Gutta-percha piece present: can I do an Implant?

It would be best to remove the GP at osteotomy time with a facial fenestration type access. Use measurements taken from the CBCT for an exact access. If you leave the GP there is a risk for bacterial colonization of the implant surface. Do not risk a failure. Dennis Flanagan DDS MSc

The gutta percha is inert and if there is no infection associated with the material then you can just proceed as if it was not there.

There is a significant chance that when you drill the implant site you will drill directly into the gutta percha and in doing so it will be removed. Trying to remove it surgically through the buccal plate may cause a bigger problem then a small amount of an inert material.

Don't wake up sleeping lion. Just treat normally as if there is no gutta percha. Nice landmark to notify you when to stop / continue drilling.

It is difficult to give an opinion on a situation when a lot of important information is missing......why did tooth #11 fail following endodontic treatment and have to be extracted? If the extraction was necessary because of a failed endo treatment...then possibly there is bacterial contamination which could affect the outcome of the implant placement. Was the tooth extracted because of a root fracture...which would have almost certainly created a bacterial invasion....... It would probably be best to remove the gutta percha..... since an osteotomy has to be prepared, with careful monitoring of the depth being drilled.... it would probably be very simple to insert an extra long large diameter endodontic broach and snag the gutta percha........come on guys.... this is easy stuff...... let the implant sit in a nice clean site, and it will be successful

I placed an implant 3 years ago in a bony bed that had embedded pieces of amalgam that had been left when the tooth extracted. Pieces were positioned right in the middle of planned osteotomy. All pieces disappeared after osteotomy. Follow up shows normal functioning well integrated implant . Regards

looks like a root fragment to me, like the apical 2mm Anyone else see that? I would make my osteotomy palatal anyway- I think its okay to leave. watch while you drill, you may see it and be able to remove it i would not make a buccal fenestration- no infection present. no reason to create trauma

In my opinion mostly the apex of the extracted tooth is very close to the buccal plate. If you drill far palatally you would be far enough and it won't touch the implant. If duriring drilling you hit the remaining GP it would disappear. Try to place the implant in palatal direction and don't worry since there's no sign and symptoms anyway. Good luck.

Most likely the gp piece will be removed during the osteotomy I would verify that and worse case use a currette to get what remains out before placing the implant into the osteotomy

Similar to a socket shield, leaving root remnants to support buccal plate while installing implant. My suggestion: perform osteotomy, IRRIGATE, place your implant.

I've had similar and even worse bits of GP exactly in the ideal osteotomy site. One case, not dissimiliar to yours, I prepared the osteotomy as if nothing was there, took a PA after and found a clean bed so I placed the implant- excellent aesthetics and function 10 years later. DON'T go through the buccal plate! Finally, inform patient that they may have to have a delayed procedure if site doesn't look too good- I've had to do this a couple of times and patients are ALWAYS grateful that you're proceeding in a professional manner with their best interests in mind.

I'd proceed as there's no GP. There's a great chance to GP comes out when drilling. Drill, irrigate and try to place your implant in palatal direction. Good luck!

Mostly the GP will be removed during drilling sequence if not try to remove it in some cases it may cause infection in future dont risk the implant