# Comparative antibacterial efficacy of MTA, amniotic membrane, and hyaluronic acid in pulp therapy for primary teeth

## TL;DR

This study compares the antibacterial effectiveness of MTA, amniotic membrane, and hyaluronic acid in treating primary teeth, finding MTA to be the most effective.

## Contribution

The study provides a novel comparison of three pulp capping materials' antibacterial efficacy against specific bacteria in pediatric dentistry.

## Key findings

- MTA showed the strongest antibacterial effect against Enterococcus faecalis and Streptococcus mutans.
- Hyaluronic acid had limited antibacterial activity, while amniotic membrane was ineffective against some bacteria.
- Lactobacillus acidophilus was resistant to all tested materials.

## Abstract

Pulp therapy is a widely used treatment for cariously exposed asymptomatic primary teeth. Formocresol (FC) has traditionally been considered the standard treatment for pulpotomy, but its safety has raised concerns in recent years. Consequently, various alternative materials were explored and proposed.

The purpose of this study is to compare the anti-bacterial effects of three pulp capping materials against Enterococcus faecalis, Streptococcus mutans, and Lactobacillus acidophilus.

The antibacterial effect of the three pulp capping materials was evaluated using the agar diffusion method, Group I; MTA, Group II: amniotic Membrane, Group III: hyaluronic acid against Streptococcus mutans, Enterococcus faecalis, and Lactobacillus acidophilus.

A statistically significant difference was observed among the tested groups. MTA exhibited the largest inhibition zone (18.25 ± 1.71 mm) against E.faecalis, followed by the amniotic membrane (11.75 ± 3.86 mm), while hyaluronic acid showed no antibacterial activity.Similarly, a significant difference was observed in inhibition zones among the tested groups against Streptococcus mutans (p < 0.001), where MTA showed the highest inhibitory effect (13.50 ± 1.2 mm), followed by hyaluronic acid (12.00 ± 0.82 mm), whereas the amniotic membrane exhibited no antibacterial effect. Lactobacillus acidophilus was not affected by any of the tested materials in terms of antibacterial activity.

MTA and the amniotic membrane demonstrated effectiveness against Enterococcus faecalis, while hyaluronic acid showed no antibacterial activity against this strain. Both MTA and HA exert antibacterial effects against Streptococcus mutans, whereas the amniotic membrane had no effect. The tested materials were ineffective against Lactobacillus acidophilus, which showed resistance. Overall, MTA displayed the strongest antibacterial effect among the tested groups.

The online version contains supplementary material available at 10.1186/s12903-025-07038-3.