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Controversy remains regarding the relative toxicity versus inertness of endodontic filling materials, including gutta-percha, in vital tissues.We discuss reaction to and possible toxicity of gutta-percha and sealers and present 2 cases of symptomatic chronic inflammatory reaction where gutta-percha and associated filling materials were found to have extruded past the confinement of the root structure and were embedded in soft tissue and bone.Successful surgical removal of the extruded gutta-percha with surrounding granulation tissue prompted proper healing and resolution of the long-term symptoms.