Evolution of macrodesign and microdesign in implantology – A literature review

Dental implantology has transformed dramatically from ancient gold wires and seashells to today’s precision-engineered titanium systems. This review explores the fascinating journey of implant evolution, focusing on how macrodesign (such as shape, threads, and dimensions) and microdesign (surface textures and coatings) have advanced to improve stability, healing, and long-term success. Innovations in materials, especially biocompatible metals and ceramics, have set new standards in osseointegration. Cutting-edge surface modifications such as laser treatments, nanostructuring, and bioactive coatings with growth factors and bone-preserving drugs now allow implants to actively stimulate bone regeneration. The emergence of mini-implants, one-piece designs, and nanotechnology marks a new era of faster healing, enhanced aesthetics, and greater reliability. This review highlights how science and technology have merged to create implants that not only replace teeth but also regenerate the surrounding biology for lasting success.