Improving dental implant design through a combined analysis of the insertion process and push-in test

This study examined the influence of key dental implant design parameters, including taper angle, thread thickness, thread pitch, and number of thread starts, on the primary stability (PS) indicators derived from insertion process and push-in test. Finite element models of nine implant designs, including a baseline and eight single-parameter variations, were developed. Simulations of implant insertion were performed to evaluate maximum insertion torque (MIT) and insertion energy (IE), followed by push-in tests to assess bone-implant construct stiffness and strength. Linear regression analysis quantified the influence of each design parameter on the PS indicators and examined interrelationships among PS indicators. The results showed that PS indicators are affected in a complex, parameter-specific manner. Increasing taper angle increased MIT while decreasing IE, with minimal effects on stiffness and strength, whereas increasing thread thickness increased both MIT and IE but reduced construct stiffness and strength. No overall linear relationships were observed among PS indicators; however, variations in thread thickness and pitch produced strong linear relationships between MIT and IE (R² = 0.93 and 0.94, respectively). By jointly considering the insertion process and push-in test through linear regression analysis, an improved implant design was identified, resulting in 17% higher MIT and 10% greater bone-implant construct strength.