Peri-implant soft tissue response to different abutment materials: A randomised controlled clinical trial

Peri-implant soft tissue response varies with different transmucosal abutment materials, but their comparative effects on clinical, histologic and microbiologic markers are not well understood. This randomized, controlled, split-mouth clinical trial compared titanium (Ti), zirconia (Zr) and titanium with a TiO₂ bioactive coating (Ti+TiO₂) in 50 systemically healthy participants. Over 12 months, zirconia and Ti+TiO₂ showed lower bleeding on probing (BoP) and reduced inflammatory markers compared to titanium, with Ti+TiO₂ demonstrating denser connective tissue attachment. Zirconia was preferred for esthetics. This study advances knowledge by highlighting the comparative advantages of Ti+TiO₂ and zirconia in peri-implant tissue response.