Abstract
            Background. Accurate evaluation of the pulp  condition is one of the greatest diagnostic challenges  in pediatric dentistry. A comprehensive diagnosis  of pulp status is achieved by integrating diagnostic  data from multiple sources. Understanding the  correlation and consistency among these various  data points is important. This study aimed to  determine the correlation between history-based,  clinical, radiographic, and operative diagnoses.  
  Methods. In this cross-sectional study, 4‒8-year-old children attending the Department of Pediatric  Dentistry for routine dental treatment between  August 1, 2021 and July 7, 2022 were included.  A total of 180 primary molars were clinically  and radiographically evaluated, and their dental  histories were recorded. The pulpal diagnosis was  determined based on the dental history, clinical  findings, and radiography. The operative diagnosis  was determined during pulp therapy. Finally, the  correlation was assessed by Spearman’s correlation  test.  
  Results. The strongest correlation was observed  between operative and radiographic diagnoses  (r=0.831, P<0.001). Moreover, the correlations between clinical diagnosis and operative  diagnosis and between clinical diagnosis and radiographic diagnosis were the weakest (r=0.556,  P<0.001 and r=0.591, P<0.001, respectively). The correlation between the diagnosis based on  history and operative diagnosis (r=0.676, P<0.001) was stronger than that with the clinical  diagnosis (r=0.633, P<0.001) and radiographic diagnosis (r=0.656, P<0.001).  
  Conclusion. The findings of this study underscore the importance of integrating multiple diagnostic  approaches for an accurate assessment of pulp condition. Radiographic diagnosis demonstrated  the strongest reliability in assessing the pulp status. Additionally, moderate correlations between  clinical, history-based, and radiographic diagnoses indicate the need for a combined diagnostic  strategy approach to achieve higher accuracy and effective treatment planning.