Evaluating the Harmony Between Clinical Observations and Pathological Findings in Oral Soft Tissue Lesions: A Two-Decade Retrospective Study of Diagnostic Consistency.

Aim: This study aims to evaluate the concordance rate between clinical diagnoses and pathological findings of oral soft tissue lesions.

Methods: In this retrospective descriptive-analytical study, we analyzed 7901 cases of oral tissue lesions referred to the pathology department at Shahid Beheshti Faculty of Dentistry from 1996 to 2022. Data extracted from archived records included age, sex, lesion location, and both clinical and histopathological diagnoses.

Results: A total of 2592 samples of oral soft tissue lesions meeting the inclusion criteria were evaluated. The concordance rate between clinical and pathological diagnoses was 65.3%. A significant relationship was found between the anatomical location of the lesion and the matching rate ( < 0.001), with the lips exhibiting the highest matching rate at 77.3% and the sinus presenting the lowest at 45.4%. Additionally, the type of lesion significantly correlated with the concordance rate ( < 0.001), with connective tissue lesions showing the highest concordance at 83.3% and nonodontogenic lesions the lowest at 46.1%. However, no significant associations were found between gender/age ( > 0.743/ > 0.506) and the concordance rate.

Conclusion: The findings underscore the need for enhanced training for clinicians, greater attentiveness to clinical symptoms, and improved collaboration between dentists and pathologists to facilitate accurate diagnoses and effective treatment.

Supplementary Information: The online version contains supplementary material available at 10.1007/s12663-025-02447-x.