Clinical studies indicate that soft tissue responses around dental implants vary, depending on the material used. It is therefore also possible that there are differences in how epithelial cells attach to various biomaterial surfaces. We studied the adhesion of cultured epithelial cells to five different dental material surfaces and to glass. The efficacy of adhesion was evaluated by using scanning electron microscopy (SEM) and immunofluorescence microscopy (IF) with antibodies to vinculin and alpha(6)beta(4) integrin, two cell surface molecules that are functional in epithelial cell adhesion. Our results indicate that epithelial cells adhere and spread more avidly on metallic surfaces (titanium, Ti(6)Al(4)V titanium alloy, dental gold alloy) than on ceramic surfaces (dental porcelain, aluminum oxide). As revealed by SEM, cells on metallic surfaces had a flattened morphology and formed multicellular islands. On porcelain and aluminum oxide most cells were round and adhesion occurred as single cells. Surface coverage was over twofold on metallic surfaces as compared to ceramic surfaces. IF of cells grown on metallic surfaces revealed vinculin in well-organized focal contacts and alpha(6)beta(4) integrin in punctate patterns typical of prehemidesmosomes. On porcelain and aluminum oxide surfaces the cells were mostly round and showed less well-organized adhesion complexes. Our results indicate that smooth metallic biomaterial surfaces are optimal for epithelial cell adhesion and spreading. These findings may have clinical implications in the design of transgingival implant structures.