Concordance: clinical impressions vs. pediatric oral histology

• Published in: RGO - Revista Gaúcha de Odontologia 2024, Vol.72
• Main Authors: Rezende, Karla Mayra, Gentile, Ana Carolina, Silva, Mirele Brito, Marinho, Giovanna Bueno, Haddad, Ana Estela, Bönecker, Marcelo
• Format: Article
• Language: English
• Subjects: Child; DENTISTRY, ORAL SURGERY & MEDICINE; Diagnosis, oral; Pathology, oral; Preschool
• ISSN: 0103-6971; 1981-8637; 1981-8637
• DOI: 10.1590/1981-86372024002720240010

ABSTRACT Several pathologies often lead to disagreements regarding their identification in clinical practice, particularly in the context of oral pathologies. The data obtained during anamnesis and physical examination frequently require revision to reach a diagnosis. Objective: The present study aimed to evaluate the agreement between clinical and histopathological diagnoses and report the frequency of completing forms for specimens submitted to histopathological examination, examined retrospectively. Methods: Data on 93,950 specimens submitted for histopathological examination were retrieved from medical records. Results: A total of 5,052 reports from patients aged 0 to 14 years were included. Agreement was defined based on categorizing the nature of the injury according to its diagnostic category. The highest agreement rate was observed for mucocele and papilloma (86%), followed by pyogenic granuloma (60%). Low rates of histopathological confirmation of clinical impressions were observed for hemangioma (17.5%) and peripheral giant cell lesion (35%). Among lesions related to dental tissues, odontoma showed the highest agreement (84%), followed by keratocyst (74%), while radicular cyst showed the most discordance (21%). Conclusion: This study found an acceptable level of agreement for the most frequent injuries. However, understanding the characteristics of oral lesions in children and their clinicopathological correlations is crucial for providing optimal treatment in each case. RESUMO Diversas patologias conduzem frequentemente a divergências quanto à sua identificação na prática clínica, nomeadamente no contexto das patologias orais. Os dados obtidos durante a anamnese e o exame físico frequentemente necessitam de revisão para o diagnóstico. Objetivo: O presente estudo teve como objetivo avaliar a concordância entre os diagnósticos clínicos e histopatológicos e relatar a frequência de preenchimento de formulários de espécimes submetidos ao exame histopatológico, examinados retrospectivamente. Métodos: Dados de 93.950 espécimes submetidos para exame histopatológico foram obtidos de prontuários médicos. Resultados: Foram incluídos 5.052 laudos de pacientes de 0 a 14 anos. A concordância foi definida a partir da categorização da natureza da lesão de acordo com sua categoria diagnóstica. A maior taxa de concordância foi observada para mucocele e papiloma (86%), seguido por granuloma piogênico (60%). Baixas taxas de confirmação histopatológica de impressões