Which radiographic feature denotes an early disease change in the anterior dentition?

• A. Pointed crest
• B. Blunted, non-corticated crest
• C. Normal physiologic height
• D. Blunted crest

Answer: (B)

Early signs of periodontal bone change show the alveolar crest becoming less distinct and flattened. This is because bone resorption begins to blur the crisp, corticated outline that normally traces the crest. When the crest is blunted and the cortical border is no longer well defined (non-corticated), it signals the start of bone loss rather than healthy anatomy. The combination of a blunted crest with a non-corticated border best reflects this initial disease change in the anterior dentition. In contrast, a pointed crest or a crest with normal physiologic height indicates a healthy state, or at least not yet early disease, while a plain blunted crest without noting the border quality is less specific.