrix, greatly contributing to high strength and high durability of the composite resin.
As described above, in order for the composite resin to satisfy the performance levels required of a dental
material, the monomer, the inorganic filler and their interfaces must achieve their respective roles sufficiently.

Since the composite resin is polymerized by irradiation with visible light, the monomer and thephotosensitizer are combined. When irradiated with light, radical polymerization of monomers occurs,
and polymers are formed and cured.
Radical polymerization usually does not proceed with the monomer alone. A thermal sensitizer in thecase of polymerization by heating, and a photosensitizer in the case of polymerization by lightirradiation, are used as an initiator. Many of the composite resins are polymerized and cured by lightirradiation using a photosensitizer such as camphorquinone (CQ) or a promoter such as tertiary amine.
Radical polymerization is constituted by at least 4 kinds of elementary reactions, initiation, propagation,
termination, and chain transfer, shown in Figure 4. In the case of polymerization by light irradiation, thephotosensitizer generates an initiating radical by light irradiation; then a propagating radical isgenerated by addition of the initiating radical to a monomer. These two reactions are the initiation. In
propagation, a propagating radical grows to high molecular weight by repeating additions to a monomer
one after another. At termination, growth radicals become inactive due to recombination or
disproportionation by two molecules of growing radicals, and high molecular chains of one molecule or
two molecular are generated.
Initiation

2.2 Photo-radical polymerization reaction mechanism by photosensitizer
To obtain polymer from monomer, a particular reaction called polymerization reaction is necessary. The
polymerization reaction is classified as a chain reaction or a successive reaction. In the chain reaction, as soon asa polymerized active species is formed from the monomer, it reacts with another monomer, followed by a rapid
reaction to another monomer. (Figure 3) As a result, the monomer changes instantaneously to a mixture of highmolecular weight polymer and unpolymerized monomer by chain reaction. By contrast, since the consumptionof the monomer is slow in the successive reaction, it takes some time for the polymer to achieve a highmolecular weight.

+

2
Initiating radical
Propagation

Monomer

Shortest propagating radicalnPropagating radical

Termination

2(Recombination)
Or

−H +

(Disproportionation)

Chain transfer

When the polymerizable group is a monomer (crosslinkable monomer) with a plurality in the molecule,the polymer forms a network structure (crosslinked structure) by polymerization, and as the―4―

Propagating radical

Chain transfer agent

Inactivation

Reinitiating radical

Figure 4 Elementary reactions of radical polymerization―5―

2.3 Initiating reaction and light irradiator
Radical polymerization of composite resin is initiated by light irradiation from a light irradiator, but thelight used for initiation has to be absorbed by the photosensitizer.
CQ is widely used as a photopolymerization initiator for dental materials; it shows an absorption maximum
around 470 nm and is therefore excited by light irradiation in this wavelength region. Photoexcited CQ
withdraws hydrogen from a hydrogen donor such as a tertiary amine and generates an initiating radical.
From the CQ/amine type initiator, two types of radicals are generated by visible light irradiation, but CQH
does not cause addition to the monomer due to its large solid life. By contrast, R "CH (.) N (R) (R2 ') causes
addition to the monomer and becomes an initiating radical.
R
O
CQ

O

N CH2R"+RE

Tertiary amine

O
Visible lightirradiationOR
N CH2R"RER+ N CH2R"
K

Electron-transfer

O

OH
Withdrawing H+

RE

CQH(Inactive)OR

Product Name

Effective Wavelength Region(nm)

Maximum Emissive Power(mW/cm2)

PIERCE/YAMAKIN

Penguin α

380 ~ 415
440 ~ 480

2400

PIERCE

Delight ortho

420 ~ 490

2700

YOSHIDABlueLEX Alpha450 ~ 470

1400

VALO curing light395 ~ 480

4500

VALO CORDLESS

395 ~ 480

3200

MORITA

PenCure 2000

450 ~ 470

2000

Kerr

Demi Ultra

450 ~ 470

1330

GC

G-Light Prima-II Plus

390 ~ 410
455 ~ 475

2000

Hakusuimini L.E.D. III

420 ~ 4803300

ULTRADENT JAPANBluephase 20i

385 ~ 515

2200

Bluephase Style 20i

385 ~ 515

2000

MICRO TECH

LEDEX Turbo WL-090

440 ~ 480

2400

Forest-one

FUSION 5

420 ~ 490

4000

Dental Technica

NOBLESS

430 ~ 490

3000

N CHR"DENTRADE

D-LUX LED430 ~ 490

2400

RE

B.S.A sakurai

X Light

430 ~ 480

2500

Initiating radical

Figure 5 Generating radical from CQ/Tertiary amine initiator by visible light irradiation
In other words, a resin material which is employing CQ as photosensitizer is polymerized and cured byirradiation light whose wavelength is around 470 nm.
Depending on the intensity of the irradiation light, the rate of polymerization and the physicalproperties of the generated polymer (cured dental material) are different. Light curing material must be
irradiated with light of appropriate wavelength and intensity. If it is not appropriate, it is impossible tosufficiently proceed the initiating reaction, and as a result, it is thought that the polymerization may beinsufficient, and the material after polymerization may not be able to exert its original physicalproperties. At present, light irradiators with various light sources and light quantities are commerciallyavailable. Halogen lamps, plasma lamps, and LED lamps are used as light sources, but in recent years
LED light irradiators have become mainstream (Table 1).
Also, in LED light irradiators, products with the highest maximum irradiance have been madecommercially available in order to shorten the curing time of resin materials, and the irradiation timethat can be set has also become shorter. Products (Penguin Alpha etc.) which have both blue LED (about
470 nm) and purple LED (about 400 nm) are also on sale so that they can also be applied to surface
lubricants and whitening.

―6―

Manufacturer

Ivoclar Vivadent

Exciplex(Excited complex)

O

Table 1 Commercially available light irradiator

Each product has various features and it is necessary to irradiate the composite resin to be used withlight with the appropriate light amount and time.
The instructions for use, in many cases, when comparing halogen lamps with LED lamps, indicate that
LED lamps can shorten the irradiation time to about half. This is because LED lamps can irradiate lightof 470 nm, which is the excitation wavelength of CQ, in a limited manner as compared with halogen
lamps, and even if the irradiation time is short, a sufficient polymerization rate can be achieved. The
development of such a light source also contributes to the efficiency of dental treatment.
2.4 Expanding the scope of applications
For composite resin, flowable type is available. In order to facilitate filling into cavities of different sizes
and shapes, each product has unique properties such as very high flowability or the ability to shaped
while filling is in progress. Recent technological developments have been remarkable; they include a
flowable type with strength which not inferior to that of the universal type, and products showing acuring depth of 4.0 mm by photopolymerization. Composite resin will continue to evolve in the futureand it is thought that it will increase its value in restorative treatment.

―7―3. Concept of TMR-Z Fill 10.
3.1 Making full use of filler technology
The resin-based dental restorative material iGOS, released by YAMAKIN in February 2016, realized
both strength and sustained fluoride release property, a combination which had been thought difficult toachieve. This technology later helped hybrid resin blocks for CAD/CAM to obtain a competitive
advantage.
Now, we have carried the concept of "iGOS" further, and launched a new product, "TMR-Z Fill 10. ("ZFill"), in pursuit of qualities such as easy operability and outstanding color tones in clinical practice. The
key point of this technology is to make full use of YAMAKIN's filler technology.
Table 2 YAMAKIN’s filler technology
Image

Filler Technology

EffectCeramics Cluster Filler(C.C.F.)

Application to Z Fill
Universal

Flow, Low Flow

Improving mechanicalstrength✓−

Sustained Fluoride
Release Filler

Sustained fluoride
release property;
recharge of fluoride✓✓

Spherical Nano-Filler

Improving mechanicalstrength and operability✓✓

Organic and Inorganic
Composite Filler(OCF)

Improving operability
and aesthetics✓✓

3.2 Innovation through the TMR Series
YAMAKIN’s TMR Series consists of “Z Fill,” the dental
adhesive for dentine, “TMR-AQUA BOND 0” (Figure 7), andthe dental pulp capping material “TMR-MTA cement Mielle”(MTA CEMENT). (Figure 8) The series is used for the missionof “no extraction,” “minimal grinding,” and “preserving teeth”
based on the MI concept.
For example, pulp protection treatment is an important
treatment for preserving natural teeth. However, the successrate is low. To avoid the risk of infection, extraction of pulp ischosen in many cases. To help solve such a process gap,
YAMAKIN offers the innovations which we have combined in
the functions of TMR series.

Figure 7 TMR-AQUA BOND 0

We will pursue the possibilities of pulp protection through thefunctions of each product. “MTA CEMENT” exhibits goodsealing, excellent stability after curing, and promotion of hardtissue formation, as confirmed in experiments.
Figure 8 TMR-MTA cement Mielle“AQUA BOND” (see below for its adhesion concept) adheres to
MTA CEMENT, and enables immediate CR filling after the dental pulp protection treatment carried out
using "MTA CEMENT". “Z Fill” releases fluoride ions and is expected to strengthen teeth substance andinhibit bacterial adhesion.

CR
BOND
MTA

As shown in Table 2, various fillers are combined
depending on the product concept. These include
ceramics cluster fillers (C.C.F.), spherical nano filler ofabout 20 nm (essential for achieving high strength),sustained fluoride release fillers (for imparting fluoride
sustained release property), and organic composite
fillers (for improving operability and aesthetics). "Z
Fill" can be said to be a culmination of YAMAKIN’s
use of all of the filler technologies carefully developedin our past resin products.

MTA＋ BOND ＋CR＝ TMR Series

Figure 9 Innovation through the TMR Series

Figure 6 Image of fillers in Z Fill (Universal)

Concept of adhesion of “MTA CEMENT” and “AQUA BOND”“MTA CEMENT” contains moisture since it is made into a paste by being mixed with water; therefore,
it does not combine well with hydrophobic bonding materials. However, “AQUA BOND” is hydrophilic
thanks to M-TEG-P®, whose adherent component is amphiphilic; as a result, it combines well with the
moisture-containing “MTA CEMENT,” and it is thought that it adheres also to irregularities on the
cement surface.

―8―

―9―

It is known that the phosphoric acid monomer reacts excellently with zirconia1-3). It is thought thatbinding between zirconia, which is the radiographic agent for “MTA CEMENT,” and the phosphategroup of M-TEG-P, which is contained in "AQUA BOND," will be effective for adherence (Figure 11).

TMR-MTA cement Mielle

Figure 10 Image of interface

M-TEG-P

-P

M-TEG

G-P
TE

M-

P

TMR-MTA cement Mielle

GTE
M-

-P
EG
-T

M

TMR-AQUA BOND 0

Zirconia Fine Particles

Figure 11 Binding between M-TEG-P and Zirconia

8

Tensile bond strength (MPa)

4.1 Mechanical strength
4.1.1 Flexural strength
Flexural strength of “Z Fill” was evaluated by three-point bending test, with reference to ISO 4049: 2009 4).
To make a test specimen, “Z Fill” was filled ina mold of 2.0 mm×2.0 mm×25 mm, cured by light, andadjusted by waterproof polishing paper. The specimen was kept in a water at 37°C for 1 day, then measured
with a small table-top material tester (EZ-Graph: SHIMADZU CORPORATION [Japan]).
For the evaluation of durability, a thermal cycle test is used, which utilizes the difference in coefficient ofthermal expansion of constituents and alternately repeats immersion in warm water and cold water topromote deterioration of the material. This test is a model test assuming use in the oral cavity. In this case,conditions of immersing for 30 seconds each at 4°C. and 60°C. were carried out for 5,000 cycles, and then athree-point bending test was conducted to confirm the durability (Figure 13).
The Universal, Flow and Low Flow versions of “Z Fill” showed the same degree of flexural strength anddurability; therefore, operators can select the appropriate paste type to be used for the application site
without having to consider the strength or durability of each version.
200

Flexural Strength (MPa)The evaluation results for the bonding strength of the TMR Series, which is a complete system foradhering “Z Fill” to “MTA CEMENT” using “AQUA BOND,” are shown in Figure 12.
A silicon mold was filled with “MTA CEMENT” after it had been mixed with water. It was dried by air(0-30 sec) 5 min after mixing. “AQUA BOND” was applied on it, then a stainless bur was set as a test
specimen, using resin cement. Tensile bond strength was measured 1 day later.
As shown in Figure 12, a fixed bond strength was confirmed and it can be called a new value for thiscombination.

4. Features of “TMR- Z Fill 10.”6

4After 5,000 thermal cycles

160

120

80

40

0

2

Before thermal cycle test

Universal

Flow

Low Flow

Figure 13 Flexural strength before and after thermal cycle
0

0

10

20

Air-drying time (sec)Figure 12 Adhesion by TMR Series30

4.1.2 Vickers hardness
Composite resin need to be cured sufficiently by several seconds of light curing. Therefore, the Vickers
hardness of Z Fill was measured by the following method:“Z Fill” was filled in a mold with a diameter of 12 mm and a thickness of 2.0 mm and irradiated for 10
sec by an LED irradiator with a light amount of 1,000 mW/cm2 and over. The upper surface (irradiatedsurface) and the lower surface (non-irradiated surface) of the cured resin were measured with a Vickers
hardness tester (HV-113: Mitutoyo) under the conditions of a load of 200 g, a loading time of 15 seconds,
and a number of tests of n = 1. The measurement was carried out three times per surface, and theaverage value thereof was calculated.
The ISO standard 5) of hard resin for dental crowns assumes that the Vickers hardness is 18 (HV 0.2) or
more, and that the hardness of the bottom surface is 70% or more of the hardness of the upper surface.
The surface of "Z Fill" showed high Vickers hardness and the bottom surface was 70% or more of theupper surface.

― 10 ―― 11 ―

Vickers Hardness (Hv0.2)60Upper surface

Lower surface

50
40

4.2.3 Flowability
Two types of flowable type resins with different levels of flowability
are available in the "Z Fill" lineup. Using this difference inflowability depending on the case makes it possible to carry out
appropriate restoration.

30
20
10
0

Universal

Flow

Low Flow

Figure 14 Vickers Hardness

4.2 Operability
4.2.1 Ease of discharge
When conducting restoration by composite resin clinically, it is very important to control the discharge
amount from the syringe. Particularly for the flowable type, it is necessary to avoid stress as much as
possible when squeezing the product out of the syringe. Therefore, "Z Fill" was designed not only withthe contents of the resin but also the shape inside the syringe taken into consideration. It was designed to
be able to discharge with less force (about 1/2) than our conventional product, and to be less stringy andeasier to control (Figure 15).

Our conventional product4.2.4 Formability"Z Fill universal" has been fine-tuned for consistency, and exhibits
minimal entrainment of air bubbles when closely adhering to thetooth substance. Therefore, it is expected that the original physicalproperties of the product will be demonstrated in clinical practice,
too. In addition, while it has the property of adhering to the toothmaterial, the resin is less likely to adhere to a filling instrument, so
separation is favorable. Furthermore, due to its superior
formability, delicate repair work is also possible (Figure 17).
For Low Flow, the flowability is designed to be low as describedabove, and as shown in Figure 18, the shape can be held in the vertical direction. Therefore, it is also possible to restore the occlusal
surface using Low Flow.

Figure 16 “Z Fill Flowable type”(Left: Flow, Right: Low Flow)

Figure 17 Formability of“Z Fill Universal”

Z FillFlow
Figure 18 Formability of “Z Fill” Flowable type resin(Left: Flow Right: Low Flow)
Low Flow

0

2

4

6

8

Discharge strength (kg)Figure 15 Ease of discharge― 12 ―

10

4.2.5 Polishability
It is said that plaque tends to adhere easily unless its surface
roughness is made as small as possible by firmly polishing after
restoration by composite resin. Since the operation is carried out inthe oral cavity, it is required to have characteristics such thatpolishing is completed in a short time, in order to minimize theburden on the patient as much as possible. Figure 19 shows "Z Fill
Flow" polished only with tissue paper. "Z Fill" is designed to beeasy to polish and to obtain gloss by deploying filler technology.

― 13 ―

Figure 19 “Z Fill Flow” polished bytissue paper

4.3 Color tone
4.3.1 Line-up
Figure 20 shows samples of color tones of "Z Fill" when irradiated for 10 seconds with a light irradiator witha light amount of 1,000 mW/cm2 or more. Note that each sample has a thickness of 1.0 mm, and the color
tone changes depending on the thickness and the background color.

“Z Fill” was filled in a mold with a diameter of 15 mm and a thickness of 1.0 mm, and cured with alight-curing device. The cured surface was then mirror-polished to be used as a test specimen.
Bovine teeth were prepared by exposing dentin and enamel in advance, and placed in the center of amold with a diameter of 25 mm and a thickness of 1.5 mm. After that, the specimen was held with a resinso that the resin exposed surface became a flat surface, and the specular surface was polished to prepare atest piece. Each test piece was immersed in a black tea aqueous solution and stored in a thermostaticchamber at 37°C, taken out from the container at each immersion time of 6, 24, and 48 hours, andthoroughly washed with running water. After washing, the test specimens were measured with aspectrophotometer (CM-3610d: Konica Minolta) to calculate the color difference ΔE from the test piece
before coloring.

Basic Shade

Opaque ShadeWhitening

Enamel

4.3.3 Coloring resistance test
Given the aesthetics of composite resin restoration, it is also important to evaluate the effect of
discoloration and coloring due to food and drink. on this occasion, coloring resistance evaluation of "ZFill" was carried out using black tea, as follows:

Only Universal type offers a line-up
from B1 to D2 of the standard shades.
Only Flow and Low Flow types
offer a line-up from OA3.5 to OA5.

Figure 20 Sample of color tones of “Z Fill”"Z Fill" is designed to have a high transmittance, and it is possible to naturally reproduce the color tone of
the incisal tooth etc. Therefore, it is possible to repair one treatment with one shade. The universal type has
17 colors and the flowable type has 14 colors, so you can choose the appropriate color tone for everyone,
regardless of age and case (Table 3).

As shown in Figure 22, the degree of coloring tends to increase as the immersion time of both the resinmaterial and the bovine teeth increases. However, when comparing bovine teeth with "Z Fill" which was
immersed in tea solution for 48 hours, it was confirmed that "Z Fill" was more difficult to color withblack tea solution.

In addition, A5 and OA5 shades, which are popular in our conventional products, are available in thelineup. These have lower lightness than the A4 shade and they have high color saturation. They are
therefore effective for tooth substance with high color tone, such as cervical teeth in the elderly.

Product nameCategory

A1

A2

A3

A3.5

A4

A5

B1

B2

B3

C2

C3

D2

Z Fill 10. Universal

DentineOpaque

●

●

●

●

●

●

●

●

●

●

●

●

●

●

Z Fill 10. Flow

DentineOpaque

●

●

●

●

●

●

●

●

●

●

●

Z Fill 10. Low Flow

DentineOpaque

●

●

●

●

●

●

●

●

●

●

●

OthersQTY of shadeContents

BW, E, OW

17

3.8 g (2 mL)

BW, E, OW

14

2.6 g (1.5 mL)

14

2.6 g (1.5 mL)

BW: Bleaching White E: Enamel OW: Opaque White

4.3.2 Chameleon effect
In combination with the filler technology, excellent light-scattering property was achieved while maintaining
the same transmittance as our conventional products. A chameleon effect can be expected from thischaracteristic, since the light scatters so that the surrounding colors become more natural.

Figure 21 Light-scattering property(Left: Z Fill Right: Our conventional product)― 14 ―

Universal
Flow

Color difference of Bovine enamel(Left: Before immersing
Right: 48 hours after immersing)

40
30
20
10
0

BW, E, OW

Bovine Dentine
Bovine Enamel

50

Color difference⊿E

Table 3 Line-up

60

0

24

Immersing time (h)48Color difference of “Z Fill Universal”(Left: Before immersing
Right: 48 hours after immersing)

Figure 22 Coloring resistance test (black tea solution)
4.4 Sustained fluoride release property
4.4.1 Amount of released fluoride ions
It is known that fluoride ions taken into the oral cavity exhibit decalcification suppression of enamel,promotion of remineralization and caries prevention effect 6-10). In anticipation of these effects, "Z Fill" ismixed with sustained fluoride release fillers. Therefore, the sustained fluoride release property of "Z Fill"was evaluated as follows;“Z Fill” was filled in a mold with a diameter of 12 mm and a thickness of 0.5 mm and cured by alight-curing device. The surface of the cured test specimens were then trimmed with a waterproof abrasive
paper. After washing the test specimens thoroughly with running water, they were immersed in 15 ml ofdistilled water. After a predetermined period of time, the specimens were taken out and the fluoride ion
concentration of the immersion water was measured with an ion meter (F-55: Horiba Seisakusho) to
calculate the sustained release amount of the fluoride ion per unit area.

― 15 ―

Universal

8

Flow

6

4

Resin containing sustained fluoride release filler
Resin without sustained fluoride release filler

0.8
0.6
0.4
0.2
0.0

2

0

1.0

Release amount of fluoride ions
(μg/cm2)

Cumulative sustained fluoride ion
release amount(μg/cm2)

The measurement (Figure 23) demonstrated that "Z Fill" stably releases fluoride ions over a long period of
2 months or longer.

1st recharge

2nd recharge

3rd recharge

4th recharge

Figure 24 Release amount of fluoride ions when brushing using a fluoride-containing toothpaste
0

10

20

30

40

50

60

Immersing days

Figure 23 The sustained release amount of fluoride ions4.4.2 Fluoride recharge property"Z Fill" was tracked for the amount of sustained release fluoride ions for 2 months, and it is thought that its
sustained release amount will decline. However, the fluoride sustained-release fillers used for "Z Fill" can berecharged with fluoride ions by brushing with a toothpaste containing fluoride. The following modelexperiment was conducted for verification:“Z Fill” was filled in a mold with a diameter of 12 mm and a thickness of 0.5mm and cured by light-curing
device. The surface of the cured test specimens were then trimmed with a waterproof abrasive paper. Test
specimens whose fluoride ions were released to certain degree by being totally immersed in 15 ml ofdistilled water for 48 hours were used. Brushing of specimens after releasing of fluoride ions was carried out
using a simple toothbrush abrasion tester with reference to ISO 14569-1 11). The specimens were fixed in a
toothpaste suspension containing fluoride. The toothbrush was slid 500 times at a load of 2.0 N and asliding speed of 850 mm/s. The specimens after brushing were thoroughly washed with running water andthe amount of fluoride ions gradually released from the specimens was measured with an ion meter.
Brushing and measurement of fluoride ions was performed four times in total.
From the measured amount of fluoride ions (Figure 24), it was confirmed that fluoride rechargeability was
exhibited by brushing with a fluoride-containing toothpaste. In addition, it is shown that even if thenumber of times of recharge is repeated, the sustained release amount of fluoride ions is stable and has highreproducibility. That is, if sustained fluoride release fillers which are used as a composite resin are
maintained in the oral cavity for several years or more, they can be expected to exhibit permanent sustained
fluoride release by periodic brushing.
On the other hand, recharging behavior was not observed even when the same experiment was performed
on a resin material which did not contain sustained fluoride release fillers. As a result, it is understood that
this property was derived from the sustained fluoride release fillers which are also used for "Z Fill."

4.4.3 Risks involved in the use of fluoride ions
We have described the sustained fluoride release property of "Z Fill" thus far. Although fluoride hasvarious cariostatic properties, there are some reports about the risks of fluoride.
One example of research on fluoride risks is the investigation about the corrosion of pure titanium ortitanium alloys. Since titanium has excellent corrosion resistance and biocompatibility, pure titanium
and titanium alloys such as Ti-6Al-4V have been used for dental materials, such as dental implants,
denture bases, orthodontics materials. The excellent corrosion resistance of titanium depends on thepassive film formed on the titanium surface. However, the passive film may be destroyed by hydrofluoric
acid (HF) produced from fluoride under specific conditions 12). On the basis of the relationship between
the corrosion potential and the elution amount of titanium, Nakagawa et al. reported that further
corrosion of titanium might easily occur even at low concentrations of fluoride under acidic and low
dissolved-oxygen conditions 13-15).
The pH in the oral cavity varies in the range of 4 to 7, due to the ingestion of foods and liquids 16)．Because
the proximal surface of the crown restoration, the mucosal surface of the denture base, and the clearance
between oral implant superstructures and gingiva are not in contact with the atmosphere, oxygen
concentration in these site is 1/3 to 1/10 or less than that of the atmosphere 17).
In the oral site with low pH and low concentration of oxygen, dental materials containing fluoride, such as
tooth surface coating agents (about 9,000 ppm), toothpaste (about 900 ppm) or mouthwash (about 450 ppm)
may cause the corrosion of titanium. If the corrosion resistance of the titanium or titanium alloy implant
body is lowered by the fluoride generated in the oral cavity, there is concern about corrosion and breakingof implants. However, in actual professional care at dental clinics, application of a neutral sodium fluoride
solution is recommended, avoiding application of a phosphoric acid acidic sodium fluoride solution. In
addition, most fluoride products used in home care are pH neutral. Therefore, it is considered that theapplication of fluoride containing products in the oral environment does not cause the corrosion oftitanium implants.
Through a literature review, Aida et al. acknowledged the possibility that titanium–implants may beslightly corroded by dental materials containing fluoride and used in the oral environment, because
titanium may be slightly corroded by fluoride in neutral or mildly acidic conditions of pH 4.7 or lower.
However, they presume that the probability of titanium corrosion in the weakly acidic region is extremely
low 18). In addition, it has been reported that the fluoride concentration in saliva after brushing withtoothpaste containing fluoride significantly decreases over a short time 19).

― 16 ―― 17 ―

As described above, it is considered that the risks involved in the use of fluoride derived from available
dental materials for the corrosion of titanium prostheses are minimal. The sustained release amount offluoride ions for "Z Fill" is 1.4 μg/cm2 (Universal type) a day, which is much lower than the amount offluoride contained in tooth surface application agents and in toothpaste. Therefore, it can be presumed thatthe possibility of corrosion of titanium by the fluoride released from "Z Fill" is minimal.

When toxic components are eluted froma test specimen, cells are damaged andcell membranes are destroyed.
THP.1Cell
Test Specimen

Toxic components

4.5 Biological safety
The biological safety of medical devices which come into contact with the human body must be evaluated.
Biological safety issues include cytotoxicity, irritation, sensitization, genetic toxicity, implantation and soon. Appropriate tests are conducted on the basis of the nature of the physical contact and of the contact
duration of the medical devices taking the characteristics of the medical devices into consideration.

TB
Trypan blue
Dead cell

TB
Living cellThis section describes the cytotoxicity test of "Z Fill" using the human monocytic leukemia cell line THP.1
cell (distributed by the Department of Oral and Maxillofacial Surgery, Kochi Medical School, Kochi
University) (Figure 25).

Trypan blue are taken up to the cell with destroyed cell membrane,
and stains the cytoplasm.

Figure 26 Principle of Trypan-blue exclusion test

Figure 25 Human monocytic
leukemia cell line THP.1 cell
〈Test Specimen〉
Each type of “Z Fill”—Universal, Flow, and Low Flow—was filled in a mold with a diameter of 15 mm anda thickness of 1.0 mm and cured by light-curing device. The cured test specimen was then polished with awaterproof abrasive paper (P2000) and placed in a well of 24-well plate. 100,000 THP.1cells were seeded on
the specimen and cultured at 37°C for 3 days under 5% CO2. Cells cultured without test specimen wereused as a control.

Cell viability (%)

100
80
60
40
20
0

Control

Flow

Low Flow

Figure 27 Cell viability of THP. 1 Cell

4.5.1 Trypan blue-exclusion test 20）
When cells are cultured on test specimens with toxicity, toxic components are eluted from the test
specimen into the cell culture medium. When cells are damaged by toxic components, the cell membranethat separates the interior of the cell from the outside environment is destroyed. Because the cell
membrane can exclude dyes such as trypan blue, in the mixture of cell suspension and trypan blue, living
cells have a clear cytoplasm whereas dead cells have blue cytoplasm stained with trypan blue. Therefore,
counting the number of clear cells (living cells) and blue-stained cells (dead cells) (that is, the proportionof living cells in cultured cells) with a hematocytometer allows evaluation of the effect of the specimen on
cell viability (Figure 26).
As shown in Figure 27, all types (Universal, Flow, and Low Flow) of "Z Fill" had high cell viability
equivalent to that of the control.

― 18 ―― 19 ―

Universal

4.5.2 WST-8 Cytotoxicity test 21, 22）
WST-8 (2-(2-methoxy-4-nitrophenyl)-3-(4-nitrophenyl)-5-(2,4-disulfophenyl)-2H-tetrazolium) is reduced tothe orange-colored WST-8 formazan (λmax = 450 nm) by dehydrogenase contained in living cells. On thebasis of this principle, quantification of WST-8 formazan measuring absorbance at 450 nm can evaluate themetabolic activity of the cell cultured on test specimen. That is, in the cells cultured on the cytotoxic
specimen, the absorbance at 450 nm is low (light orange), whereas in the cells cultured on the non-cytotoxic
specimen, the absorbance at 450 nm is high (dark orange) as shown in Figure 28.

SO3-

SO3N

The following clinical cases do not include the entire composite resin restoration process. Please checkthe instructions for use for details of actual use and for operational methods.
■ Case 1, Repairing cavity (Photo provided by: Yamakita Dental Office (Kochi, Japan) )

NO2

NO2

H
N

N
N+

SO3-

5. Clinical Cases

SO3-

NO2

N
MeO

N
N

WST-8

N

NO2

MeO

Dehydrogenase

WST-8 formazan

WST-8 is reduced to orange-colored WST-8 formazan by the activity of dehydrogenase in cells.

1. Forming a cavity

2. Applying AQUA BOND

3. Filling with Z Fill Flow

4. Filling with Z Fill Universal

NO2

SO3SO3-

Orange: light

H
N

N
N

NO2

N
MeO

High toxicity: Amount of WST-8 formazan
decreases due to lowering of metabolic
activity of cells.
NO2

SO3SO3-

Orange: dark

HN

5. After the treatment

N
N

NO2

N
MeO

Low toxicity: Amount of WST-8 formazan ishigh due to continuation of metabolic activityof cells.

■ Case 2, Repairing cavity (Photo provided by: Yamakita Dental Office (Kochi, Japan))Figure 28 Principle of WST-8 Cytotoxicity test
Cells cultured on a test specimen were transferred to wells of 96-well culture plate, and WST-8 reagent wasthen added to the wells. After incubation at 37°C for 2 hours, the absorbance of WST-8 formazan wasmeasured at 450 nm. In "Z Fill" (Universal, Flow, Low Flow), all test specimens showed equivalent
absorbance to that of the control, and no adverse effect of "Z Fill" on the metabolic activity of THP.1 cells
was observed (Figure 29).

Absorbance (450 nm)

3.0

1. Forming a cavity

2. Applying Multi-Echant

5. Filling with Z Fill Universal

6. After the treatment

3. Applying AQUA BOND

2.5
2.0
1.5
1.0
0.5
0.0

Control

Flow

Low Flow

Universal

Figure 29 Metabolic activity of THP.1 cells― 20 ―― 21 ―

4. Filling with Z Fill Flow■ Case 3, Repairing cavity (Photo provided by: Yamakita Dental Office (Kochi, Japan) )1. Forming a cavity

2. Applying AQUA BOND

3. Air drying

4. LED light irradiation

6. Conclusion
Through its process of research and development, YAMAKIN has created "iGOS"—a composite resin for
dental filling which combines the features of "strength" and "sustained fluoride release property," acombination which had been thought difficult to achieve. Through this advancing technology, we havelaunched a new product, "TMR-Z Fill 10.," with characteristics which include excellent clinicalhandleability and color tones in addition to the advantages of "iGOS." This product is a dental material
that fully utilize the YAMAKIN's filler technology.
We hope to improve patients’ quality of life by the application of this product in dental treatment basedon the MI concept of preservation of as much of the natural tooth structure as possible. We also would
like to continue to create new products and services needed by our customers.
The joint research group of YAMAKIN and Kochi University conducted experiments in the cytotoxicity
test.

5. Filling with Z Fill Flow

6. Filling with Z Fill Universal

7. After LED light irradiation― 22 ―

8. After the treatment― 23 ―

References
1) Shimoe S, Hirata I, Otaku M, Matsumura H, Kato K, Satoda T: Formation of chemical bonds on zirconia
surfaces with acidic functional monomers. Journal of Oral Science, 60(2): 187-193, 2018.
2) SS Atsu, MA Kilicarslan, HC Kucukesmen, PS Aka: Effect of zirconium-oxide ceramic surface
treatments on the bond strength to adhesive resin. Journal of Prosthetic Dentistry, 95(6): 430-436, 2006.

20) Correa GT，Veranio GA，Silva LE，Hirata Junior R，
Coil JM，Scelza MF: Cytotoxicity evaluation of
two root canal sealers and a commercial calcium hydroxide paste on THP1 cell line by Trypan Blue
assay. J. Appl. Oral Sci., 17: 457-461, 2009．
21) Ishiyama M，Miyazono Y，Sasamoto K，Ohkura Y，Ueno K: A Highly Water-Soluble DisulfonatedTetrazolium Salt as a Chromogenic Indicator for NADH as Well as Cell Viability. Talanta, 44:
1299-1305, 1997．
22) Tominaga H，Ishiyama M，Ohseto F，Sasamoto K，Hamamoto T，Suzuki K，Watanabe M: A
water-soluble tetrazolium salt useful for colorimetric cell viability assay. Anal. Commun., 36: 47-50，
1999．

3) A Piwowarczyk, H-C Lauer, JA Sorensen: The shear bond strength between luting cements andzirconia ceramics after two pre-treatments. Operative Dentistry, 30(3): 382-388, 2005.
4) ISO 4049: 2009 – Dentistry—Polymer-based restorative materials5) ISO 10477: 2004 Dentistry -- Polymer-based crown and bridge materials
6) Hicks J, Garcia G, Milano M, Flaitz C: Compomer materials and secondary caries formation. Am. J.
Dent., 13(5): 231-234, 2000.
7) Han L, Edward C, Okamoto A, Iwaku M: A comparative study of fluoride-releasing adhesive resinmaterials. Dent. Mater. J., 21(1): 9-19, 2002.
8) Itoda T, et al.: Fussojyohousei secchakushisutemu niyoru dappaizougeshitsu no saisekkaika(Remineralization of Decalcified Dentin by a Fluoride-releasing Adhesive System). The Japanesejournal of conservative dentistry (Jpn J Conserv Dent), 44: 175-181, 2001．
9) Okuyama K, Nakata T, Pereira PN, Kawamoto C, Komatsu H, Sano H: Prevention of artificial caries:
effect of bonding agent, resin composite and topical fluoride application. Oper. Dent., 31(1): 135-142,
2006.
10) Kimura T, Komatsu H, Matsuda Y, Okuyama K, Kinugawa M, Sano H: Evaluation of the Caries
Inhibition Effect of Fluoride-releasing Resin Composites Using pH-cycling. The Japanese journal ofconservative dentistry (Jpn J Conserv Dent), 52: 39-50，
2006．
11) ISO/TR 14569-1: 2007，
Dental materials - Guidance on testing of wear - Part 1: Wear by tooth brushing.
12) J.A. Bard, “Encyclopedia of electrochemistry of the element.” Titanium, Vol.V. James WJ,
Straumanis ME, editors. New York, Marcel Dekker, pp. 305-395 (1976)
13) Nakagawa M, Matsuya S, Shiraishi T and Ohta M: Effect of fluoride concentration and pH
oncorrosion behavior of titanium for dental use. J Dent Res, 78: 1568-1572, 1999.
14）Nakagawa M, Matsuya S and Udoh K: Corrosion behavior of pure titanium and titanium alloys influoride-containing solutions. Dent Mater J, 20: 306-314, 2001.
15) Nakagawa M, Matsuya S and Udoh K: Effects of fluoride and dissolved oxygen concentrations
the corrosion behavior of pure titanium and titanium alloys. Dent Mater J, 21: 83-92, 2002.

on16) Hamada S, Oshima T: Shin ushoku no kagaku (New science of dental caries). Ishiyaku Pub, Inc.
(Tokyo), 1st edition (23), 2006.
17) Nakagawa M: Problems of titanium in oral environment. Journal of the Japan Dental Association, 58(6):531-541, 2005.
18) Aida J, Kobayashi S, Arakawa H, Yagi M, Isozaki A, Inoshita E, Haresaku S, Kawamura K, Maki Y:
Does Fluoride Toothpaste Increase the Risk of Peri-implantitis among Patients with Titanium
Implants?: A Literature Review. Journal of Japanese Society of Oral Health, 66 (3): 308-315, 2016.
19) Shimoido Kiyo: Caries Preventive Potentialities of Various Fluoride Products for Home-use. A Study
through the Fluoride Concentration in Saliva at the Time of Rising in the Morning. Journal of
Kanagawa Shigaku, 34(1): 43-60, 1999.

― 24 ―iGOS
Controlled Medical Device- Resin-based Dental Restorative Material
KZR-CAD HR Block 2
Controlled Medical Device - Resin Material for Dental Milling and Machining CAD/CAM Material for Dental Material
KZR-CAD HR Block 3 GAMMATHETA
Controlled Medical Device - Resin Material for Dental Milling and Machining CAD/CAM Material for Molars
TWiNY
Controlled Medical Device -Composite Resin for Crowns and Bridges
Luna-Wing
Controlled Medical Device -Composite Resin for Crowns and Bridges― 25 ―

Lineup
TMR －Z Fill 10.

Controlled medical device -Resin-based Dental Restorative Material

We will continue to create value for the future.

Single Package

TMR-Z Fill10.
Universal 3.8g (2mL)

Set Package

Standard Pack (each 1 of A1, A2, A3, E)
・Universal
A1x1
・Flow
A2x1
A3x1
・Low Flow
Enamelx1

Accessory

Needle Tip: 20 pcs.

Single Package TMR-Z Fill10.

Single Package

Flow 2.6g (1.5mL)

Accessory. Needle Tip: 10 pcs.

2 pcs Pack (each 1 of A2, A3)
・Universal
A2x1
・Flow
A3x1
・Low Flow

TMR-Z Fill10.
Low Flow 2.6g (1.5mL)

Accessory. Needle Tip: 10 pcs.

3 pcs of Same Shade Pack (Each 3pcs.of A2, A3, A3.5)
・Universal
・Flow
・Low Flow

A2x3
A3x3
A3.5x3

Related Products
Controlled medical device- Dental Adhesive for Enamel and Dentine (Dental adhesive for ceramics) (Dental adhesive for metal)

Controlled medical device - Dental pulp capping material

Storage bag withdesiccant to prevent
moistureSingle Package

TMR-AQUA BOND 0 (5mL)

Set Package

TMR-AQUA BOND 0 Set

Set Package

2 pcs Pack of TMR-AQUA BOND 0

Accessory

Disposable Applicator Brush : 50 pcs.
Disposable Plate : 50 pcs.

Microtube Type

Glass Container / Bottle Type

Glass Container / Bottle Type0.2g x3pcs.

3g

10g

Single Package

・TMR−AQUA BOND 0 (5mL)：1pc.
・Disposable Applicator Brush：50 pcs.
・Disposable Plate：25 pcs.

TMR-MTA cement Mielle (White, Light Ivory)
・Microtube Type (0.2g) : 3 pcs.
TMR-MTA cement Mielle (White, Light Ivory)
・Glass Container / Bottle Type (3g)・Accessory: Spoon (1 pc.)

・TMR−AQUA BOND 0 (5mL)：2pcs.

All manufacturing processes are conducted in clean rooms and controlled extremely strictly.

Controlled medical device-Dental etching material (Adhesive material for dental ceramics)

Controlled medical device- Bonding material for dental metal (dental ceramics, dental resin)

Multi-use Etchant for
Various Types of Materials and Tooth

For intraoral repair of restorations(metal, ceramics and resin)

Single Package
Accessory

Multi Etchant (2mL)
Accessory : Needle tip 5 pcs.

Clean room in the YAMAKIN Kochi factory

TMR-MTA cement Mielle (White, Light Ivory)
・Glass Container / Bottle Type (10g)・Accessory: Spoon (1 pc.)

Single Package

Multi Primer LIQUID (7mL)

Needle tips for Multi Etchant : 10 pcs.

M-TEG-P is a registered trademark of
YAMAKIN CO., LTD.
The actual color of the product, model and package may differ from the photographs due to printing ink and shooting conditions.
Manufactured by

1090-3 Otani, Kamibun, Kagami-cho, Konan-shi, Kochi, 781-5451 Japan《Previously Published Technical Reports》
Technical Report on ZEO CE LIGHT (Aug. 2002)
Technical Report on Luna-Wing (May 2007)
Technical Report on TWiNY ( Jul. 2010)《Previously Published Safety Test Reports》
Vol. 1 Pursuing International Standards in Quality and Safety (Dec. 2004)

Vol. 2 ZEO METAL Series Elution Test and in Vitro Cytotoxicity Test ( Jun. 2005)

Vol. 3 Elution Test and in Vitro Cytotoxicity Test of Precious-Metal Alloys and Gold Alloys for Metal Ceramic Restoration Use (Dec. 2005)
Vol. 4 Biological Evaluation of Luna-Wing ( Jun. 2006)

Vol. 5 Report on Physical Properties and Safety of High-Carat Gold Alloys (Oct. 2007)

Vol. 6 Examination of the Biological Impact of the Physical Properties of Dental-Material Alloys and Gold Alloys for Hard Resin and Metal Ceramic Restoration
Use (May 2008)

Vol. 7 Report on the Physical Properties and Safety of the Gold Alloy Nexo-Cast (Oct. 2008)
Vol. 8 Biological Evaluation of the Hybrid Composite Resin, TWiNY ( Jun. 2010)

Vol. 9 Chemical and Biological Characteristics of Precious-Metal Alloys: Elution Characteristics Produced Through Mixture with Titanium (Feb. 2011)
Vol. 10 Physical Properties and Safety of the Precious-Metal Alloy for Metal Ceramic Restoration Use Brightis (Oct. 2011)
Vol. 11 Physical Properties and Safety of the Dental Adhesive, Multi Primer (Mar. 2014)

Vol. 12 Safety of the Dental Pulp Capping Material, TMR-MTA CEMENT ( Jan. 2018)《Previously Published Macromolecule Technology Reports》
Vol. 1 The Polymerization of Dental Materials: The Basis of Radical Polymerization (1) (Oct. 2009)Vol. 2 The Polymerization of Dental Materials: The Basis of Radical Polymerization (2) (Feb. 2010)
Vol. 3 The Polymerization of Dental Materials: Restoration-Material Monomers (1) (Mar. 2010)
Vol. 4 The Polymerization of Dental Materials: Restoration-Material Monomers (2) ( Jul. 2010)
Vol. 5 The Polymerization of Dental Materials: The Influence of Oxygen (Aug. 2011)
Vol. 6 The Polymerization of Dental Materials: Primers and Developers (Oct. 2012)

Vol. 7 Polymerization Silane Coupling Agent: Methacrylic Resin (Acrylic Resin) ( Jun. 2013)
Vol. 8 Shrinkage of Dental Composite in Polymerization (Nov. 2014)

Vol. 9 Application of Iodonium Salt as Initiator Component in Dental Material (Mar. 2017)
Vol.10 Application of Nanogel to Dental Resin and Adhesive ( Jun. 2018)《All Previously Published Science Reports》
Vol. 1 Dental Surgery and Bisphosphonate Formulation (Aug. 2010)

Vol. 2 Reactive Oxygen: Its Generation, Elimination and Effects (Nov. 2011)
Vol. 3 The Hypoxic World ( Jul. 2012)

Vol. 4 Recent Progress in the Regeneration of Tooth Material (Feb. 2014)
Vol. 5 Application of Fluoride and Its Effect (Oct. 2016)《Previously Published Product Reports》
Basic Information and Product Report on Zirconia (Feb. 2014)
Basic Information and Product Report on Titanium ( Jun. 2016)
Basic Information and Product Report on Hybrid Resin for CAD/CAM use (Sep. 2014)
Basic Information and Product Report on Dental Restorative Material (Sep. 2015)
Basic Information and Product Report on Dental Bonding Material ( Jan. 2016)
Product Report on Multi Primer Series (Oct. 2017)
KZR-CAD HR Block3 GAMMATHETA Product Report ( Jan. 2018)
Multi Etchant Product Report ( Jul. 2018)
Basic Information and Product Report on KZR-CAD NANOZR ( Jul.2018)

Editor: Takahiro Kato
Publisher: Shigenari Yamamoto
Date of publication: 8 Feb. 2019