Osseo-compression oral implantology, A paradigm shift

Purpose: The aim of this study was to develop a polygonal, solid, and one-piece (1P) dental implant based on the concepts of fulcrum-lever force dissipation and circumferential and apical wedging to maximize initial stability for immediate loading. A threadless implant was designed with a Restorative Attachment and a Bone Engagement Zone as one unit and without any screws. Material and Methods: For this in-vitro study, two random human mandibles were chosen. Impact, drill, and hybrid delivery methods were used to insert 30 prototype dental implants in D1 dense bone zone. Placements were recorded and evaluated with pre- and post-operative CBCT studies and digital photographs. All implants were subjected to Finite Element Analysis and periotest before extraction to evaluate the structural fatigue and stress resistance, initial stability, resistance to micromovement, and amount of autogenous bone graft collected during each delivery method of the new design implant. Results: Regardless of the protocol implemented, initial stability and retention of the polygonal concept exceeded all expectations during the periotest evaluation. Macrogeometries on implant bodies were filled with the bone particle and a significant amount of fine bone was harvested during osteotomy. Although fatigue failure was no longer a concern, FEA demonstrated exceptional structural strength due to strategic design features. The structural integrity of both bone and implants were maintained without any observable microfractures around the osteotomy or delivery sites. Conclusion: With advancements in delivery technologies, impact implantology remains a conservative and an effective alternative delivery method. However, more in-vitro and in-vivo studies are needed. The results demonstrated the 1P fulcrum design provided profound initial stability, the most conservative osteotomy, and controlled ridge expansion. The prototype implants exhibited autogenous bone self-harvesting capabilities in all three delivery methods.