Concordance between clinical and histopathological diagnoses of biopsied oral cavity lesions

Abstract

AimThe aim of this study was to compare the clinical and histopathological diagnoses of biopsied oral cavity lesions, to evaluate the diagnostic concordance characteristics of these lesions, and to reveal the demographic characteristics of the lesions.MethodIn this retrospective study, histopathological reports of patients who underwent biopsy at Gaziosmanpaşa University, Faculty of Dentistry, Oral, Dental and Maxillofacial Surgery Clinic between February 2013 and May 2018 were analyzed. Gender, age, lesion location, clinical diagnosis, and final histopathological diagnosis were recorded. Lesions were classified into three main groups according to histopathological findings: Group 1 (developmental, inflammatory, reactive lesions of the jaws), Group 2 (cystic lesions), and Group 3 (tumors and tumor-like lesions). Cases with missing data or repeated operations were excluded. Concordance between clinical and final histopathological diagnoses was calculated.ResultsA total of 506 patients were included (215 maxilla, 291 mandible; 275 males, 231 females; age range 8–80 years, mean 37.1 ± 17.5 years). Group distribution: Group 1: 105 (20.8%), Group 2: 333 (65.8%), Group 3: 68 (13.4%). The most common lesions were radicular cysts (n = 209; 41.3%), dentigerous cysts (n = 89; 17.5%), and irritation fibroma (n = 40; 7.9%). Concordance between clinical and histopathological diagnoses was 87.4% overall: 58.1% for Group 1, 97.8% for Group 2, and 80.8% for Group 3.ConclusionThe clinician’s knowledge about oral cavity lesions significantly affects concordance with histopathology. Early and correct diagnosis prevents unnecessary treatments and delayed surgeries. Radicular cysts were the most prevalent cystic lesions, and odontomas were the most common tumors. Maximum discordance was observed in Group 1 lesions, particularly pyogenic and giant cell granulomas, often misdiagnosed clinically.

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