Titanium tattooing associated with zirconia implant abutments: a clinical report of two cases.

Worn particulate titanium abraded from a titanium dental implant that discolors the adjacent soft tissues has not previously been reported. Two cases of this gingival tissue "tattooing" are reported here. While the use of zirconia abutments in areas of high esthetic concern is widespread, the effects of particulate titanium being worn from the implant by the much harder abutment material and then taken up in the adjacent soft tissues should be considered as a potential complication and a consideration when selecting the type of abutment to be used.