Supplementary Material for: Demineralization Inhibitory Effects of Highly Concentrated Fluoride Dentifrice and Fluoride Gels/Solutions on Sound Dentin and Artificial Dentin Caries Lesions in vitro

<b><i>Objectives:</i></b> The aim of this in vitro study was to compare the demineralization inhibitory effect of gels/solutions used in combination with either standard or highly fluoridated dentifrices on sound dentin as well as on artificial dentin caries-like lesions. <b><i>Methods:</i></b> Bovine dentin specimens (<i>n</i> = 240) with two different surfaces each (sound [ST] and artificial caries lesion [DT]) were prepared and randomly allocated to twelve groups. Weekly interventions during pH-cycling (28 days, 6 × 120 min demineralization/day) were: the application of gels/solutions containing amine fluoride/sodium fluoride (12,500 ppm F [ppm]; pH = 4.4; AmF); NaF (12,500 ppm; pH = 6.6; NaF1); NaF (12,500 ppm; pH = 6.3; NaF2); silver diamine fluoride (14,200 ppm; pH = 8.7; SDF); acidulated phosphate fluoride (12,500 ppm; pH = 3.8; APF), and no intervention (standard control; S). Furthermore, half of the specimens in each group were brushed (10 s; twice per day) with dentifrice slurries containing either 1,450 ppm (e.g., AmF₁₄₅₀) or 5,000 ppm (e.g., AmF₅₀₀₀). Differences in integrated mineral loss (ΔΔZ) and lesion depth (ΔLD) were calculated between values before and after pH-cycling using transversal microradiography. <b><i>Results:</i></b> After pH-cycling Ss showed significantly increased ΔZ_DT and LD_DT values, indicating further demineralization. In contrast, except for one, all groups including fluoride gels/solutions showed significantly decreased ΔZ_DT values. Additional use of most fluoride gels/solutions significantly enhanced mineral gain, mainly in the surface area; however, acidic gels/solutions seemed to have negative effects on lesion depths. <b><i>Significance:</i></b> Under the present pH-cycling conditions the highly fluoridated dentifrice significantly reduced caries progression and additional application of nearly all of the fluoride gels/solutions resulted in remineralization. However, there was no difference in the remineralizing capacity of fluoride gels/solutions when used in combination with either standard or highly fluoridated dentifrices.

<b><i>研究目的：</i></b> 本体外研究旨在对比与标准含氟牙膏或高氟牙膏联用的凝胶/溶液，对健康牙本质（sound dentin, ST）以及人工龋样牙本质损伤的脱矿抑制效果。<b><i>实验方法：</i></b> 制备240件牛牙本质标本，每件标本包含两种不同表面：健康牙本质（sound dentin, ST）与人工龋损牙本质（artificial caries lesion, DT），并将其随机分为12组。在为期28天的pH循环（每日进行6次脱矿，每次120分钟）过程中，每周干预措施如下：使用含胺氟/氟化钠（amine fluoride/sodium fluoride, AmF）的凝胶/溶液（氟浓度12500ppm F，pH=4.4）、氟化钠（sodium fluoride, NaF）溶液（12500ppm F，pH=6.6，记为NaF1）、氟化钠溶液（12500ppm F，pH=6.3，记为NaF2）、氟化氨银（silver diamine fluoride, SDF）（14200ppm F，pH=8.7）、酸化磷酸氟（acidulated phosphate fluoride, APF）凝胶（12500ppm F，pH=3.8），以及无干预的标准对照组（standard control, S）。此外，每组中半数标本每日以含1450ppm氟（如AmF₁₄₅₀）或5000ppm氟（如AmF₅₀₀₀）的牙膏浆刷洗10秒，每日两次。采用横向显微放射摄影（transversal microradiography），计算pH循环前后标本的积分矿物质丢失量（integrated mineral loss, ΔΔZ）与损伤深度（lesion depth, ΔLD）的差值。<b><i>实验结果：</i></b> pH循环结束后，标准对照组（S）的ΔZ_DT与LD_DT值均显著升高，提示病变进一步脱矿。与之相反，除1组外，所有含氟凝胶/溶液干预组的ΔZ_DT值均显著降低。多数氟化物凝胶/溶液的额外使用可显著提升矿物质沉积，尤以表面区域为主；但酸性凝胶/溶液似乎会对损伤深度产生不利影响。<b><i>研究意义：</i></b> 在本实验的pH循环条件下，高氟牙膏可显著减缓龋病进展，且几乎所有氟化物凝胶/溶液的联用均可促进牙本质再矿化。但无论与标准含氟牙膏还是高氟牙膏联用，各类氟化物凝胶/溶液的再矿化能力并无显著差异。