Agreement between clinical and histopathological diagnoses of oral-maxillofacial lesions: a multicenter study.
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OBJECTIVE: To evaluate the agreement between clinical and histopathological diagnoses at 4 Brazilian universities' oral-maxillofacial pathology services. STUDY DESIGN: This is a multicenter retrospective study that evaluated the agreement between clinical and histopathological diagnoses in 20,005 oral and maxillofacial pathology cases from Brazilian universities over 11 years. The analysis also included information on cases where radiographic examinations were requested as complementary diagnostic procedures. RESULTS: The overall agreement rate was 67.8% (Kappa = 0.23). Most cases occurred in 2018 and 2019, decreasing significantly in 2020. Agreement was excellent for potentially malignant, epithelial, dermatological-immunological, and salivary gland lesions (Kappa > 0.85) and weak for bone lesions, developmental defects, and odontogenic tumors (Kappa < 0.15). Radiographic examinations were requested in 25.9% of all cases, with cystic lesions representing 78.6% of these requests. The odontogenic tumor group accounted for a small proportion of cases, and among these few cases, radiographic examinations were seldom requested (19.7%), which may have contributed to the lower agreement between clinical and histopathologic diagnoses. CONCLUSIONS: Clinical-histopathological agreement varied between diagnostic groups. Greater training and complementary exams are needed to improve diagnostic accuracy, especially in lesions with low agreement.