Oftentimes, especially in the printing industry, a client will come to you with an old PDF that they want changed. They don't have the original design files for one reason or another but they need a change made to the artwork for a reprint, maybe changing the offer or some such. There's no budget so resetting the whole thing is out of the question, but the background is complicated so you cant just slap a new text box over the top. What to do?
Well one thing you can do is open the PDF in Illustrator and make the changes. Open it up, load the relevant fonts if any are missing, edit the text and then hit SAVE – NB not SAVE AS. Hitting save will preserve all the attributes of the original PDF like bleed, trims etc.
One caveat. If the last time you used illustrator you created a PDF with say bleed and trim marks, then when you hit save Illustrator may add an additional set of those trims and bleeds to your newly edited PDF. So its not a bad idea before you edit a PDF in this way you quickly create a blank illustrator document and save it as a normal, Illustrator PDF.
But what if you open up the PDF and you find out you're missing a vital font. Some unusual, grungy font you'll never be able to identify has opened up in the default font, which is completely wrong. Well in this case you can open a new document and PLACE the PDF into it. With the PDF still selected go to OBJECT > FLATTEN TRANSPARENCY. You will see a dialog box and here you must make sure you have checked "Convert All Text to Outlines". This will produce a result similar to above but with all the text converted to outlines (using the font data embedded in the PDF). From this you can keep the outlined versions of that unusual, grungy missing font.
Between the two techniques you can usually get a result. In fact if you open up the PDF you want to edit in Illustrator you can also actually place a copy of itself off to the side, lined up horizontally with the artwork and use flatten transparency to create an outlined version. Then delete the elements which aren't working on the artboard and slide across their outlined counterparts. Then hit save!