The surface roughness of a dental implant affects the epithelial wound healing process and may significantly enhance implant prognosis.

We explored the influence of surface roughness on peri‐implant epithelium (PIE) sealing and down‐growth by comparing machine‐surfaced (Ms) and rough‐surfaced (Rs) implants.

(1) Maxillary first molars were extracted from rats and replaced with Ms or Rs implants. (2) We also compared changes in the morphology of cultured rat oral epithelial cells (OECs) grown on Ms or Rs titanium (Ti) plates.

(1) After 4 weeks, the PIE around Ms and Rs implants showed a similar structure to junctional epithelium (JE). At 16 weeks, Rs implants appeared to form a weak epithelial seal at the tissue‐implant interface and exhibited markedly less PIE down‐growth than Ms implants but was deeper than that observed in natural teeth. (2) We observed less expression of adhesion proteins in OECs cultured on Rs plates than in cells grown on Ms plates. Additionally, cell adherence, migration, and proliferation on Rs plates were lower, whereas apoptosis was reduced on Ms plates.

Ms implants are a better choice for integration with an epithelial wound healing process.