Burr hole trepanation is a surgical procedure in which one or more small holes, or trephines, are made in the skull to allow for the drainage of fluids or to relieve pressure within the skull. Burr hole trepanation is generally considered a safe and effective treatment for conditions such as brain abscesses and subdural hematomas. However, the bone defects must be closed after the surgery with a suitable implant. Current designs are mostly based on bone plates with limited lifetime, revision access, and low esthetic. Within this study, a new type of cranial implant is proposed made using additive manufacturing (AM) techniques. The implant is anchored in the burr hole and does not penetrate the skull space or prominate the skull. Four different types of implants have been proposed on the basis of an analytical model and verified using finite element analysis (FEA). New push-in mechanical tests are introduced using artificial bone to determine the strength of the locking mechanisms and ensure the safety of implants. The burr-hole implant with an overlap on the bone surface after implantation was proven to be the safest solution. The design of the new cranial implant could improve the esthetic outcome after surgery and minimize invasiveness in reoperations.