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.致龋环境中的有机物含量与龋坏牙釉质中结合的有机物含量呈相关关系。学界普遍认为，结合的有机物会减少可用于再矿化（remineralization）与树脂渗透（resin infiltration）的孔隙体积，但此类预期效应尚未被量化。本研究探究了致龋剂中的有机物含量对人工釉质下龋（subsurface enamel caries）的再矿化效果以及树脂阻塞孔隙体积的影响。本研究分别采用富含有机物的酸性凝胶（G1组）与低有机物水溶液（G2组）诱导人类牙釉质产生釉质下龋损，制备未脱矿的组织学切片并进行显微放射摄影（microradiography），随后开展体外树脂渗透实验。在组织学观测位点（G1组n=38，G2组n=34），通过显微放射摄影与偏振显微镜（polarizing microscopy）测量牙釉质各组分体积，包括矿物质、有机物、可再矿化体积（总水体积）、疏松结合水与紧密结合水体积以及树脂阻塞体积。本研究的主要观测指标为实验测得体积与预测体积的差值（Δ可再矿化体积与Δ树脂阻塞体积），并通过共聚焦扫描激光显微镜（confocal scanning laser microscopy）确认了树脂渗透的效果。与G2组相比，G1组的结合有机物体积更高，Δ可再矿化体积更低（p=0.003；Hedges g效应量（Hedges g）=0.66；检验功效（power）=0.87），疏松结合水体积的增幅更小（p=0.0013；Hedges g=0.74；检验功效=0.93），表层再矿化体积更低（p=0.017；Hedges g=0.68；检验功效=0.8），且Δ树脂阻塞体积更低（p=0.0015；Hedges g=0.73；检验功效=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阻塞体积产生负面影响。