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

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. 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. 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.