Artefacts in oral incisional biopsies in general dental practice:: a pathology audit

OBJECTIVES: To investigate the artefacts in oral biopsies taken by general dental practitioners (GDP) and oral and maxillofacial surgeons (O&MF) and to assess the concordance of clinical and pathological diagnoses. DESIGN: Cross-sectional investigation. SETTING: Primary care and hospital practice. MATERIAL AND METHODS: A total of 354 randomly selected oral biopsy samples studied by the same pathologist. MAIN OUTCOME MEASURES: Clinical and pathological diagnoses - prevalence and location of surgical handling artefacts: crush, splits, haemorrhage and fragmentation. RESULTS: Artefacts identified in GDPs biopsies: crush 27.1%; haemorrhage 19.8%; splits 11.3%; and fragmentation 6.2%. O&MSs biopsies showed: crush 10.2%; splits 13%; fragmentation 2.3%; and haemorrhage 8.5%. No differences in split or fragmentation were identified between GDPs and O&MSs. Crush (chi(2) = 16.76; P = 0.000) and haemorrhage (chi(2) = 9.31; P = 0.003) were more frequently identified in GDPs biopsies. Concordance between clinical and pathological diagnoses was excellent ( > 0.75) for both groups in all disorders considered. CONCLUSIONS: The elicited clinical knowledge, the quality of the samples sent to the pathologists seem to suggest the advisability for the GDPs to perform diagnostic biopsies.