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Two independent reviewers screened literature, extracted data, and assessed methodological quality (QUIN tool) and certainty of the evidence (GRADE framework).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thirty-eight studies comprising 185 distinct experiments across eight outcome measures were included. Marked heterogeneity was observed regarding RC composition (7 categories), specimen geometry, cell lines, and experimental durations. When evaluating cellular survival and damage independently, 27% of cytotoxicity experiments reported significant cell damage\/death, while 45% of cell viability assays demonstrated a decreased metabolic activity. DNA damage was prominent, with 50% of 18 experiments reporting significant alterations. Significant increases occurred in reactive oxygen species production (71%) and inflammatory mediator release (62%). Conversely, 85% of morphology experiments showed no significant alterations. The overall certainty of evidence was graded as low to moderate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Dental resin composites can induce notable, independent adverse biological responses in human gingival fibroblasts\n                      <jats:italic>in vitro<\/jats:italic>\n                      , characterized by oxidative stress, inflammatory mediator release, DNA damage, and compromised viability. While highlighting a clear potential for toxicity, the low-to-moderate certainty and lack of physiological simulations leave their direct clinical significance open to further investigation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical relevance<\/jats:title>\n                    <jats:p>\n                      Synthesized evidence indicates that dental RCs exert moderate\n                      <jats:italic>in vitro<\/jats:italic>\n                      biological effects on gingival fibroblasts, including DNA-damage and inflammatory responses.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00784-026-07149-3","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T07:52:57Z","timestamp":1791186777000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Biological effects of dental resin composites on human gingival fibroblasts: a systematic review of in vitro evidence"],"prefix":"10.1007","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9048-7988","authenticated-orcid":false,"given":"Elmira","family":"Boloori","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7234-0037","authenticated-orcid":false,"given":"Dagmar E.","family":"Slot","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8794-552X","authenticated-orcid":false,"given":"Bruno G.","family":"Loos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6464-5172","authenticated-orcid":false,"given":"Teun J.","family":"de Vries","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5075-8384","authenticated-orcid":false,"given":"Fridus G.A.","family":"van der Weijden","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,5]]},"reference":[{"key":"7149_CR1","unstructured":"UNEP, Report (2013) Minamata Convention on mercury https:\/\/www.unep.org\/resources\/report\/minamata-convention-mercury"},{"key":"7149_CR2","doi-asserted-by":"publisher","first-page":"426","DOI":"10.14219\/jada.archive.1955.0215","volume":"4","author":"EW Skinner","year":"1955","unstructured":"Skinner EW, Jones PM (1955) Dimensional stability of self-curing denture base acrylic resin. 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