Background While the function of dentogingival junction, the epithelial and connective tissue attachments to the tooth, has been well documented, the attachment of peri-implant soft tissues to dental implants remains uncertain. Recently, dental implants made of zirconia (Zr) have been developed. Our previous study demonstrated the strength of osseointegration of Ce-TZP Al2O3 was greater than that of acid etched Ti in a rat model. However, the attachment of Ce-TZP Al2O3 to the soft-tissues remains unknown. Aim/Hypothesis In order to evaluate the capability of Ce-TZP Al2O3 to achieve the soft tissue attachment, this study aimed to assess the attachment, proliferation, morphology, and extracellular matrix (ECM) synthesis of HGF-1 on Ce-TZP Al2O3 and Ti surfaces with different grades of roughness. Material and Methods We prepared three types of Ce-TZP Al2O3 substrates with different grades of surface roughness (mirror, smooth and roughZr) as test surfaces, and two types of Ti (machined and mirrorTi) substrates as control. We observed the surface characteristics of all samples, including topography, elemental composition, and hydrophilicity using scanning electron microscopy (SEM), X-ray photoelectron spectroscopy (XPS), and contact angle goniometer, respectively. Initial cell attachment and proliferative activities were evaluated after 3 hours, 24 hours, and 3 days of cultivation on the discs. Cell morphologies were observed using immunofluorescent staining with rhodamine phalloidin for actin cytoskeleton and with DAPI for the nucleus after 3 hours of incubation. Using Sirius red staining and colorimetry, we measured collagen synthesis on the HGF-1 disc cultures after 28 days. Expression of inflammatory cytokines, including TNF, were assessed on 30 minutes in the HGF-1 cultures using a cytokine ELISA systems. Results SEM images of machined Ti revealed a typical topography with wavy microgrooves. Additionally, the uniform linear structures along the polishing appeared on both rough and smooth Zr. Early response of HGF-1 fibroblasts on mirror Zr showed significantly greater than that on Ti surfaces. The highest proliferative capacities were observed on the mirror Zr compared with the other discs. Confocal microscopic images of HGF-1 staining revealed that fibroblasts on two types of Ti showed typical spindle-shapes, whereas those on the Zr discs had small round cells including contractile ring-like structures and developed cytoskeletons. HGF-1 on the mirror Zr surface was clearly larger than that on the other two Zr surfaces. The amount of collagen deposited on mirror Zr increased significantly compared with the other discs. Inflammatory cytokine production was significantly lower on mirror Zr than that on machined Ti and mirror Ti. There were no significant difference among three Zr surfaces. Conclusions and Clinical Implications The HGF-1 on mirror Zr surfaces exhibited more matured morphology and greater cellular viability and differentiation than those of other surfaces, which might be through their grater biocompatibility as demonstrated by the lower proinflammatory cytokine synthesis. These results indicate that the mirrored Ce-TZP Al2O3 surfaces may show a higher affinity for soft tissue around dental implant than Ti and the unlevel Ce-TZP Al2O3 surfaces.