Supplementary Material for: High Amount of Organic Matter during Caries Formation Reduces Remineralization and Resin Infiltration of Enamel Caries

The amount of organic material in the cariogenic environment correlates with the amount of organic material incorporated in carious enamel. The incorporated organic material may be expected to reduce the pore volumes available for remineralization and resin infiltration, but these expected outcomes have not yet been quantified. We tested the effect of the amount of organic content in the cariogenic agent on remineralization and the resin-occluded pore volume in artificial subsurface enamel caries. An acid gel (organic-rich; G1) and an aqueous solution (organic-poor; G2) were used to induce subsurface lesions in human enamel. Undemineralized histological sections were prepared, microradiographed, and then submitted to resin infiltration in vitro. The enamel component volumes (mineral, organic, remineralizable [total water volume], loosely and firmly bound water volumes, and resin-occluded volume) were measured (by microradiography and polarizing microscopy) at histological sites (<i>n</i> = 38, G1; <i>n</i> = 34, G2). The main outcomes were the differences between the experimental and the predicted volumes (Δremineralizable and Δresin-occluded volumes). Resin infiltration was confirmed by confocal scanning laser microscopy. Compared to G2, G1 presented more incorporated organic volume and lower Δremineralizable volume (<i>p</i> = 0.003; Hedges <i>g</i> = 0.66; power = 0.87), a lower increase in loosely bound water volume (<i>p</i> = 0.0013; Hedges <i>g</i> = 0.74; power = 0.93), a lower remineralization volume in the surface layer (<i>p</i> = 0.017; Hedges <i>g</i> = 0.68; power = 0.8), and a lower Δresin-occluded volume (<i>p</i> = 0.0015; Hedges <i>g</i> = 0.73; power = 0.92). In conclusion, the higher amount of organic matter in the cariogenic gel negatively affected remineralization and the resin-occluded volume in subsurface lesions.

致龋环境（cariogenic environment）中的有机物含量与龋损牙釉质（carious enamel）内掺入的有机物含量具有相关性。学界推测，掺入的有机物会减少可用于再矿化（remineralization）与树脂渗透（resin infiltration）的孔隙容积，但该推测尚未被量化验证。本研究探讨了致龋剂中的有机物含量对人工釉质下龋损（artificial subsurface enamel caries）再矿化效果与树脂封闭孔隙容积的影响。本研究采用富含有机物的酸性凝胶（G1组）与贫含有机物的水溶液（G2组）构建人牙釉质下龋损模型。制备非脱钙组织切片并进行显微放射成像（microradiography），随后开展体外树脂渗透实验。通过显微放射成像与偏振显微镜（polarizing microscopy）技术，对组织学样本的牙釉质各组分容积进行测定，包括矿物相、有机相、可再矿化组分（总水容积）、松散结合水容积、紧密结合水容积以及树脂封闭容积，其中G1组样本量n=38，G2组n=34。本研究的主要结局指标为实验测得容积与预测容积的差值，即可再矿化容积差值与树脂封闭容积差值。通过共聚焦扫描激光显微镜（confocal scanning laser microscopy）验证树脂渗透效果。与G2组相比，G1组的掺入有机相容积更高，Δ可再矿化容积更低（p=0.003；赫奇斯g值（Hedges g）=0.66；检验效能（power）=0.87），松散结合水容积增幅更低（p=0.0013；赫奇斯g值=0.74；检验效能=0.93），表层再矿化容积更低（p=0.017；赫奇斯g值=0.68；检验效能=0.8），且Δ树脂封闭容积更低（p=0.0015；赫奇斯g值=0.73；检验效能=0.92）。综上，致龋凝胶中更高的有机物含量会对釉质下龋损的再矿化效果与树脂封闭容积产生负面影响。