Purpose Fiber-reinforced composites (FRCs) have received considerable attention, owing to their potential use in dental prostheses or bone fracture fixation applications. The aim of this systematic review was to analyze and report the biological properties of FRCs reported in the existing literature.

Study selections A systematic search of four databases (PubMed/MEDLINE, Scopus, Web of Science, and Cochrane library) was performed to identify all relevant studies published between 1962 and 2019. The search was limited to laboratory-based studies published in English. Citation mining was also performed through cross-referencing of included studies and hand searching of relevant journals.

Results A total of 1283 potentially relevant articles were initially identified, and thirty-three articles were full-text screened. In the final ten studies included for review, four investigated bacterial adhesion and growth abilities on FRCs, four investigated the fibroblastic cytotoxicity of different surface-treated FRCs, and two investigated the osseointegration between bone and FRCs. Owing to the heterogeneity of fiber types, FRC-coating, and lack of standardized testing protocols, a meta-analysis was not feasible. The included studies indicated that glass fibers, and in particular E-glass fibers, are superior to ceramics and other FRCs in terms of bacterial adherence, fibroblast cytotoxicity, and cell viability.

Conclusions Glass-fiber-reinforced composites are cytocompatible materials that possess satisfactory biological properties and can be used in dental prosthesis and craniofacial implants. Further research is necessary to regulate the matrix ion release/degradation of FRCs to prolong the initially demonstrated properties.