The patient's ill-fitting denture has been relined/adjusted and antifungal therapy given, but a persistent tissue lesion at the sulcus remains after adequate healing time. What is the next best step?

Correct answer: D. Excisional biopsy of the persistent lesion

• A. Taking an impression on inflamed/unresolved tissue would capture distorted anatomy and fail to address the underlying pathology.
• B. Continued observation of a persistent lesion after treatment delays diagnosis of possible dysplasia or malignancy.
• C. Making a new denture on unresolved tissue does not address the etiology of a persistent lesion.
• D. CORRECT — Any oral lesion that fails to resolve after removing the causative irritant (denture adjustment) and appropriate treatment must be biopsied to rule out malignancy or dysplasia. This is a standing rule for persistent oral lesions greater than 2 weeks after irritant removal.