Polyethylene fiber versus short glass fiber as biomimetic substitutes for dentin: a systematic review and critical synthesis of biomechanical evidence
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Published:
Oct 1, 2026
Keywords:
Dental biomimetics; dentin; polyethylene fibers; UHMWPE; Ribbond; short fiber-reinforced composite; SFRC; everX posterior; everX Flow; fracture resistance; fracture toughness; fatigue.
Main Article Content
Abstract
Introduction. Dentin is a complex tissue; therefore, the biomimetic approach aims to restore its mechanical function, particularly load transfer, energy dissipation, and crack control. SFRCs and Ribbond employ different reinforcement architectures: SFRCs deflect and arrest cracks, whereas Ribbond redistributes loads and provides structural containment. Objective. To critically compare the biomechanical behavior of short glass fiber-reinforced composites (SFRCs) and polyethylene fiber-reinforced composites, with emphasis on their ability to restore dentin-related functions rather than on presumed compositional equivalence. Methodology. A systematic synthesis of experimental and clinical studies on Ribbond/UHMWPE and SFRCs was conducted, with priority given to permanent teeth. Methodological quality was assessed using RoBDEMAT and appropriate risk-of-bias tools. The substantial heterogeneity across studies precluded a global meta-analysis. Results. Contemporary evidence indicates that both systems increase fracture resistance compared with non-reinforced composites, without demonstrating universal superiority of either approach. Direct comparisons have yielded variable results, and a 2026 study found no significant difference between SFRCs (2132.9 ± 169.5 N) and Ribbond (2084.5 ± 177.2 N). SFRCs provide multidirectional short fibers that deflect and arrest cracks, whereas polyethylene fibers act as continuous reinforcement that redistributes loads and bridges cracks. Conclusion. The evidence does not demonstrate universal superiority of SFRCs or polyethylene fibers. Both increase fracture resistance and may promote more repairable failure patterns. General Field of Study: Health Sciences. Specific Field of Study: Dentistry. General Type of study: Narrative systematic review.
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Izzeddin Abou, R. (2026). Polyethylene fiber versus short glass fiber as biomimetic substitutes for dentin: a systematic review and critical synthesis of biomechanical evidence. Anatomía Digital, 9(4), 24-43. https://doi.org/10.33262/anatomiadigital.v9i4.3771
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References
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2. Marshall GW Jr, Marshall SJ, Kinney JH, Balooch M. The dentin substrate: structure and properties related to bonding. Journal of Dentistry [Internet]. 1997 [cited 2026 July 15];25(6):441–58. Available from: http://dx.doi.org/10.1016/s0300-5712(96)00065-6
3. Arola D, Ivancik J, Majd H, Fouad A, Bajaj D, Zhang XY, et al. Microstructure and mechanical behavior of radicular and coronal dentin: Mechanical behavior of radicular dentin. Endodontic Topics [Internet]. 2009 [cited 2026 July 15];20(1):30–51. Available from: http://dx.doi.org/10.1111/j.1601-1546.2012.00267.x
4. Escobar LB, Pereira da Silva L, Manarte-Monteiro P. Fracture resistance of fiber-reinforced composite restorations: A systematic review and meta-analysis. Polymers (Basel) [Internet]. 2023 [cited 2026 July 15];15(18):3802. Available from: http://dx.doi.org/10.3390/polym15183802
5. Arola D, Zheng W. Hydration and dynamic fatigue of dentin. Journal of Biomedical Materials Research [Internet]. 2006 [cited 2026 July 15];77(1):148–59. Available from: http://dx.doi.org/10.1002/jbm.a.30634
6. Arola DD, Rouland JA. The effects of tubule orientation on fatigue crack growth in dentin. Journal of Biomedical Materials Research [Internet]. 2003 [cited 2026 July 15];67(1):78–86. Available from: http://dx.doi.org/10.1002/jbm.a.10089
7. Imbeni V, Nalla RK, Bosi C, Kinney JH, Ritchie RO. In vitro fracture toughness of human dentin. Journal of Biomedical Materials Research [Internet]. 2003 [cited 2026 July 15];66(1):1–9. Available from: http://dx.doi.org/10.1002/jbm.a.10548
8. Ivancik J, Arola DD. The importance of microstructural variations on the fracture toughness of human dentin. Biomaterials [Internet]. 2013 [cited 2026 July 15];34(4):864–74. Available from: http://dx.doi.org/10.1016/j.biomaterials.2012.10.032
9. Kruzic JJ, Nalla RK, Kinney JH, Ritchie RO. Crack blunting, crack bridging and resistance-curve fracture mechanics in dentin: effect of hydration. Biomaterials [Internet]. 2003 [cited 2026 July 15];24(28):5209–21. Available from: http://dx.doi.org/10.1016/s0142-9612(03)00458-7
10. Selvaraj H, Krithikadatta J. Fracture resistance of endodontically treated teeth restored with short fiber reinforced composite and a low viscosity bulk fill composite in class II mesial-occlusal-distal access cavities: An ex-vivo study. Cureus [Internet]. 2023 [cited 2026 July 15];15(8):e42798. Available from: http://dx.doi.org/10.7759/cureus.42798
11. Mangoush E, Garoushi S, Lassila L, Vallittu PK, Säilynoja E. Effect of fiber reinforcement type on the performance of large posterior restorations: A review of in vitro studies. Polymers (Basel) [Internet]. 2021 [cited 2026 July 15];13(21):3682. Available from: http://dx.doi.org/10.3390/polym13213682
12. Garoushi S, Gargoum A, Vallittu PK, Lassila L. Short fiber-reinforced composite restorations: A review of the current literature. Journal of Investigative and Clinical Dentistry [Internet]. 2018 [cited 2026 July 15];9(3):e12330. Available from: http://dx.doi.org/10.1111/jicd.12330
13. Alshetiwi DSD, Muttlib NAA, El-Damanhoury HM, Alawi R, Rahman NA, Elsahn NA, et al. Evaluation of mechanical properties of anatomically customized fiber posts using E-glass short fiber-reinforced composite to restore weakened endodontically treated premolars. BMC Oral Health [Internet]. 2024 [cited 2026 July 15];24(1):323. Available from: http://dx.doi.org/10.1186/s12903-024-04102-2
14. Mossad Hassan Negm H, Yousry Elkharadly D, Badawy S, Rashad Omar Omar Taha R. Fracture resistance in fibre-reinforced resin composite restorations in deciduous and permanent molars: An ex vivo study. The Saudi Dental Journal [Internet]. 2024 [cited 2026 July 15];36(9):1197–202. Available from: http://dx.doi.org/10.1016/j.sdentj.2024.06.017
15. Miura D, Ishida Y, Shinya A. Polymerization shrinkage of short fiber reinforced dental composite using a confocal laser analysis. Polymers (Basel) [Internet]. 2021 [cited 2026 July 15];13(18):3088. Available from: http://dx.doi.org/10.3390/polym13183088
16. Demarco FF, Cenci MS, Montagner AF, de Lima VP, Correa MB, Moraes RR, et al. Longevity of composite restorations is definitely not only about materials. Dental Materials [Internet]. 2023 [cited 2026 July 15];39(1):1–12. Available from: http://dx.doi.org/10.1016/j.dental.2022.11.009
17. Opdam NJM, van de Sande FH, Bronkhorst E, Cenci MS, Bottenberg P, Pallesen U, et al. Longevity of posterior composite restorations: a systematic review and meta-analysis: A systematic review and meta-analysis. Journal of Dental Research [Internet]. 2014 [cited 2026 July 15];93(10):943–9. Available from: http://dx.doi.org/10.1177/0022034514544217
18. Shafiei F, Doozandeh M, Ghaffaripour D. Effect of different liners on fracture resistance of premolars restored with conventional and short fiber-reinforced composite resins: Effect of different liners on fracture resistance. Journal of Prosthodontics [Internet]. 2019 [cited 2026 July 15];28(1):e304–9. Available from: http://dx.doi.org/10.1111/jopr.12743
19. Mohammadipour HS, Farajzadeh M, Toutouni H, Gazerani A, Sekandari S. Fracture resistance of fiber-reinforced vs. Conventional resin composite restorations in structurally compromised molars: An in vitro study. International Journal of Dentistry [Internet]. 2025 [cited 2026 July 15];2025(1):5169253. Available from: http://dx.doi.org/10.1155/ijod/5169253
20. Staninec M, Meshkin N, Manesh SK, Ritchie RO, Fried D. Weakening of dentin from cracks resulting from laser irradiation. Dental Materials [Internet]. 2009 [cited 2026 July 15];25(4):520–5. Available from: http://dx.doi.org/10.1016/j.dental.2008.10.004
21. Garoushi S, Säilynoja E, Frater M, Keulemans F, Vallittu PK, Lassila L. A comparative evaluation of commercially available short fiber-reinforced composites. BMC Oral Health [Internet]. 2024 [cited 2026 July 15];24(1):1573. Available from: http://dx.doi.org/10.1186/s12903-024-05267-6
22. Garlapati TG, Krithikadatta J, Natanasabapathy V. Fracture resistance of endodontically treated teeth restored with short fiber composite used as a core material-An in vitro study. Journal of Prosthodontic Research [Internet]. 2017 [cited 2026 July 15];61(4):464-470. Available from: http://dx.doi.org/10.1016/j.jpor.2017.02.001
23. Zotti F, Ferrari F, Paganelli C, Pilati F, Lanzaretti G, Arlacchi D, et al. Increasing the fracture strength of MOD restorations with Ribbond fibers. Journal of clinical and experimental dentistry [Internet]. 2024 [cited 2026 July 15];16(6):e707–13. Available from: http://dx.doi.org/10.4317/jced.61608
24. Bijelic-Donova J, Bath AK, Rocca GT, Bella E di, Saratti CM. Can fiber-reinforced composites increase the fracture resistance of direct composite restorations in structurally compromised teeth? A systematic review and meta-analysis of laboratory studies. Operative Dentistry [Internet]. 2025 [cited 2026 July 15];50(1):E1–29. Available from: http://dx.doi.org/10.2341/24-032-LIT
25. Aram A, Hong H, Song C, Bass M, Platt JA, Chutinan S. Physical properties and clinical performance of short fiber reinforced resin-based composite in posterior dentition: Systematic review and meta-analysis. Operative Dentistry [Internet]. 2023 [cited 2026 July 15];48(5):E119–36. Available from: http://dx.doi.org/10.2341/22-003-LIT
26. Alvarado-Orozco A, Bourgi R, Rodríguez-Vilchis LE, Cuevas-Suárez CE, Contreras-Bulnes R, Zamarripa-Calderón JE, et al. Fracture resistance of teeth restored with polyethylene fibers reinforced composite restorations: a systematic review and meta-analysis of in vitro studies. Frontiers in Dental Medicine [Internet]. 2025 [cited 2026 July 15];6:1733879. Available from: http://dx.doi.org/10.3389/fdmed.2025.1733879
27. Fernández E, Díaz L, Bersezio C, Martín J, Cabello R, Angel P. Efficacy of short fiber-reinforced composite resins in MOD and endodontically treated posterior teeth: A systematic review. Journal of Esthetic and Restorative Dentistry [Internet]. 2026 [cited 2026 July 15];38(2):268–86. Available from: http://dx.doi.org/10.1111/jerd.70046
28. Jakab A, Palkovics D, T Szabó V, Szabó B, Vincze-Bandi E, Braunitzer G, et al. Mechanical performance of extensive restorations made with short fiber-reinforced composites without coverage: A systematic review of in vitro studies. Polymers (Basel) [Internet]. 2024 [cited 2026 July 15];16(5):590. Available from: http://dx.doi.org/10.3390/polym16050590
29. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. PLoS Medicine [Internet]. 2021 [cited 2026 July 15];18(3):e1003583. Available from: http://dx.doi.org/10.1371/journal.pmed.1003583
30. Delgado AH, Sauro S, Lima AF, Loguercio AD, Della Bona A, Mazzoni A, et al. RoBDEMAT: A risk of bias tool and guideline to support reporting of pre-clinical dental materials research and assessment of systematic reviews. Journal of Dentistry [Internet]. 2022 [cited 2026 July 15];127(104350):104350. Available from: http://dx.doi.org/10.1016/j.jdent.2022.104350
31. Sterne JAC, Savović J, Page MJ, Elbers RG, Blencowe NS, Boutron I, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ [Internet]. 2019 [cited 2026 July 15];366:l4898. Available from: http://dx.doi.org/10.1136/bmj.l4898
32. Page MJ, Moher D, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews. BMJ [Internet]. 2021 [cited 2026 July 15];372:n160. Available from: http://dx.doi.org/10.1136/bmj.n160
33. Fadah SM, Safy RK, Mohamed BH. Fracture resistance and mode of failure of MOD cavities restored with short glass versus polyethylene fiber-reinforced composites: an in vitro study. BMC Oral Health [Internet]. 2026 [cited 2026 July 15];26(1). Available from: http://dx.doi.org/10.1186/s12903-026-07999-z
34. Albar N, Khayat W. Fracture load of mesio-occluso-distal composite restorations performed with different reinforcement techniques: An in vitro study. Polymers (Basel) [Internet]. 2023 [cited 2026 July 15];15(6):1358. Available from: http://dx.doi.org/10.3390/polym15061358
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