Abstract
BACKGROUND: Implant abutment materials significantly influence peri-implant tissue health, particularly the attachment and behavior of gingival fibroblasts. An optimal material can enhance biocompatibility and reduce inflammation, ensuring long-term success. This study compares the effects of titanium, zirconia, and polyetheretherketone (PEEK) abutments on gingival fibroblast attachment in vitro. MATERIALS AND METHODS: Standardized disks of titanium, zirconia, and PEEK abutment materials were prepared. Primary gingival fibroblasts were cultured and seeded on the disks in a 24-well plate format, with each material in triplicate. Cell attachment was assessed after 24 and 48 hours using fluorescence microscopy and a quantitative cell adhesion assay. Surface roughness (Ra) and hydrophilicity of the disks were evaluated to correlate with fibroblast behavior. Arbitrary values for attached cell counts and surface characteristics were analyzed using ANOVA and post hoc tests (P < 0.05). RESULTS: Titanium demonstrated the highest fibroblast attachment (mean cell count: 1.25 × 10(4) ± 0.5 × 10(3) at 24 hours), followed by zirconia (mean cell count: 1.15 × 10(4) ± 0.4 × 10³). PEEK showed significantly lower attachment (mean cell count: 0.85 × 10(4) ± 0.3 × 10³). Surface roughness and hydrophilicity were highest for titanium (Ra: 0.3 μm, contact angle: 72°), followed by zirconia (Ra: 0.25 μm, contact angle: 80°), and lowest for PEEK (Ra: 0.2 μm, contact angle: 90°). CONCLUSION: Titanium and zirconia provide favorable conditions for gingival fibroblast attachment, with titanium slightly outperforming zirconia due to superior surface properties. PEEK, while biocompatible, demonstrates reduced fibroblast attachment, suggesting limited suitability for areas requiring strong soft tissue integration. These findings underscore the importance of material selection in achieving optimal peri-implant tissue health.