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Background@#Immediate breast reconstruction after mastectomy can be challenging in some patients for medical or oncological reasons. Delayed two-stage tissue expander/implant breast reconstruction is a reliable option for these patients. However, data regarding surgical techniques, outcomes, and complication rates are limited. This study reports our experience using the two-stage tissue expander/implant procedure for delayed breast reconstruction. @*Methods@#This retrospective study included 32 patients (34 breasts) who underwent delayed two-stage tissue expander/implant breast reconstruction at our institution from January 2018 to July 2022. We summarized the techniques used in the procedure and evaluated the 1-year postoperative outcomes and complication rates. @*Results@#The mean time from mastectomy to expander insertion was 210±25 days, and 8.2±2.3 additional expansions were required prior to the implant insertion. The mean time of tissue expansion was 187±15 days, and the mean volume of expansion was 495±31 mL. No major complications occurred that required reoperation, and the patients were highly satisfied with the surgical results. @*Conclusions@#Although delayed two-stage tissue expander/implant breast reconstruction resulted in satisfactory outcomes, consensus regarding the operative technique is still needed. Two-stage tissue expander/implant breast reconstruction is a safe and effective option for delayed breast reconstruction.
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Purpose@#Partial breast reconstruction is challenging in medially located breast cancer, particularly in terms of achieving satisfactory aesthetic coverage. Thus, we aimed to investigate surgical strategies for filling medial defects resulting from breast-conserving surgery to improve patient satisfaction and aesthetic outcomes. @*Methods@#We retrospectively evaluated 113 patients (114 cases) with medially located breast cancer between 2007 and 2018. We analysed the patient data, such as breast size, specimen weight, complications, and aesthetic results obtained using a questionnaire. @*Results@#The mean body mass index and specimen weight were 23.43 kg/m2 (range, 18.5–26.8) and 83.29 g (range, 15–290 g), respectively. The tennis racket and round-block techniques were chosen for small defects ( 30%). Hematoma was found in 1 case (0.96%), linear skin necrosis was found in 1 case (0.96%), seroma in the LD flaps was found in 8 cases (7.69%); fat necrosis in the rotational flaps was found in 2 cases (1.92%); and fat necrosis in an anterior intercostal artery perforator flap was found in 1 case (0.96%). 91 patients (87.5%) were satisfied with the aesthetic results. @*Conclusion@#The techniques used in this study for medially located breast cancer can produce fine aesthetic outcomes with regard to breast size and resection volume, with few complications.
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Recently, several breast surgeons have reported a new method for sentinel lymph node biopsy (SLNB) by using indocyanine green (ICG) with infrared camera. This study aimed to determine whether the lymph nodes (LNs) with ICG uptake are true SLNs and to assess the reliability of using only ICG for SLNB. Data were prospectively collected between April and September 2021. All palpable LNs were fat-trimmed and ordered from high to low signal of the gamma detector. The degree of radioisotope uptake and brightness of ICG staining of the axillary LNs detected with a fluorescent camera were compared and associated factors were analyzed. Discordance was defined as sentinel LNs (SLNs) showing a single uptake of radioisotope or fluorescence of ICG only, or when the orders of uptake and intensity degree were different between the 2 materials. A total of 79 SLNBs were performed on 78 patients with breast cancer. The breast cancer was classified as cTis-2N0-1. The discordance rate was 14/79 (17.7%) overall and 45/270 (16.7%) of the total retrieved axillary LNs. The first SLNs showed the lowest discordance rate of 6.3%, whereas the second and third SLNs showed higher discordance rates of 27.6% and 60.0%, respectively. There were no associated clinicopathologic factors that affected the discordance between uptake of radioisotope and fluorescence intensity of ICG. The use of ICG alone for SLNB may be insufficient because of the high discordance rates between radioisotopes and ICG uptake. However, the first SLN could be cautiously regarded as a true SLN.
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Background@#In addition to vascular endothelial cells, vascular smooth muscle cells (VSMCs) are subject to continuous shear stress because of blood circulation. The angiogenic properties of VSMCs in extracranial arteriovenous malformations (AVMs) may exceed those of normal blood vessels if the body responds more sensitively to mechanical stimuli. This study was performed to investigate the hypothesis that rapid angiogenesis may be achieved by mechanical shear stress. @*Methods@#VSMCs were obtained from six patients who had AVMs and six normal controls. The target genes were set to angiopoietin-2 (AGP2), aquaporin-1 (AQP1), and transforming growth factor-beta receptor 1 (TGFBR1). Reverse-transcriptase polymerase chain reaction (RT-PCR) and real-time PCR were implemented to identify the expression levels for target genes. Immunofluorescence was also conducted. @*Results@#Under the shear stress condition, mean relative quantity values of AGP2, AQP1, and TGFBR1 in AVM tissues were 1.927±0.528, 1.291±0.031, and 2.284±1.461 when compared with neutral conditions. The expression levels of all three genes in AVMs were higher than those in normal tissue except for AQP1 under shear stress conditions. Immunofluorescence also revealed increased staining of shear stress-induced genes in the normal tissue and in AVM tissue. @*Conclusions@#Shear stress made the VSMCs of AVMs more sensitive. Although the pathogenesis of AVMs remains unclear, our study showed that biomechanical stimulation imposed by shear stress may aggravate angiogenesis in AVMs.
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PURPOSE@#The purpose of this study was to compare the surface roughness, phase transformation, and surface topography of dental zirconia with three different yttrium oxide compositions under same grinding and polishing conditions. @*MATERIALS AND METHODS@#Three zirconia disks (IPS e.max ZirCAD LT, MT, MT multi, Ivoclar Vivadent AG, Schaan, Liechtenstein) were selected for experimental materials. Sixty-nine bar-shaped specimens were fabricated as 12.0 × 6.0 × 4.0 mm using a milling machine and glazing was conducted on 12.0 × 6.0 mm surface by same operator. With a custom polishing device, 12.0 × 6.0 mm surfaces were polished under same condition. Surface roughness (Ra[µm]) was measured before grinding (C), after grinding (G), and at every 3 steps of polishing (P1, P2, P3). X-ray diffraction and FE-SEM observation was conducted before grinding, after grinding, and after fine polishing (P3). Statistical analysis of surface roughness was performed using Kruskal-Wallis test and Mann-Whitney-U test was used as a post hoc test (α = .05). @*RESULTS@#There were no significant differences of surface roughness between LT, MT, and MM groups. In LT, MT, and MM groups, P3 groups showed significantly lower surface roughness than C groups. X-ray diffraction showed grinding and polishing didn’t lead to phase transformation on zirconia surface. In FE-SEM images, growths in grain size of zirconia were observed as yttrium oxide composition increases. @*CONCLUSION@#Polished zirconia surface showed clinically acceptable surface roughness, but difference in yttrium oxide composition had no significant influence on the surface roughness. Therefore, in clinical situation, zirconia polishing burs could be used regardless of yttrium oxide composition.
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Background@#In recent years, implant-based breast reconstruction has been performed because of its simplicity, short operation time, and rapid recovery of patients. Several studies have reported treatment methods for implant surgery-related infection, which is a serious complication. The aim of this study was to introduce our strategy for salvaging infected implants and to evaluate its effectiveness. @*Methods@#The authors performed a retrospective study of 145 cases from 132 patients who underwent implant-based breast reconstruction from January 2012 to December 2018. Empirical antibiotics were immediately administered to patients with suspected infections. The patients then underwent salvage treatment including appropriate antibiotics, ultrasonography-guided aspiration, debridement, antibiotic lavage, and implant exchange through a multidisciplinary approach. Patient demographics, operative data, duration until drain removal, adjuvant treatment, and complications were analyzed. @*Results@#The total infection rate was 5.5% (8/145). A longer indwelling catheter period and adjuvant treatment were significantly associated with infection. The salvage treatment showed a success rate of 87.5% (7/8). Seven patients who received early aggressive salvage treatment recovered from infection. One patient with methicillin-resistant Staphylococcus aureus, who received salvage treatment 11 days after symptom onset, did not respond to drainage and antibiotic treatment. That patient subsequently underwent explantation. @*Conclusions@#In implant-based breast reconstruction, prevention of infection is of the utmost importance. However, if an infection is suspected, proactive empirical antibiotic therapy and collaboration with the necessary departments are required. Through a multidisciplinary approach and proactive early management, swift and appropriate salvage should be performed.
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Background@#Arteriovenous malformation (AVM) which is a high-blood-flow lesion with connections between arteries and veins without an intervening capillary bed, is difficult to manage. The ear is the second most common site of extracranial AVM. However, studies regarding the management of this condition remain lacking. The purpose of this study was to share managing experiences in our center and to investigate the treatment effect through a retrospective analysis of cases. @*Methods@#Among 265 patients with AVM treated in our vascular anomalies center between January 2008 and January 2021, 10 patients with auricular AVM were included in the study to investigate the lesion distribution, clinical stage, and treatment methods by performing a retrospective evaluation. @*Results@#Among 10 patients, five patients had AVMs distributed in the upper half of the ear, one patient in the lower half of the ear, and four patients in whole ear, respectively. Seven patients had Schobinger stage II, and three had stage III. One patient received surgical treatment only, four patients received sclerotherapy only, and five patients received both surgical treatment and sclerotherapy. The posttreatment status was checked as controlled in two patients, improved in seven patients, persistent in one patient. There were no worsening patients. @*Conclusion@#Auricular AVM is a disease that is difficult to manage by one specific department, thus requiring a collaborative management effort from multidisciplinary team.
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Background@#The use of acellular dermal matrix in implant-based breast reconstruction immediately after mastectomy has attracted attention in recent years because it yields good outcomes. Herein, we analyzed the usefulness of meshed SurgiMend in direct-to-implant (DTI) breast reconstruction. @*Methods@#In this retrospective single-center analysis, 44 one-stage breast reconstructions using SurgiMend were performed in 42 patients from May 2016 to December 2017. The implant was inserted into the subpectoral plane and SurgiMend was applied to the inferolateral part that lacked tissues to wrap the silicone implant. In 19 patients (20 breasts), fenestration was performed with SurgiMend, while in the remaining 23 patients (24 breasts), SurgiMend that was meshed at a ratio of 1:1.5 was used. We analyzed the frequency of complications. Patient satisfaction was compared and analyzed using a five-item questionnaire (shape, texture, symmetry, pain, and overall outcome). @*Results@#The average age of the patients was 43.2 years, and their mean body mass index was 21.1 kg/m2. The average follow-up period was 24.0 months. In the control (fenestrated SurgiMend) and experimental (meshed SurgiMend) groups, major seroma occurred in five of the 20 breasts (25.0%) and two of the 24 breasts (8.3%), respectively. Minor complications were resolved with conservative treatment. The patient satisfaction score for shape, texture, symmetry, pain, and overall satisfaction was 4.3, 4.1, 4.7, 4.5, and 4.4, respectively. @*Conclusions@#Applying meshed SurgiMend in DTI breast reconstruction is a useful surgical technique.
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PURPOSE@#The purpose of this study was to compare the surface roughness, phase transformation, and surface topography of dental zirconia with three different yttrium oxide compositions under same grinding and polishing conditions. @*MATERIALS AND METHODS@#Three zirconia disks (IPS e.max ZirCAD LT, MT, MT multi, Ivoclar Vivadent AG, Schaan, Liechtenstein) were selected for experimental materials. Sixty-nine bar-shaped specimens were fabricated as 12.0 × 6.0 × 4.0 mm using a milling machine and glazing was conducted on 12.0 × 6.0 mm surface by same operator. With a custom polishing device, 12.0 × 6.0 mm surfaces were polished under same condition. Surface roughness (Ra[µm]) was measured before grinding (C), after grinding (G), and at every 3 steps of polishing (P1, P2, P3). X-ray diffraction and FE-SEM observation was conducted before grinding, after grinding, and after fine polishing (P3). Statistical analysis of surface roughness was performed using Kruskal-Wallis test and Mann-Whitney-U test was used as a post hoc test (α = .05). @*RESULTS@#There were no significant differences of surface roughness between LT, MT, and MM groups. In LT, MT, and MM groups, P3 groups showed significantly lower surface roughness than C groups. X-ray diffraction showed grinding and polishing didn’t lead to phase transformation on zirconia surface. In FE-SEM images, growths in grain size of zirconia were observed as yttrium oxide composition increases. @*CONCLUSION@#Polished zirconia surface showed clinically acceptable surface roughness, but difference in yttrium oxide composition had no significant influence on the surface roughness. Therefore, in clinical situation, zirconia polishing burs could be used regardless of yttrium oxide composition.
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In the 1980s, vascular anomalies were divided into two major subgroups—vascular tumors and vascular malformations—based on the functional framework. This concept has been fundamental to the management of vascular anomalies and expanded and refined by the International Society for the Study of Vascular Anomalies. Vascular malformations are further sub-divided into several types; however, there are many cases with insufficient information about the disease.Current Concepts: Several instances have shown that the diagnosis of vascular malformations can be achieved after a careful evaluation of patient history and examination. However, recently developed imaging technology has been of great help in the diagnosis. Doppler ultrasonography, magnetic resonance imaging, computed tomography scan, and angiography are valuable tools for diagnostic and therapeutic planning. Advanced diagnostic and therapeutic technologies have also provided more accurate and safer diagnoses and appropriate treatment. Recently, an improved method of managing vascular malformations has emerged, based on a multidisciplinary approach, which is very useful for increasing the treatment efficacy. The development of gene research has enabled the investigation of disease-related genes and the development of new medications.Discussion and Conclusion: Accurate diagnosis of vascular malformations is one of the most crucial factors in determining treatment plan and prognosis, based on which it would be possible to achieve effective results through appropriate management and a multidisciplinary team approach.
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Surgical approaches in breast cancer have been changing to ensure both oncologic safety and cosmetic results. Although the concept of “oncoplastic breast surgery” has been accepted for decades, breast and plastic surgeons have been striving to develop more advanced surgical skills that ensure non-inferior oncologic outcomes with better cosmetic outcomes.Endoscopic or robotic devices, which are currently available only for chest or abdominal surgeries, could be used for breast surgery to ensure better cosmetic outcomes. The authors refer to this surgical concept as “aesthetic scar-less breast surgery and reconstruction,” a term that encompasses the consequential concepts rather than naming it with simple technical words such as endoscopy-assisted or robot-assisted surgery. The “scar-less” term simply means leaving less of a scar, and better results can be expected by designing incisions on invisible areas. Herein, we summarize our experiences with various techniques of “aesthetic scar-less” surgery and review the existing literature on this topic.
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Background@#Arteriovenous malformation (AVM) which is a high-blood-flow lesion with connections between arteries and veins without an intervening capillary bed, is difficult to manage. The ear is the second most common site of extracranial AVM. However, studies regarding the management of this condition remain lacking. The purpose of this study was to share managing experiences in our center and to investigate the treatment effect through a retrospective analysis of cases. @*Methods@#Among 265 patients with AVM treated in our vascular anomalies center between January 2008 and January 2021, 10 patients with auricular AVM were included in the study to investigate the lesion distribution, clinical stage, and treatment methods by performing a retrospective evaluation. @*Results@#Among 10 patients, five patients had AVMs distributed in the upper half of the ear, one patient in the lower half of the ear, and four patients in whole ear, respectively. Seven patients had Schobinger stage II, and three had stage III. One patient received surgical treatment only, four patients received sclerotherapy only, and five patients received both surgical treatment and sclerotherapy. The posttreatment status was checked as controlled in two patients, improved in seven patients, persistent in one patient. There were no worsening patients. @*Conclusion@#Auricular AVM is a disease that is difficult to manage by one specific department, thus requiring a collaborative management effort from multidisciplinary team.
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Background@#The use of acellular dermal matrix in implant-based breast reconstruction immediately after mastectomy has attracted attention in recent years because it yields good outcomes. Herein, we analyzed the usefulness of meshed SurgiMend in direct-to-implant (DTI) breast reconstruction. @*Methods@#In this retrospective single-center analysis, 44 one-stage breast reconstructions using SurgiMend were performed in 42 patients from May 2016 to December 2017. The implant was inserted into the subpectoral plane and SurgiMend was applied to the inferolateral part that lacked tissues to wrap the silicone implant. In 19 patients (20 breasts), fenestration was performed with SurgiMend, while in the remaining 23 patients (24 breasts), SurgiMend that was meshed at a ratio of 1:1.5 was used. We analyzed the frequency of complications. Patient satisfaction was compared and analyzed using a five-item questionnaire (shape, texture, symmetry, pain, and overall outcome). @*Results@#The average age of the patients was 43.2 years, and their mean body mass index was 21.1 kg/m2. The average follow-up period was 24.0 months. In the control (fenestrated SurgiMend) and experimental (meshed SurgiMend) groups, major seroma occurred in five of the 20 breasts (25.0%) and two of the 24 breasts (8.3%), respectively. Minor complications were resolved with conservative treatment. The patient satisfaction score for shape, texture, symmetry, pain, and overall satisfaction was 4.3, 4.1, 4.7, 4.5, and 4.4, respectively. @*Conclusions@#Applying meshed SurgiMend in DTI breast reconstruction is a useful surgical technique.
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Background@#Venous malformations (VMs) are the most common type of vascular malformations. Intramuscular venous malformations (IMVMs) are lesions involving the muscles, excluding intramuscular hemangiomas. The purpose of this study was to compare clinical outcomes between patients with IMVMs who were treated with sclerotherapy and those who were treated with surgical excision. @*Methods@#Of 492 patients with VMs treated between July 2011 and August 2020 at a single medical center for vascular anomalies, 63 patients diagnosed with IMVM were retrospectively reviewed. Pain, movement limitations, swelling, and quality of life (QOL) were evaluated subjectively, while radiological outcomes were assessed by qualified radiologists at the center. Complication rates were also evaluated, and radiological and clinical examinations were used to determine which treatment group (sclerotherapy or surgical excision) exhibited greater improvement. @*Results@#Although there were no significant differences in pain (P=0.471), swelling (P=0.322), or the occurrence of complications (P=0.206) between the two treatment groups, the surgical treatment group exhibited significantly better outcomes with regard to movement limitations (P=0.010), QOL (P=0.013), and radiological outcomes (P=0.017). Moreover, both duplex ultrasonography and magnetic resonance imaging showed greater improvements in clinical outcomes in the surgical excision group than in the sclerotherapy group. @*Conclusions@#Although several studies have examined IMVM treatment methods, no clear guidelines for treatment selection have been developed. Based on the results of this study, surgical excision is strongly encouraged for the treatment of IMVMs.
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In the 1980s, vascular anomalies were divided into two major subgroups—vascular tumors and vascular malformations—based on the functional framework. This concept has been fundamental to the management of vascular anomalies and expanded and refined by the International Society for the Study of Vascular Anomalies. Vascular malformations are further sub-divided into several types; however, there are many cases with insufficient information about the disease.Current Concepts: Several instances have shown that the diagnosis of vascular malformations can be achieved after a careful evaluation of patient history and examination. However, recently developed imaging technology has been of great help in the diagnosis. Doppler ultrasonography, magnetic resonance imaging, computed tomography scan, and angiography are valuable tools for diagnostic and therapeutic planning. Advanced diagnostic and therapeutic technologies have also provided more accurate and safer diagnoses and appropriate treatment. Recently, an improved method of managing vascular malformations has emerged, based on a multidisciplinary approach, which is very useful for increasing the treatment efficacy. The development of gene research has enabled the investigation of disease-related genes and the development of new medications.Discussion and Conclusion: Accurate diagnosis of vascular malformations is one of the most crucial factors in determining treatment plan and prognosis, based on which it would be possible to achieve effective results through appropriate management and a multidisciplinary team approach.
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Surgical approaches in breast cancer have been changing to ensure both oncologic safety and cosmetic results. Although the concept of “oncoplastic breast surgery” has been accepted for decades, breast and plastic surgeons have been striving to develop more advanced surgical skills that ensure non-inferior oncologic outcomes with better cosmetic outcomes.Endoscopic or robotic devices, which are currently available only for chest or abdominal surgeries, could be used for breast surgery to ensure better cosmetic outcomes. The authors refer to this surgical concept as “aesthetic scar-less breast surgery and reconstruction,” a term that encompasses the consequential concepts rather than naming it with simple technical words such as endoscopy-assisted or robot-assisted surgery. The “scar-less” term simply means leaving less of a scar, and better results can be expected by designing incisions on invisible areas. Herein, we summarize our experiences with various techniques of “aesthetic scar-less” surgery and review the existing literature on this topic.
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Compared to the frequency of occurrence of pre-auricular skin tag, cervical chondrocutaneous branchial remnants is one of congenital, benign neck masses that is very rare all over the world. Most of these rare anomalies are reported in case reports and especially, rare cases of unilateral cervical chondrocutaneous branchial remnants have been reported in Korean. Materials & Methods: A 9-year-old male patient visited the hospital on September 2017 for a rod-shaped mass. As a simultaneous diagnosis and treatment method, complete surgical excision was executed. Results: Excised mass was 0.5cm in diameter, 1.2cm in. Histologically, a hyaline and elastic cartilage was found in the core. As a family history, the same remnant was found in the right Anterior neck area of his mother. Conclusion: In this case, it is possible to diagnose and treat simply at the same time and even an optimal aesthetic result can be obtained.
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Compared to the frequency of occurrence of pre-auricular skin tag, cervical chondrocutaneous branchial remnants is one of congenital, benign neck masses that is very rare all over the world. Most of these rare anomalies are reported in case reports and especially, rare cases of unilateral cervical chondrocutaneous branchial remnants have been reported in Korean. Materials & Methods: A 9-year-old male patient visited the hospital on September 2017 for a rod-shaped mass. As a simultaneous diagnosis and treatment method, complete surgical excision was executed. Results: Excised mass was 0.5cm in diameter, 1.2cm in. Histologically, a hyaline and elastic cartilage was found in the core. As a family history, the same remnant was found in the right Anterior neck area of his mother. Conclusion: In this case, it is possible to diagnose and treat simply at the same time and even an optimal aesthetic result can be obtained.
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Purpose@#The purpose of this study is to compare the flexural strength of CAD/CAM denture base resins with conventional denture base resins based on their thicknesses. @*Materials and Methods@#For the conventional denture base resins, Lucitone 199® (C-LC) was used. DIOnavi - Denture (P-DO) and DENTCA Denture Base II (P-DC) were taken for the 3D printing denture base resins. For the prepolymerized PMMA resins, Vipi Block Gum (M-VP) and M-IVoBase® CAD (M-IV) were used. The final dimensions of the specimens were 65.0 mm x 12.7 mm x 1.6 mm / 2.0 mm / 2.5 mm. The 3-point bend test was implemented to measure the flexural strength and flexural modulus. Microscopic evaluation of surface of fractured specimen was conducted by using a scanning electron micro-scope (SEM). After testing the normality of the data, one-way ANOVA was adopted to evaluate the differences among sample groups with a significance level of P = 0.05. The Tukey HSD test was performed for post hoc analysis. @*Results@#Under the same thicknesses, there are significant differences in flexural strength between CAD/CAM denture base resins and conventional denture base resins except for P-DO and C-LC. M-VP showed higher flexural strength than conventional denture base resins, P-DC and M-IV displayed lower flexural strength than conventional denture base resins. Flexural modulus was highest in M-VP, followed by C-LC, P-DO, P-DC, M-IV, significant differences were found between all materials. In the comparison of flexural strength according to thickness, flexural strength of 2.5 mm was significantly higher than that of 1.6 mm in C-LC. Flexural strength of 2.5 mm and 2.0 mm was significantly higher than that of 1.6 mm in P-DC and M-VP. In M-IV, as the thickness increases, significant increase in flexural strength appeared.SEM analysis illustrates different fracture surfaces of the specimens. @*Conclusion@#The flexural strength of different CAD/CAM denture base resins used in this study varied according to the composition and properties of each material. The flexural strength of CAD/ CAM denture base resins was higher than the standard suggested by ISO 20795-1:2013 at a thickness of 1.6 mm or more though the thickness decreased. However, for clinical use of dentures with lower thickness, further researches should be done regarding other properties at lower thickness of denture base resins.
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Purpose@#The purpose of this study was to compare the accuracy of impression taking method using the encoded healing abutment, scan body and pick-up impression coping with different implant angulations. @*Materials and Methods@#Master model was fabricated by 3D printer and three implants were placed into the model with 0°, 10° and 20° mesial angulation. The abutments were secured to each implants and master model was scanned to make a reference model. Group P model was fabricated using pick-up impression copings and model was scanned after securing the abutments. Encoded healing abutment (Group E) and scan body (Group S) were secured on the master model and digital impression was taken using intraoral scanner 15 times each. Each STL files of test groups were superimposed with reference model using best fit alignment and root mean square (RMS) value was analyzed. @*Results@#The RMS values were lowest in Group P, followed by Group S and Group E. Group P showed significant difference with Group S and E (P< 0.05) while there was no significant difference between Group S and E. Correlation between implant angulation and RMS value was significant in Group E (P < 0.05). @*Conclusion@#The pick-up impression coping method showed higher accuracy and there was no significant difference in accuracy between the healing abutment and the scan body. The clinical use of the encoded healing abutment is possible, but it should be used with caution in the case of angulated implant.