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Zirconia abutments provide a promising biological alternative to titanium by promoting stable soft-tissue integration and reducing inflammation, whereas PEEK abutments offer strong mechanical properties but require surface modification to overcome limited cell attachment. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

January 1, 2026Journal of Prosthodontic Research2 citationsOpen Access

Peri-implant soft-tissue responses to tooth-colored abutment materials: A systematic review

WTWatcharaphol TiskratokSuranaree University of Technology PLPhoonsuk LimraksasinChulalongkorn University MKMaythwe KyawsoewinChulalongkorn University

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Abstract

PURPOSE: This systematic review aimed to investigate and compare peri-implant soft-tissue responses to tooth-colored abutment materials frequently used in implant dentistry. STUDY SELECTION: A comprehensive electronic search was performed in three databases (MEDLINE via PubMed, Google Scholar, and Scopus) to identify relevant literature. The study-selection criteria included original research articles written in English that investigated the effects of various tooth-colored abutment materials on peri-implant soft-tissue responses. RESULTS: In total, 136 articles were included in this systematic review. Tooth-colored abutment materials, particularly zirconia and polyetheretherketone (PEEK), facilitated favorable soft-tissue adaptation, enhanced esthetics, and contributed to long-term implant success. Zirconia demonstrated excellent biocompatibility, enhanced cell viability and attachment, and lower inflammatory responses compared to titanium, suggesting improved soft-tissue integration and reduced biofilm-related risks. PEEK exhibited favorable mechanical properties and biocompatibility but limited cell attachment due to its hydrophobicity, indicating the need for surface modification. Titanium remains the clinical standard for integration but is associated with greater inflammation and biofilm formation than tooth-colored materials. CONCLUSIONS: This review highlights the effects of tooth-colored abutment materials on peri-implant soft-tissue responses and emphasizes the importance of selecting appropriate materials for successful dental implants. Zirconia represents a promising biological alternative to titanium, promoting a stable soft-tissue barrier that contributes to minimizing inflammation and maintaining long-term tissue health. Conversely, while PEEK offers strong mechanical properties, it faces challenges regarding cell proliferation and matrix production, limiting its optimal biological performance. Further research will provide deeper insights into the best options for enhancing patient and esthetic outcomes.

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