Synergy D6 (1 yr)

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1-Year Clinical Performance

Coltene/Whaledent, Inc.
800.221.3046 - 330.916.8800
www.coltenewhaledent.com

Consultants' Comments

• “Composite surface is smooth.”
• “The duo shade system is simple to use.”
• “Restorations blend best when an enamel shade is used on the surface.”

Description

Synergy D6 is a resin composite system composed of six dentin duo shades (D6 designation) and two enamel shades. The material is a sculptable, radiopaque, highly filled nano-hybrid composite for restoration of anterior and posterior teeth. The average filler particle size is 0.6 μm with a range of particle sizes from 0.02 to 2.5 μm. The filler content is 80% by weight and 65% by volume. The dentin duo shades (White Bleach, A1/B1, A2/B2, A3/D3, A3.5/B3, C2/C3) are created by combining Vita shades with similar color (hue), intensity (chroma) and lightness/darkness (value). The two enamel shades (Universal and White Opalescent) have high translucency. The composite can be cured with halogen or LED light-curing units. Synergy D6 is packaged in kits containing eight, 4-g syringes or 80, 0.25-g unit-dose tips; One Coat Self-Etching Bond; and accessories. This product received a 96% rating for clinical performance at one year.

Clinical Evaluation Protocol

279 Synergy D6 restorations were placed in 141 patients.
• Anterior and posterior restorations were placed (Figure 1).
• 126 restorations were available for evaluation of clinical performance at one year after placement.
• One Coat Self-Etching Bond was used to bond all restorations.
• Restorations were evaluated on a 1-5 rating scale:
  1 = poor, 2 = fair, 3 = good, 4 = very good, 5 = excellent.

Clinical Observations

Resistance to Fracture
Ninety-eight percent of Synergy D6 restorations recalled showed no chips or fractures (Figure 2). Two restorations were chipped, requiring refinishing. Only one restoration was fractured, requiring replacement.

Esthetics
Synergy D6 dentin shades have moderate opacity and effectively block out underlying stained dentin. When the dentin shades were used alone, the finished restorations were rated lower, with consultants noting that the appearance was too opaque or dull. In the majority of cases, one of the translucent enamel shades was layered on top, resulting in more esthetic restorations. Ninety-nine percent of restorations were rated very good to excellent (Figure 2).

Resistance to Marginal Discoloration
One Coat Self-Etching Bond was used to bond Synergy D6 restorations; no additional etching of peripheral enamel was done at the time of placement. Ninety-three percent of restorations had no visible staining at the margins (Figure 2). Light stain along the margins was noted in six percent of restorations. Two percent of restorations had moderate stain, but none were replaced.

Wear Resistance
Synergy D6 exhibited excellent wear resistance. Ninety-eight percent of restorations received ratings of excellent (Figure 2), as they exhibited no visible signs of wear.

Sensitivity
With few exceptions, no post-operative sensitivity was reported by patients when they were asked at six months and one year (Figure 2). One posterior restoration was replaced at six months due to temperature sensitivity. Two patients reported mild sensitivity at six months that resolved without further treatment.

Summary

Synergy D6 was used with the 6^th-generation bonding agent, One Coat Self-Etching Bond, in restoring 279 teeth in 141 patients. The restorations were evaluated as the patients reported for their next scheduled dental appointments, approximately six months and one year after placement. Six restorations were replaced during the first year. Four of the replacements were due to caries on another surface of the tooth and were unrelated to the filling material. One posterior restoration (tooth #15-MO) was replaced at six months due to sensitivity and one posterior restoration (tooth #29-MOD) fractured at the distal marginal ridge, requiring replacement. Marginal staining was minimal, and no wear was observed on the restorations. Overall, Synergy D6 was highly rated for producing esthetic anterior and posterior restorations.

More About: Coltene/Whaledent, Inc., Composite - Nanohybrid