An impacted third molar occurs when neighboring teeth overlying the bone or soft tissue hinder its normal eruption. Thus, it fails to fully emerge by the expected age of 20 years. The impacted third molar is not always associated with clinical symptoms, and an unknown percentage of unerupted third molars remain asymptomatic for years. This study aimed to evaluate radiolucent lesions associated with impacted third molars in terms of their pathological diagnosis and the sex and age distribution of the affected individuals. This was a retrospective cross-sectional study conducted at the King Khalid Dental University Hospital, Riyadh, Saudi Arabia, between January 2020 and August 2023. A total of 312 orthopantomography (OPGs) were recovered. Among study subjects, a total of 549 teeth were studied. A total of 103 teeth had a lesion, which was more frequently seen in male than female patients and in patients aged ≤30 years than in patients aged >30 years with significant differences. Additionally, most impacted teeth were classified as impaction depth A, indicating the same or higher level regarding the occlusal plane of the second molar. In conclusion, the pattern of lower third molar and dental characteristics (impaction depth classification, ramus relationship, angulation classification, and tooth type) was associated with age. There was no association between gender and dental characteristics, except for the presence of a lesion.
