High Amount of Organic Matter during Caries Formation Reduces Remineralization and Resin Infiltration of Enamel Caries

Abstract

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 (n = 38, G1; n = 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 (p = 0.003; Hedges g = 0.66; power = 0.87), a lower increase in loosely bound water volume (p = 0.0013; Hedges g = 0.74; power = 0.93), a lower remineralization volume in the surface layer (p = 0.017; Hedges g = 0.68; power = 0.8), and a lower Δresin-occluded volume (p = 0.0015; Hedges g = 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.

Fourier Transformation Infrared Spectroscopic Analysis of Enamel Following Different Surface Treatments: An Invitro Study

“…Enamel has a very low proportion of organic content, i.e., 1%. It is present in the form of amino acids and peptides and historically represents the original developmental organic matrix, which provides the template framework for mineralization to occur [16,30]. Despite the low organic quantum present in enamel, its role in cariogenicity correlates to its presence in caries-affected enamel.…”

Ex vivo investigation on internal tunnel approach/internal resin infiltration and external nanosilver-modified resin infiltration of proximal caries exceeding into dentin

“…It should be mentioned, that the merged microscopic images showed overlaps of the different fluorescents (FITC, RITC, Berberine). Due to this fact, it can be concluded that the individual pores of the respective lesions having been stained either red (RITC) or green (FITC) have been incompletely infiltrated; presenting some blending with the blue Berberine, this would suggest that the latter was able to penetrate into residual pores previously occluded by organic compounds or trapped air [57], and obviously not completely filled by the polymerized low-viscosity infiltrant resin. However, to the best of our knowledge, we did not find any further information regarding this aspect in the literature, and more research to evaluate the exact distribution of the respective infiltrant portions would seem mandatory.…”

“…Recent studies have revealed that organic matter deposited in the porous lesion volume will hamper both remineralization and resinous infiltration of subsurface lesions [57], and removal of this organic debris has been considered pivotal for successful treatment [39]. Therefore, prior to infiltration, the outer surfaces had been deproteinized by means of sodium hypochlorite (5%; 20 min), as has been recommended previously [32,39,97].…”

“…After the grinding process, all cut surfaces were cleaned using sodium hypochlorite (NaOCl, 5%; Sigma-Aldrich, Steinheim, Germany; 2 h), to get rid of any smear layer, and to dissolve any organic material potentially occluding the porous lesion volume [57]. Then, the teeth were stored in 50 ml of hydrogen peroxide (30%, Sigma-Aldrich) for another 2 h, to completely dissolve the sodium hypochlorite, and to bleach organic residues remaining in the non-infiltrated enamel pores; this procedure ensured a reduction of the teeth's auto-fluorescence.…”

Success of resin infiltration treatment on interproximal tooth surfaces in young adults—A practice‐based follow‐up study

“…The environment of the lesion may affect the outcome by resin infiltration. Ferreira et al (2018) have suggested that amount of organic material in the environment of the developing lesion deteriorates its arresting capability by resin infiltration. The lesion may progress, even if the common problem with conventional restorations, leakage is not seen.…”