Creation of a Three-Dimensional Virtual Patient for Acquiring X-ray Tube Positioning Parameters in the Bisecting-Angle Technique for Periapical Radiography: A Preliminary Technical Feasibility Study

Creation of a Three-Dimensional Virtual Patient for Acquiring X-ray Tube Positioning Parameters in the Bisecting-Angle Technique for Periapical Radiography: A Preliminary Technical Feasibility Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Creation of a Three-Dimensional Virtual Patient for Acquiring X-ray Tube Positioning Parameters in the Bisecting-Angle Technique for Periapical Radiography: A Preliminary Technical Feasibility Study Yujia Zhu, Yuhan Liu, Linlin Wang, Yue Gao, Zhipu Ge This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8394233/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract The bisecting-angle technique is a commonly used method for periapical radiography. Its successful execution requires the operator to position the X-ray tube so that the central beam is perpendicular to the imaginary bisector of the angle formed by the tooth and the image receptor—a process heavily reliant on operator experience. Detailed tube positioning parameters for different teeth are therefore essential for effective training. However, due to radiation risks, obtaining these parameters through direct measurement on patients is not feasible. This study addresses this challenge by creating a three-dimensional (3D) virtual patient. Using data from an intraoral scanner, cone-beam computed tomography (CBCT), and a facial scanner, the virtual patient was constructed through image segmentation, 3D modeling, and image registration. This model enables simulation of periapical radiographic examinations in a software environment, allowing accurate determination of key parameters for the bisecting-angle technique—including vertical and horizontal tube angulations and the facial entry point of the central beam—for any specific tooth. Health sciences/Anatomy Physical sciences/Engineering Health sciences/Health care Health sciences/Medical research bisecting-angle technique digital dentistry periapical radiography virtual patient Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8394233","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":617645686,"identity":"c8647602-012e-47d4-886e-bd5e19278564","order_by":0,"name":"Yujia Zhu","email":"","orcid":"","institution":"Qingdao Stomatological Hospital Affiliated to Qingdao University","correspondingAuthor":false,"prefix":"","firstName":"Yujia","middleName":"","lastName":"Zhu","suffix":""},{"id":617645689,"identity":"8fcd7b88-5b70-4538-a236-c5256d23967f","order_by":1,"name":"Yuhan Liu","email":"","orcid":"","institution":"Qingdao Stomatological Hospital Affiliated to Qingdao University","correspondingAuthor":false,"prefix":"","firstName":"Yuhan","middleName":"","lastName":"Liu","suffix":""},{"id":617645693,"identity":"eed41769-eefd-442e-aa13-d9a8ec4bd76f","order_by":2,"name":"Linlin Wang","email":"","orcid":"","institution":"Qingdao Stomatological Hospital Affiliated to Qingdao University","correspondingAuthor":false,"prefix":"","firstName":"Linlin","middleName":"","lastName":"Wang","suffix":""},{"id":617645695,"identity":"316377dd-74b2-41f6-ab29-ef8bf1628681","order_by":3,"name":"Yue Gao","email":"","orcid":"","institution":"Qingdao Stomatological Hospital Affiliated to Qingdao University","correspondingAuthor":false,"prefix":"","firstName":"Yue","middleName":"","lastName":"Gao","suffix":""},{"id":617645698,"identity":"018232ad-9583-4210-b922-4bbb2a20c1f0","order_by":4,"name":"Zhipu Ge","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA1ElEQVRIiWNgGAWjYDCCA3AW84EDHypI08KWeHDGGdK08Bgf5m0hQgff7cMHP92ouGc3f3bPhwO8DQzy/GIH8GuRPJeWLJ1zpji5cc7ZDQckdzAYzpydgF+LwRkeA+nctoRkZoncDQcMzzAkGNwmqIX/8+/cfwnJbBI5Dw4kthGlhYdNOrchwY5HIofhwEFitEieYTOzzjmWkCAhc8zgYMMZCcJ+4TvD/Ph2Tk2Cvfzs5sef/1TYyPNLE9ACA4kNEmBagjjlIGBPiuJRMApGwSgYYQAAOqBKIMxN3JIAAAAASUVORK5CYII=","orcid":"","institution":"Qingdao Stomatological Hospital Affiliated to Qingdao University","correspondingAuthor":true,"prefix":"","firstName":"Zhipu","middleName":"","lastName":"Ge","suffix":""}],"badges":[],"createdAt":"2025-12-18 10:23:29","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8394233/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8394233/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":107058223,"identity":"3c550ad1-62a7-4c60-a762-db5de5e81053","added_by":"auto","created_at":"2026-04-16 09:42:52","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":631382,"visible":true,"origin":"","legend":"","description":"","filename":"SRManuscriptEd1.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8394233/v1_covered_f2b1f020-5a11-43a7-ac97-3cacc781eb91.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Creation of a Three-Dimensional Virtual Patient for Acquiring X-ray Tube Positioning Parameters in the Bisecting-Angle Technique for Periapical Radiography: A Preliminary Technical Feasibility Study","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"bisecting-angle technique, digital dentistry, periapical radiography, virtual patient","lastPublishedDoi":"10.21203/rs.3.rs-8394233/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8394233/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eThe bisecting-angle technique is a commonly used method for periapical radiography. Its successful execution requires the operator to position the X-ray tube so that the central beam is perpendicular to the imaginary bisector of the angle formed by the tooth and the image receptor\u0026mdash;a process heavily reliant on operator experience. Detailed tube positioning parameters for different teeth are therefore essential for effective training. However, due to radiation risks, obtaining these parameters through direct measurement on patients is not feasible. This study addresses this challenge by creating a three-dimensional (3D) virtual patient. Using data from an intraoral scanner, cone-beam computed tomography (CBCT), and a facial scanner, the virtual patient was constructed through image segmentation, 3D modeling, and image registration. 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