Trends and Future Perspectives in Additive Modifications of Calcium Silicate-Based Cements: A Scoping Review...

This scoping review identified commonly modified commercial calcium silicate-based cements (CSCs), evaluate additive-property trends and highlight research gaps relevant to their clinical application. Laboratory studies published between 2015 and 2024 were searched in PubMed, ScienceDirect and Web of Science following PRISMA-ScR. Fifty-one studies met the inclusion criteria, with ProRoot being the most frequently studied CSC. Additive modifications primarily targeted setting time, biocompatibility, antibacterial property and osteogenic differentiation. A recent shift from bioactivity-focused to physicochemical optimization was observed. Heat map analysis demonstrated distinct additive category-property associations, with metals and fluorides mainly linked to antibacterial enhancement, phosphate-based and bioactive compounds to biocompatibility and osteogenic outcomes, and commonly used setting modifiers, including calcium chloride, associated with accelerated setting. These findings indicate that single-category additive strategies are insufficient and that several CSC properties remain underexplored, supporting the need for more integrative CSC design.