The improvement of quaternary ammonium antiseptics for healthcare and dentistry needs. A review
DOI:
https://doi.org/10.32782/2786-7684/2025-1-11Keywords:
quaternary amines, healthcare, dentistry, antiseptics, surfactants, compositesAbstract
Introduction. For a long time, quaternary ammonium compounds (QACs) have been the active ingredient of most antiseptics and disinfectants for healthcare and other sectors of economic activity. Surface-active QACs often combine disinfectant, wetting, foaming, and anticorrosive properties.Aim of the work: to analyze available sources of scientific and medical information related to the development and application of quaternary ammonium compounds in healthcare and dentistry.Materials and methods of the study. An information and patent search was conducted on the Internet on the websites of electronic libraries PubMed, MedLine, SciFinder, HEP Search, Jstor using the keywords "bi-quaternary ammoniums", "antiseptics", "antimicrobial agents", "ionic liquids" and "surfactants". The search depth was 10 years.Research results and their discussion. In nature, QACS can be found in a number of plant alkaloids, terpenoids, acetylenes, coumarins, etc. Considering the isomerism and easy modification of QACS, their antimicrobial, toxic and surface-active properties can be successfully changed by essential modifications of the molecular structure – changing the number of charged nitrogen atoms (mono-, bis-, multi-QACS), changing the structure of the "head" of the molecule (non-heterocyclic, heterocyclic, aromatic), types of bonds (aliphatic, aromatic, saturated, unsaturated, mixed, etc.) and the structure of the "tails" (saturated, unsaturated, branched, unbranched), the properties are also dramatically affected by the length of the aliphatic chains. A separate type of QACS modification is the replacement of a substituent molecule. In addition to reducing the toxic and irritating properties of QACS (while maintaining their antimicrobial and virucidal properties), a separate promising way to improve them has become the synthesis of "hybrid" substances by forming their complexes with previously known antimicrobial agents. For example, the combination of QACS with semi-synthetic penicillins. A separate promising direction for improving the introduction of QACS into medical practice is the development of polymeric QACS and their salts as ionic liquids of a new type. And this has opened a whole new direction in the development of new antimicrobial agents of local action. The inclusion of QACS in the composition of dental composite filling materials reduces the risk of biodegradation of composites, which increases the durability of dental restorations and prevents the development of secondary dental caries. The caries-static effect is realized through bacteriostatic and anti-biofilm-forming effects. The improvement of dental composite technology consists in fixing the QACS themselves as low-functional groups on methacrylate monomers. Epoxy-functionalized QACS are new directions of development. These compounds are combined with epoxy resins, which can subsequently be polymerized. Such QACS can be included in the composition of polymers and retain a long-term bacteriostatic effect.Conclusions: QACS are important substances for medical practice and dentistry in particular. The newest substances are promising antiseptics and antimicrobial agents that can be included in the composition of many types of medical devices. A progressive direction is the modification of epoxy resins and methacrylate monomers in dental composite materials by incorporating modified QACS into the structure.
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