Comparative Analysis of Inflammatory Tissue Responses in Patients with Metal-Based and Ceramic-based Dental Prostheses

Abstract Introduction: The selection of restorative materials for fixed dental prostheses significantly influences peri-prosthetic tissue health and long-term treatment success. Metal-based prostheses have been extensively used for decades; however, concerns regarding metal ion release and potential inflammatory responses have prompted increased interest in all-ceramic alternatives. Understanding the comparative inflammatory tissue responses between these material types is essential for evidence-based clinical decision-making. Materials and Methods: This prospective comparative clinical study evaluated inflammatory tissue responses in 120 patients receiving fixed dental prostheses, allocated to either metal-ceramic restorations (Group A, n = 60) or all-ceramic zirconia-based restorations (Group B, n = 60). Clinical periodontal parameters, including the gingival index (GI), probing depth (PD), bleeding on probing (BOP) and plaque index, were assessed at baseline, 3, 6 and 12 months post-cementation. Gingival crevicular fluid samples were collected and analysed for interleukin-1β (IL-1β), IL-6, tumour necrosis factor-alpha and matrix metalloproteinase-8 (MMP-8) concentrations using enzyme-linked immunosorbent assay. Results: Metal-ceramic restorations demonstrated significantly higher inflammatory biomarker concentrations at 12 months, with IL-1β levels of 142.6 ± 48.3 pg/mL compared to 82.4 ± 34.6 pg/mL in all-ceramic restorations ( P < 0.001). Clinical parameters revealed elevated GI scores (1.12 ± 0.42 vs. 0.54 ± 0.28, P < 0.001), increased PDs (2.48 ± 0.46 mm vs. 2.04 ± 0.38 mm, P < 0.001) and higher BOP rates (58.3% vs. 26.7%, P < 0.001) in the metal-ceramic group. Conclusion: All-ceramic zirconia-based dental prostheses demonstrate superior biocompatibility with significantly reduced inflammatory tissue responses compared to metal-ceramic restorations, supporting their preferential use in patients seeking optimal peri-prosthetic tissue health.