Background and purpose: The most effective way to achieve a correct diagnosis of oral lesions is appropriate biopsy and pathological examination. This study evaluated the concordance between clinical and histopathological diagnoses in patients with oral lesions.

Materials and methods: A cross-sectional descriptive-analytic study was performed in 206 patients who had biopsies in a center for oral and maxillofacial pathology in Sari, Iran during 2011-2015. Demographic characteristics including age and gender were recorded. Also, consistency and color of the lesion, the biological process, anatomical location, exophytic or flat lesion, surface shape, peripheral or central, specialty of physicians and clinical diagnosis, and consistency with the histopathologic diagnosis were studied and analyzed by Chi-square and Fisher, Kappa test.

Results: Clinical diagnosis was consistent with histopathologic diagnosis in 77.1% of the cases. Correct clinical diagnosis in malignant lesions (75%) was more than that in benign lesions (72.7%). Compared with peripheral lesions, the diagnosis of central lesions was more in agreement with histopathologic diagnosis (81.1%), amongst which radicular cysts were diagnosed correctly in most of the cases (coefficient agreement: 92%). The most correct clinical diagnosis was in the smooth lesions (68.3%) and gum lesions (68.5%). The highest coefficient agreement with pathology results was observed in maxillofacial surgeons (86.5%).

Conclusion: A high rate of clinical diagnosis and pathology reports corroborated each other, nevertheless, significant rate of mismatch still exist which should decrease by suitable approaches.