Tabriz University of Medical Sciences Journal of Dental Research, Dental Clinics, Dental Prospects 2008-210X 19 3 2025 09 30 Correlation between Clinical manifestations, radiographic findings, and operative diagnosis of pulpal status in primary molars in 4‒8-year-old children: A cross-sectional study 185 192 10.34172/joddd.025.42755 EN Naser Asl Aminabadi https://orcid.org/0000-0002-6624-4994 Farnaz Haji Abbas Oghli https://orcid.org/0000-0001-6279-3008 Shabnam Mohammadzadeh Zahra Jamali Journal Article 10.34172/joddd.025.42755 2025 05 29 2025 09 05 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.