I have treatment planned a patient for an implant in #30 site to replace a mandibular first molar that I extracted because of failed root canal treatment and failed attempts at re-treatment. When I extracted the tooth, I placed a cortical bone graft. Four months later when the patient returned, I took a CBCT and noted fragments of gutta percha remaining in the cancellous bone from a prior gutta percha overfill. I had planned to place a 5×11.5mm implant. But if I do that, I will come into contact with the gutta percha fragments. Should I attempt to remove the gutta percha fragments at the time of the osteotomy? Should I use a shorter implant, like a 5x10mm? Or should I just go ahead and place the implant and just observe if there is a complication associated with the gutta percha fragments?
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