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The Penetration Depth and Bactericidal Efficacy of 2% Chlorhexidine Iontophoresis in Human Coronal Dentin In Vitro.

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Title: The Penetration Depth and Bactericidal Efficacy of 2% Chlorhexidine Iontophoresis in Human Coronal Dentin In Vitro.
Authors: Kijsamanmith K; Department of Oral Biology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand. Electronic address: kanittha.kij@mahidol.ac.th., Satitthummanit N; Mahidol International Dental School, Faculty of Dentistry, Mahidol University, Bangkok, Thailand., Thotsaphonphaisan C; Mahidol International Dental School, Faculty of Dentistry, Mahidol University, Bangkok, Thailand., Kurucharoenporn C; Mahidol International Dental School, Faculty of Dentistry, Mahidol University, Bangkok, Thailand., Ratarsa T; Mahidol International Dental School, Faculty of Dentistry, Mahidol University, Bangkok, Thailand., Lerdmaneepha V; Mahidol International Dental School, Faculty of Dentistry, Mahidol University, Bangkok, Thailand., Kanchanathipkhachorn N; Mahidol International Dental School, Faculty of Dentistry, Mahidol University, Bangkok, Thailand., Klaophimai A; Department of Oral Microbiology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand., Srisatjaluk R; Department of Oral Microbiology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand; Faculty of Dentistry, Bangkok Thonburi University, Bangkok, Thailand.
Source: International dental journal [Int Dent J] 2026 Apr; Vol. 76 (2), pp. 109439. Date of Electronic Publication: 2026 Feb 14.
Publication Type: Journal Article
Language: English
Journal Info: Publisher: Elsevier Country of Publication: England NLM ID: 0374714 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1875-595X (Electronic) Linking ISSN: 00206539 NLM ISO Abbreviation: Int Dent J Subsets: MEDLINE
Imprint Name(s): Publication: 2021- : London : Elsevier
Original Publication: London : FDI World Dental
MeSH Terms: Chlorhexidine*/administration & dosage , Chlorhexidine*/pharmacokinetics , Chlorhexidine*/pharmacology , Iontophoresis*/methods , Dentin*/microbiology , Dentin*/metabolism , Dentin*/drug effects , Anti-Infective Agents, Local*/administration & dosage , Anti-Infective Agents, Local*/pharmacokinetics , Anti-Infective Agents, Local*/pharmacology, Biofilms/drug effects ; Streptococcus mutans/drug effects ; Microbial Viability/drug effects ; Humans ; Microscopy, Confocal ; In Vitro Techniques ; Rhodamines ; Dentin Permeability ; Molar, Third
Abstract: Objectives: Iontophoresis could facilitate drug transport into human dentin. This study aimed to investigate the impact of iontophoresis on the penetration depth and bactericidal efficacy of 2% chlorhexidine (CHX) in human coronal dentin using confocal laser scanning microscopy (CLSM).
Methods: Fifty-one coronal dentin specimens, prepared from 51 extracted intact human third molars, were used in the study, which was divided into 2 series. Series 1 investigated the penetration depth of 2% CHX labeled with rhodamine B dye (CHX + R) in coronal dentin using CLSM, comparing a 5-minute passive treatment and 5-minute iontophoresis (n = 10/group). Series 2: part 2.1 studied the bactericidal efficacy of 2% CHX iontophoresis by determining the percentage of intratubular bacterial viability using CLSM (group 1: noninfected dentin, group 2: untreated infected dentin, group 3: 5-minute distilled water iontophoresis, group 4: 5-minute passive CHX treatment, group 5: 5-minute CHX iontophoresis; n = 5/group); part 2.2 verified the presence of Streptococcus mutans biofilms within dentinal tubules of a dentin infection model by the centrifugation method using scanning electron microscopy (n = 6). The data were analyzed using an independent samples t test (series 1) and a 1-way analysis of variance, followed by the Tukey test (series 2), with a significance level of α = 0.05.
Results: Five-minute iontophoresis (713.31 ± 169.45 μm) exhibited deeper penetration of CHX + R in coronal dentin than 5-minute passive treatment (199.54 ± 36.83 μm, P < .001). Also, 5-minute CHX iontophoresis could reduce the percentage of intratubular bacterial viability more than 5-minute passive CHX treatment (P < .001); meanwhile, 5-minute distilled water iontophoresis could not show this effect (P = .994).
Conclusions: Anode iontophoresis could increase the penetration depth and bactericidal efficacy of 2% CHX in human coronal dentin.
Clinical Relevance: A 2% CHX iontophoresis has potential use in reducing the viability of intratubular bacteria in human coronal dentin.
(Copyright © 2026 The Authors. Published by Elsevier Inc. All rights reserved.)
Competing Interests: Conflict of interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
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Pediatr Dent. 2017 Jul 15;39(4):308-312. (PMID: 29122072)
Crit Rev Oral Biol Med. 2002;13(2):171-83. (PMID: 12097359)
Adv Dent Res. 2016 May;28(2):49-57. (PMID: 27099357)
J Dent Educ. 2001 Oct;65(10):1028-37. (PMID: 11699974)
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J Conserv Dent. 2012 Jan;15(1):22-6. (PMID: 22368330)
J Endod. 2011 Oct;37(10):1380-5. (PMID: 21924186)
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Contributed Indexing: Keywords: Chlorhexidine; Confocal laser scanning microscopy; Dentin disinfection; Dentinal tubules; Iontophoresis; Penetration depth
Substance Nomenclature: R4KO0DY52L (Chlorhexidine)
0 (Anti-Infective Agents, Local)
0 (Rhodamines)
Entry Date(s): Date Created: 20260215 Date Completed: 20260707 Latest Revision: 20260813
Update Code: 20260813
PubMed Central ID: PMC12925274
DOI: 10.1016/j.identj.2026.109439
PMID: 41691851
Database: MEDLINE
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  Data: The Penetration Depth and Bactericidal Efficacy of 2% Chlorhexidine Iontophoresis in Human Coronal Dentin In Vitro.
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  Data: &lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Kijsamanmith+K%22&quot;&gt;Kijsamanmith K&lt;/searchLink&gt;; Department of Oral Biology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand. Electronic address: kanittha.kij@mahidol.ac.th.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Satitthummanit+N%22&quot;&gt;Satitthummanit N&lt;/searchLink&gt;; Mahidol International Dental School, Faculty of Dentistry, Mahidol University, Bangkok, Thailand.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Thotsaphonphaisan+C%22&quot;&gt;Thotsaphonphaisan C&lt;/searchLink&gt;; Mahidol International Dental School, Faculty of Dentistry, Mahidol University, Bangkok, Thailand.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Kurucharoenporn+C%22&quot;&gt;Kurucharoenporn C&lt;/searchLink&gt;; Mahidol International Dental School, Faculty of Dentistry, Mahidol University, Bangkok, Thailand.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Ratarsa+T%22&quot;&gt;Ratarsa T&lt;/searchLink&gt;; Mahidol International Dental School, Faculty of Dentistry, Mahidol University, Bangkok, Thailand.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Lerdmaneepha+V%22&quot;&gt;Lerdmaneepha V&lt;/searchLink&gt;; Mahidol International Dental School, Faculty of Dentistry, Mahidol University, Bangkok, Thailand.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Kanchanathipkhachorn+N%22&quot;&gt;Kanchanathipkhachorn N&lt;/searchLink&gt;; Mahidol International Dental School, Faculty of Dentistry, Mahidol University, Bangkok, Thailand.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Klaophimai+A%22&quot;&gt;Klaophimai A&lt;/searchLink&gt;; Department of Oral Microbiology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Srisatjaluk+R%22&quot;&gt;Srisatjaluk R&lt;/searchLink&gt;; Department of Oral Microbiology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand; Faculty of Dentistry, Bangkok Thonburi University, Bangkok, Thailand.
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– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Objectives: Iontophoresis could facilitate drug transport into human dentin. This study aimed to investigate the impact of iontophoresis on the penetration depth and bactericidal efficacy of 2% chlorhexidine (CHX) in human coronal dentin using confocal laser scanning microscopy (CLSM).&lt;br /&gt;Methods: Fifty-one coronal dentin specimens, prepared from 51 extracted intact human third molars, were used in the study, which was divided into 2 series. Series 1 investigated the penetration depth of 2% CHX labeled with rhodamine B dye (CHX + R) in coronal dentin using CLSM, comparing a 5-minute passive treatment and 5-minute iontophoresis (n = 10/group). Series 2: part 2.1 studied the bactericidal efficacy of 2% CHX iontophoresis by determining the percentage of intratubular bacterial viability using CLSM (group 1: noninfected dentin, group 2: untreated infected dentin, group 3: 5-minute distilled water iontophoresis, group 4: 5-minute passive CHX treatment, group 5: 5-minute CHX iontophoresis; n = 5/group); part 2.2 verified the presence of Streptococcus mutans biofilms within dentinal tubules of a dentin infection model by the centrifugation method using scanning electron microscopy (n = 6). The data were analyzed using an independent samples t test (series 1) and a 1-way analysis of variance, followed by the Tukey test (series 2), with a significance level of α = 0.05.&lt;br /&gt;Results: Five-minute iontophoresis (713.31 &#177; 169.45 μm) exhibited deeper penetration of CHX + R in coronal dentin than 5-minute passive treatment (199.54 &#177; 36.83 μm, P &amp;lt; .001). Also, 5-minute CHX iontophoresis could reduce the percentage of intratubular bacterial viability more than 5-minute passive CHX treatment (P &amp;lt; .001); meanwhile, 5-minute distilled water iontophoresis could not show this effect (P = .994).&lt;br /&gt;Conclusions: Anode iontophoresis could increase the penetration depth and bactericidal efficacy of 2% CHX in human coronal dentin.&lt;br /&gt;Clinical Relevance: A 2% CHX iontophoresis has potential use in reducing the viability of intratubular bacteria in human coronal dentin.&lt;br /&gt; (Copyright &#169; 2026 The Authors. Published by Elsevier Inc. All rights reserved.)
– Name: Abstract
  Label: Competing Interests
  Group: Ab
  Data: Conflict of interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
– Name: Ref
  Label: References
  Group: RefInfo
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  Data: &lt;i&gt;Keywords: &lt;/i&gt;Chlorhexidine; Confocal laser scanning microscopy; Dentin disinfection; Dentinal tubules; Iontophoresis; Penetration depth
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  Data: R4KO0DY52L (Chlorhexidine)&lt;br /&gt;0 (Anti-Infective Agents, Local)&lt;br /&gt;0 (Rhodamines)
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  Data: &lt;i&gt;Date Created: &lt;/i&gt;20260215 &lt;i&gt;Date Completed: &lt;/i&gt;20260707 &lt;i&gt;Latest Revision: &lt;/i&gt;20260813
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  Data: 10.1016/j.identj.2026.109439
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      – Type: doi
        Value: 10.1016/j.identj.2026.109439
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        StartPage: 109439
    Subjects:
      – SubjectFull: Biofilms drug effects
        Type: general
      – SubjectFull: Streptococcus mutans drug effects
        Type: general
      – SubjectFull: Microbial Viability drug effects
        Type: general
      – SubjectFull: Humans
        Type: general
      – SubjectFull: Microscopy, Confocal
        Type: general
      – SubjectFull: In Vitro Techniques
        Type: general
      – SubjectFull: Rhodamines
        Type: general
      – SubjectFull: Dentin Permeability
        Type: general
      – SubjectFull: Molar, Third
        Type: general
      – SubjectFull: Chlorhexidine administration & dosage
        Type: general
      – SubjectFull: Chlorhexidine pharmacokinetics
        Type: general
      – SubjectFull: Chlorhexidine pharmacology
        Type: general
      – SubjectFull: Iontophoresis methods
        Type: general
      – SubjectFull: Dentin microbiology
        Type: general
      – SubjectFull: Dentin metabolism
        Type: general
      – SubjectFull: Dentin drug effects
        Type: general
      – SubjectFull: Anti-Infective Agents, Local administration & dosage
        Type: general
      – SubjectFull: Anti-Infective Agents, Local pharmacokinetics
        Type: general
      – SubjectFull: Anti-Infective Agents, Local pharmacology
        Type: general
    Titles:
      – TitleFull: The Penetration Depth and Bactericidal Efficacy of 2% Chlorhexidine Iontophoresis in Human Coronal Dentin In Vitro.
        Type: main
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            – D: 01
              M: 04
              Text: 2026 Apr
              Type: published
              Y: 2026
          Identifiers:
            – Type: issn-electronic
              Value: 1875-595X
          Numbering:
            – Type: volume
              Value: 76
            – Type: issue
              Value: 2
          Titles:
            – TitleFull: International dental journal
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