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We evaluated the biological effects of implant abutments made from ceria-stabilized zirconia/alumina nanocomposite (Ce-TZP/Al2O3) with surface roughness variations using human gingival fibroblasts (HGF-1) in the transmucosal region. Two types of titanium (Ti) and Ce-TZP/Al2O3 disks with different surface roughness profiles were prepared (Ra0.9 and Ra0.02). Surface properties were evaluated using SEM, EDX, and wettability analysis. Biological parameters including cell adhesion, proliferation and morphology, collagen deposition, and inflammatory cytokine expression were evaluated for each disk. Surface morphology analysis of Ce-TZP/ Al2O3 and Ti elucidated the uniform linear structures of Ra0.9 and the smooth and flat structures of Ra0.02. Cell morphology showed spindle-shaped and large, circular forms, respectively. Cell adhesion and proliferation and collagen deposition were significantly increased on Ce-TZP/Al2O3 Ra0.02 disk compared with the others, with no significant differences in cytokine expression among all the disks. The reduced surface roughness of Ce-TZP/Al2O3 was advantageous for promoting biological effects in the transmucosal region. [ABSTRACT FROM AUTHOR]