Recent advances in the application of quaternary ammonium compounds in biomedical materials

Microbial infections affect people worldwide. Quaternary ammonium salts serve antibacterial, antifungal, antiviral, anti-matrix metalloproteinase and polymerization functions. While the modification of biomaterials with quaternary ammonium salts cannot affect the physical or chemical properties of the biomaterials, this process can confer them with stable biological activity. Currently, quaternary ammonium salts are widely used in the development of functional orthopedic materials, sutures, dressings and dental materials, and the idea of modifying biomedical materials with quaternary ammonium salts has become the most promising, e.g., for preparing antimicrobial biomaterials. Recent studies have found that quaternary ammonium salt-modified antimicrobial monomers are cytotoxic. Therefore, it is of great significance to explore the cytotoxic mechanism of quaternary ammonium salt-modified antimicrobial monomers and determine possible cytoprotective measures for improving the biological safety of these antimicrobial resin-based materials and expanding their clinical applications. In addition, further validation of the clinical efficacy of these biomaterials is particularly important for accurately evaluating the clinical prospects of these biomaterials. Based on a literature review, this paper summarizes the applications and toxicity of biomedical materials modified with quaternary ammonium salts.