Supplementary Material for: Effects of Self-Assembling Peptide P11-4, Fluorides, and Caries Infiltration on Artificial Enamel Caries Lesions in vitro

<p>The application of a self-assembling peptide on noncavitated caries lesions is supposed to be a feasible approach to facilitate remineralization and mask their unfavorable appearance. However, demineralizing conditions are common in the oral environment, so the aim of this pH-cycling study was to compare recommended and novel treatment methods regarding their ability to hamper demineralization and as a consequence mask artificial enamel caries lesions. Artificial caries lesions were prepared in bovine enamel and randomly allocated to 11 groups (<i>n</i> = 22). Treatments before pH-cycling were as follows: the application of a self-assembling peptide (Curodont™ Repair [C]), a low-viscosity resin (Icon® [I]), 2 fluoride solutions (10,000 ppm F<sup>-</sup>: Elmex fluid [E] and 43,350 ppm F<sup>-</sup>: Tiefenfluorid® [T]), and no intervention (N). During pH-cycling (28 days, 6 × 60 min demineralization/day) half of the specimens in each group were brushed (10 s; 2 ×/day) with either fluoride-free (named e.g., C<sub>0</sub>) or NaF (1,100 ppm F<sup>-</sup>; e.g., C<sub>1</sub>) dentifrice slurry. In another subgroup specimens were pH-cycled but not brushed (N<sub>NB</sub>). Differences in integrated mineral loss (ΔΔZ), lesion depth (ΔLD), and colorimetric values (ΔΔE) were calculated between values after pre-demineralization, surface treatment, and pH-cycling. Specimens of C<sub>0</sub>, C<sub>1</sub>, N<sub>NB</sub>, N<sub>0</sub>, N<sub>1</sub>, T<sub>0</sub>, and E<sub>0</sub> showed significantly increased ΔZ and LD values after pH-cycling (<i>p</i> ≤ 0.003; paired <i>t</i> test). C<sub>0</sub>, C<sub>1</sub>, N<sub>NB</sub>, and N<sub>0</sub> showed significantly higher changes in ΔΔZ than E<sub>1</sub>, I<sub>0</sub>, I<sub>1</sub>, and T<sub>1</sub> (<i>p</i> < 0.001; ANOVA). Significantly reduced colorimetric values could only be observed for I<sub>1</sub>, I<sub>0</sub>, E<sub>1</sub>, and E<sub>0</sub> after treatment and after pH-cycling (<i>p</i> ≤ 0.027; paired <i>t</i> test). In conclusion, under the conditions chosen only the application of a low-viscosity resin could mask caries lesions significantly, whereas self-assembling peptides could neither inhibit lesion progression nor mask the lesions considerably.</p>