## 4 Discussion
When comparing screw augmentation using PMMA versus the BKS frictional mechanism, the latter provides equivalent biomechanical anchorage while preserving biological integrity [36; 41]. Similarly, in spinal surgeries, Polyetheretherketone (PEEK) and carbon-filled PEEK (CF) screws with cement augmentation improve fixation but carry risks during revision procedures. BKS offers a bioinert, structurally integrated alternative [42; 43; 44; 45; 46; 47; 48; 49; 50]. The BKS's use in dental implantology also presents unique advantages. Traditional sinus lift and autograft procedures require staged surgeries. BKS simplifies this by collecting bone particles, cells, and proteins during drilling and reintegrating them immediately at the implant site, performing grafting and implantation simultaneously [25]. This novel approach accelerates healing and reduces the risk of contamination by minimizing bone exposure to the surgical environment [32]. Mathematical models of drilling confirmed that torque correlates with internal compaction, and testing with four synthetic bone densities (PCF 10-40) confirmed a 3.45\(\times\) compaction ratio. MIT and MRT values in each case exhibited a reliable trend: MRT always exceeded MIT, supporting the implant's resistance to pullout under load [29]. The study also contributes to biotribology, showing that blood functions as a lubricant and affects friction during insertion. A new parameter (HN = 10.7 \(\times\) 10\({}^{-7}\)) was derived from finite element analysis for cortical and cancellous bone, highlighting biological interactions typically overlooked in implant mechanics [30]. Osseous reconstruction often relies on autografts to ensure biocompatibility and osteogenic potential. BKS enables such autografts by extracting and reinserting bone during a single operation, as demonstrated in mandibular graft procedures using BKS as the implant [25]. This reduces surgical stages and enhances healing while avoiding immune responses. Standardization in implant fixation is critical. Traditionally, MIT alone has been used as a proxy for stability, despite inconsistent thresholds in the literature. The BKS paradigm introduces a dual-parameter system--MIT and MRT--across five bone densities, providing a reproducible mechanical profile that correlates with clinical outcomes. This allows practitioners to predict and control implant behavior with greater precision [33]. Mechanically, BKS functions as a modified simple machine that translates torque into linear compaction, increasing material density within its core volume. This differs from standard screw threads, which rely on external compression and risk overdriving. The geometric and material-specific characteristics of BKS allow it to act as a granular compactor, incorporating collected material to enhance retention [34; 51; 52; 53]. The BKS presents several distinct advantages when compared to expanding screws, cemented systems, and traditional threaded implants. Unlike expanding screws, which apply lateral pressure to achieve fixation, the BKS avoids such compression by simultaneously cutting, collecting, and compacting the substrate material during insertion. This approach reduces the risk of microfractures and thermal damage, particularly in osteoporonic bone, and results in a higher mechanical retention demonstrated by consistently greater maximum removal torque (MRT) than insertion torque (MIT). In contrast, expanding screws can cause uneven stress distribution and are less effective in preserving surrounding bone microstructure. While cemented systems provide immediate fixation through the use of materials such as PMMA, they introduce risks including thermal necrosis, cement leakage, and difficulty in revision surgeries. BKS, which requires no additional materials, avoids these complications by using the patient's own compacted bone as a cohesive agent within the device.