| Summary: | Zirconia is used widely for high-precision custom abutments; however, stress concentration can compromise osseointegration. Although glass–ceramic spray deposition (GCSD) can enhance the surface properties of zirconia, its biological effects remain unclear. In this study, the biological responses of human osteoblast-like (MG-63) cells to GCSD-modified zirconia surfaces were evaluated to assess the potential application in zirconia abutments. Disk-shaped zirconia and titanium alloy samples were prepared; titanium served as the control (Ti). Zirconia was subjected to polishing (NT), airborne-particle abrasion (AB), or GCSD with (GE) or without (GC) hydrofluoric acid (HF) etching. Surface characteristics, including wettability, surface energy (SE), and surface potential (SP), were analyzed. Cytotoxicity and MG-63 cell adhesion were assessed using the PrestoBlue assay, scanning electron microscopy (SEM), viability staining, and confocal laser scanning microscopy (CLSM). Statistical analysis was performed with a significance level of 0.05. GCSD produced a dense glass–ceramic coating on the zirconia surface, which significantly enhanced hydrophilicity as indicated by reduced water contact angles and increased SE in the GC and GE groups (<i>p</i> < 0.05). HF etching increased SP (<i>p</i> < 0.05). No cytotoxicity was observed in any group. SEM, viability staining, and CLSM revealed enhanced MG-63 cell attachment on Ti and GE surfaces and the highest viability ratio in the GE group. The NT group exhibited the lowest cell attachment and viability at all time points. GCSD effectively improved zirconia abutment surface properties by enhancing hydrophilicity and promoting MG-63 cell adhesion, with biocompatibility comparable to or better than that of titanium.
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