Modified Steel Probe Technique for Retrieving Fractured Burs in Third Molar Surgery: A Case Series

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 owingto anatomical constraints and limited resources in primary care settings. This case series 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. Patient1 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 minutes, 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 minutes. The patient experiencedsignificant symptom relief by day 3 and near-complete bone regeneration at 3 months. Conclusions This case series illustrates that the modified mild steel probe technique, owing to its unique adaptive design and compatibility with basic to advanced imaging, offers a viable, cost-effective solution for retrieving fractured burs in complex scenarios. It represents a valuable technical advance for primary care settings where such complications are typically referred to tertiary centers. Its successful application underscores the importance of innovative instrument design in overcoming surgical challenges.