Which of the following conditions warrants a biopsy?

The option indicating a lesion showing signs of distress warrants a biopsy because such lesions often have characteristics that suggest the possibility of malignancy or an underlying pathological process that needs further investigation. This “signs of distress” could manifest as changes in color, texture, or radiographic abnormalities that deviate from what is considered normal. When a lesion exhibits such signs, a biopsy allows for the microscopic examination of the tissue, which is essential for determining the presence of cancerous cells or other significant diseases.

In contrast, the other options do not necessarily indicate a need for a biopsy. A firm and non-symptomatic mass may not present any alarming features that suggest malignancy. A healing extraction site is usually part of the normal healing process and does not typically require a biopsy unless there are complications or unexpected symptoms. Normal appearing dental tissue does not present any concerns, as it is within the expected range of health, making it unnecessary to perform a biopsy. This reinforces the importance of assessing clinical signs and symptoms before deciding on invasive procedures like a biopsy.