A randomized, controlled, clinical study on a new titanium oxide abutment surface for improved healing and soft tissue health

Clin Implant Dent Relat Res. 2019 Mar;21 Suppl 1:55-68. doi: 10.1111/cid.12749. Epub 2019 Mar 12.


Background: A newly developed, anodized titanium oxide surface containing anatase has been reported to have antimicrobial properties that could reduce bacterial adherence to abutments.

Purpose: To investigate if abutments with the anodized surface improve healing and soft tissue health in a randomized controlled study.

Materials and methods: Test abutments with a nanostructured anodized surface were compared with control machined titanium abutments. In total, 35 subjects each received a pair of test and control abutments. The primary endpoint was reduction of biofilm formation at test abutments at the 6-week follow-up. Secondary endpoints included several soft tissue assessments. qPCR for gene markers was used to indirectly evaluate healing and soft tissue health.

Results: No significant differences in biofilm formation were observed between test and control abutments, but soft tissue bleeding upon abutment removal was significantly lower for test abutments compared with control abutments (P = 0.006) at 6 weeks. Keratinized mucosa height was significantly greater at test abutments compared with control abutments at the 6-week, 6-month, and 2-year follow-ups. Significant gene expression differences indicated differences in healing and tissue remodeling.

Conclusions: Abutments with an anodized and nanostructured surface compared with a conventional, machined titanium surface had no significant effect on bacterial colonization and proteolytic activity but were associated with better soft tissue outcomes such as a lower bleeding index at abutment removal and consistently greater height of keratinized mucosa throughout the 2-year follow-up, suggesting improved surface-dependent peri-implant healing and soft tissue health.

Keywords: RCT; bleeding on probing; keratinized mucosa height; new abutment surface; soft tissue healing and health.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Dental Abutments*
  • Gingiva
  • Humans
  • Surface Properties
  • Titanium*
  • Tooth
  • Wound Healing*
  • Zirconium


  • titanium dioxide
  • Zirconium
  • Titanium