Objectives: We aimed to evaluate the condition of retained primary molars in case of mandibular second premolar agenesis. Materials and Methods: In total, 2692 panoramic radiographs of adolescent patients were analyzed to determine the prevalence of tooth agenesis. Patients (N = 156) with at least one mandibular second premolar agenesis were further explored to determine the presence and condition of retained primary teeth. Teeth were classified as good or poor based on root resorption, infraocclusion, caries, and restorations. Results: The prevalence of mandibular second premolar agenesis was 5.8% (N = 156). For the set period for this study, 138 (58.5%) primary molars were present. Out of these retained teeth, N = 83 were in good condition. There was a statistically significant positive weak correlation between age and the level of root resorption (rs = 0.348, n = 138, p < 0.001). There was no association between infraocclusion and the level of root resorption (p = 0.747). Signs of infraocclusion were noted in 32 out of 138 teeth. There was no association between gender and the presence of infraocclusion (p = 0.067) and the presence or lack of infraocclusion and the therapeutic status of a tooth (p = 0.450). Only 28 out of 138 (20.3%) were intact. There was a significant difference in the level of root resorption between restored and/or carious (median = 3, IQR 2–4) and intact teeth (median = 2, IQR 1.75–3), U = 1168, p = 0.044, r = 0.242. Conclusions: Overall, 35.2% of corresponding primary molars were present in oral cavity, and were in good condition, and could potentially be preserved in the long term.
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