A patient with a removable prosthesis returns repeatedly complaining of soreness. After several adjustments, the tissue in contact with the framework remains red, irritated and shows a whitish inflammatory reaction. What is the MOST appropriate next step?

Correct answer: A. Contact the laboratory to determine which metal alloy was used

• A. Correct. Persistent localized mucosal inflammation that does NOT resolve after repeated occlusal/fit adjustments points away from mechanical trauma and toward a contact hypersensitivity to the framework alloy (most commonly nickel, also cobalt or chromium in base-metal alloys). The first step is to identify the alloy from the laboratory work authorization, then patch-test and remake in a biocompatible alloy (titanium, high-noble gold) if confirmed.
• B. Steroids may temporarily suppress the inflammation but do not remove the causative allergen — the reaction recurs.
• C. A soft liner addresses pressure on a denture-bearing area; it will not resolve an allergic/lichenoid contact reaction to metal.
• D. Remaking in the same alloy reproduces the same exposure and the same reaction.