Abstract
Refractory periapical periodontitis is a condition of the persistent periapical pathology of endodontic origin even after completion of root canal therapy. Although a plethora of reasons exists for failure, improper diagnosis of pulpal etiology is one of the primary causes for endodontic failures. Inability to diagnose the presence of foreign body can have risk on the success of endodontic treatment. Discovery of foreign bodies is always almost accidental in root canals of tooth. Foreign bodies lodged in pulp chambers or canals can often act as a nidus of infection. In the present case, we report a case of persistent/refractory chronic periapical abscess even after orthograde root canal treatment and retrograde periapical surgery (apicoectomy) and several regimens of multiple antibiotic therapies.
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