A malleable mild steel probe for retrieving deeply embedded fractured burs in third molar surgery: a case report emphasizing material-independent and angle-adaptive retrieval

BACKGROUND: The retrieval of fractured high-speed handpiece burs during mandibular third molar surgery, particularly those adjacent to the mandibular canal or complicated by infection, presents a significant clinical challenge. Conventional techniques often fail in such scenarios owing to anatomical constraints and limited resources in primary care settings. This case report highlights the innovative application of a modified mild steel probe technique for managing this rare but serious complication, demonstrating its adaptability across diverse clinical environments. CASE PRESENTATION: We present two cases with deeply embedded bur fragments. Patient 1 involved a 28-year-old female with a 2.8-mm fragment near the mandibular canal. Using a novel, real-time shapable (≤ 120°) unquenched mild steel probe and a "three-point" localization method under panoramic radiography, the fragment was successfully retrieved in 35 min, with resolved neurosensory deficits at the 1-month follow-up. Patient 2 involved a 27-year-old female with a larger fragment (3.2 mm × 1.5 mm) complicated by infection and bone destruction. Under CBCT guidance, an upgraded probe was shaped into a 135° reverse hook and used with a "layered dissection" technique, achieving retrieval in 25 min. The patient experienced significant symptom relief by day 3 and near-complete bone regeneration at 3 months. CONCLUSIONS: This case report demonstrates that a malleable, non-quenched mild steel probe technique may offer a material-independent, angle-adaptive, and cost-effective alternative for retrieving deeply embedded bur fragments. Its core innovation lies in overcoming the inflexibility of conventional rigid instruments and the material limitations of magnetic systems, providing a practical solution particularly in resource-conscious settings or for non-ferromagnetic fragments.