Halil Ibrahim Durmus, Kagan Fatih Kusan, Tevfik Kizilseki, Hasan Demirkol, Kaan Mert Sekerci, Adnan Oztas
Aim The aim of this study is to evaluate the effect of positional characteristics of mandibular impacted third molars on the clinical and radiographic periodontal status of adjacent second molars. Materials and methods This single-center, analytical cross-sectional study was conducted at the Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Adiyaman University. Fifty patients (100 third molar sites) with bilateral mandibular impacted third molars were included. Systemically healthy individuals aged 15-40 years without periodontitis were evaluated. Periodontal pocket depths at the distal aspects of the mandibular second molars were measured using a standard periodontal probe, and distal alveolar bone loss was assessed on panoramic radiographs. Winter angulation, Pell and Gregory classification, and impaction status were recorded. Statistical analyses included the Shapiro-Wilk test, Mann-Whitney U test, Kruskal-Wallis test, Spearman correlation analysis, multivariable linear regression, and receiver operating characteristic (ROC) curve analysis. Statistical significance was set at p < 0.05. Results Univariate analyses showed no significant associations between third molar position characteristics and periodontal parameters (p>0.05). Multivariate linear regression identified only Pell-Gregory Class III impaction and distal alveolar bone loss as independent predictors of maximum periodontal pocket depth (p<0.05). Maximum periodontal pocket depth was positively correlated with distal alveolar bone loss. ROC analysis demonstrated acceptable discrimination for predicting periodontal pocket depth ≥4 mm (area under the curve (AUC) = 0.709). Conclusion Impacted mandibular third molar position alone does not significantly affect the periodontal status of adjacent second molars. Distal alveolar bone loss is an independent predictor of periodontal pocket depth and may support treatment planning.