A male patient has had an ill-fitting denture for several years that has progressively worsened over time, with no other changes to the denture itself. What is the likely underlying cause?

Paget disease of bone causes ongoing, progressive bone remodeling and enlargement (including of the jaws), which can gradually change the shape of the denture-bearing ridges over years, making a previously well-fitting denture become progressively ill-fitting — a classic, often-tested association. Addison, Hashimoto, and multiple sclerosis do not typically cause this kind of progressive jaw bone enlargement.