Modifications of Biodentine and Their Influence on Endodontic Properties: A Scoping Review.

Background: Biodentine, an innovative biocompatible, tricalcium cement, is used widely in endodontics owing to its advantageous properties. Yet limitations concerning its radiopacity and other handling properties have compelled the development of different material modifications. Aim: This scoping review aims to map and synthesize the available evidence on the impact of different fillers and additives on the biological, mechanical, and physical properties of Biodentine in endodontics. Methodology: This review was performed in line with the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses Modifications for Scoping Reviews (PRISMA-ScR) guidelines. A Literature search was conducted comprehensively throughout major databases such as Scopus, PubMed, Web of Science, and Google Scholar. In vitro studies evaluating the modifications of Biodentine were included. Information was charted and integrated descriptively. Result: Broad range of modifications were noted, such as the addition of nanoparticles, radiopacifiers, bioactive additives. and antimicrobial agents. These modifications were focused on improving the physical and mechanical properties, improve antimicrobial efficacy and enhance radiopacity while preserving biocompatibility. However, significant heterogeneity was noted in modification process, property evaluating methods, and results. Conclusion: This scoping review indicates that modifications of Biodentine using various additives may enhance its biological, mechanical, and physical properties. Future research should focus on standardizing experimental methodologies to allow meaningful comparison across studies, identifying optimal concentrations of additives to balance material performance, and conducting well-designed in vivo and clinical studies to validate these findings and support their translation into clinical practice.