<b>Association of Depth of Impacted Maxillary Third Molar with the Prevalence of Radiolucencies and Pathologies Associated with the Adjacent Maxillary Second Molar with Respect to Gender</b>

Background: Impaction of maxillary third molars is a common clinical finding that can lead to various pathological changes in adjacent teeth, including periapical and pericoronal radiolucencies, distal dental caries, and external root resorption in the adjacent maxillary second molar. Factors such as the depth of impaction and patient gender may influence the prevalence and severity of these pathologies, but evidence remains inconclusive. Objective: To assess the association between the depth of impacted maxillary third molars and the prevalence of radiolucencies and pathologies in the adjacent maxillary second molar, with a focus on gender differences. Methods: A retrospective cross-sectional study was conducted on 235 orthopantomograms of patients aged 21 years and above presenting with impacted maxillary third molars. The depth of impaction was classified according to the Pell and Gregory system. The presence of periapical and pericoronal radiolucencies, distal dental caries, and external root resorption in adjacent second molars was evaluated. Data were analyzed using SPSS version 24.0, and associations were tested using Fisher’s exact test, with a significance level set at p ≤ 0.05. Results: Among the study population, 71.5% of third molars were classified as Class C impactions and 28.5% as Class B. No statistically significant association was observed between impaction depth and any of the assessed pathologies in either males or females (p > 0.05). However, periapical radiolucencies were more frequent in Class C impactions (67% in males, 78.9% in females), while external root resorption and distal caries were slightly more prevalent in Class B impactions among males. In females, all pathologies were predominantly associated with Class C impactions. Conclusion: Although no statistically significant relationship was identified, deeper impactions (Class C) demonstrated a greater tendency to be associated with pathological changes in adjacent second molars, particularly among females. These findings suggest that impaction depth remains a clinically relevant factor, and careful radiographic evaluation and timely intervention are recommended to prevent potential complications