Management of an unusual foreign body in periapical tissues of immature permanent maxillary central incisor

Aim: The present report describes a clinical case of apical surgery with a 3-year clinical and radiographic follow-up in an immature permanent maxillary central incisor with persistent apical periodontitis caused by a foreign body in the periapical tissues. Summary: The traumatic injuries of immature permanent teeth may have harmful influence on physiological pulp and root development. Root canal treatment of an immature tooth is a significant challenge because of the size of the canal, the thin and fragile dentin walls, and the large open apex. Even though endodontic failure is usually associated with the persistence of bacteria within the root canal system another less common cause of endodontic failure is the presence of a foreign body in the periapical tissues. Key Learning Points Foreign object in the periapical tissues act as a source of pain and infection, cause difficulty in elimination of infection. Surgical endodontic treatment should be seen as the best choice for treating persistent apical periodontitis. This treatment can manage the infection source and provide a direct hermetic seal of the apical area.