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Polyethylene fiber reinforcement in resin composite restorations : a systematic review of clinical trials

datacite.subject.fosCiências Médicas::Biotecnologia Médica
datacite.subject.sdg03:Saúde de Qualidade
dc.contributor.authorBourgi, Rim
dc.contributor.authorHoliel, Ahmed A.
dc.contributor.authorDelgado, António H. S.
dc.contributor.authorFlores-Ledesma, Abigailt
dc.contributor.authorKhafaja, Souheir
dc.contributor.authorCuevas-Suárez, Carlos Enrique
dc.date.accessioned2026-06-16T14:46:21Z
dc.date.available2026-06-16T14:46:21Z
dc.date.issued2026-06
dc.description.abstractPurpose: To synthesize evidence from randomized controlled trials (RCTs) on the clinical performance of ultra-high-molecular-weight polyethylene (UHMWPE) fiber-reinforced direct composite restorations compared to conventional composites in posterior teeth and non-carious cervical lesions. Methods: A systematic review was conducted following PRISMA guidelines (PROSPERO: CRD420251178877). Databases were searched up to November 2025 for RCTs evaluating fiber-reinforced versus non-reinforced direct composite restorations in Class I, II, or V cavities. Grey literature and trial registries were not searched, framing this as a restricted-source systematic review of peer-reviewed published evidence. The primary outcome was restoration failure/survival; secondary outcomes included marginal adaptation, discoloration, and postoperative sensitivity. Risk of bias was assessed using RoB 2, and certainty of evidence was evaluated with GRADE. Results: Four RCTs (404 patients, 494 restorations) with 12–24 month follow-up were included. All trials reported 100% restoration survival in both fiber-reinforced and control groups. No statistically significant differences were found in any clinical performance parameter. The evidence was of moderate certainty for primary outcomes in adults but low to very low for secondary outcomes and pediatric/NCCL indications, limited by short follow-up, imprecision, and risk of bias. Conclusions: Within the limited observation period of up to 24 months, UHMWPE fiber reinforcement did not demonstrate a measurable clinical advantage over contemporary non-reinforced composite protocols for posterior teeth. The uniformly high survival rates and comparable performance indicate excellent short-term outcomes for both approaches under controlled conditions. Absence of observed benefit should not be interpreted as equivalence; long-term RCTs are required to determine if fiber reinforcement mitigates late complications such as fracture in structurally compromised teeth.eng
dc.identifier.citationRim Bourgi, Ahmed A. Holiel, António HS Delgado, Abigailt Flores-Ledesma, Souheir Khafaja, Carlos Enrique Cuevas-Suárez, Polyethylene fiber reinforcement in resin composite restorations: A systematic review of clinical trials, Dentistry Review, Volume 6, Issue 2, 2026, 100422, https://doi.org/10.1016/j.dentre.2026.100422
dc.identifier.doi10.1016/j.dentre.2026.100422
dc.identifier.issn2772-5596
dc.identifier.urihttp://hdl.handle.net/10400.26/63611
dc.language.isoeng
dc.peerreviewedyes
dc.publisherElsevier
dc.relation.hasversionhttps://doi.org/10.1016/j.dentre.2026.100422
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subjectPolyethylene fibers
dc.subjectComposite resins
dc.subjectSystematic review
dc.titlePolyethylene fiber reinforcement in resin composite restorations : a systematic review of clinical trialseng
dc.typecontribution to journal
dspace.entity.typePublication
oaire.citation.issue2
oaire.citation.startPage100422
oaire.citation.titleDentistry Review
oaire.citation.volume6
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85

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