Dentistry Commons^™

The Assessment Of Ageism In Dental Hygiene Students And Dental Hygienists: A Cross-Sectional Study, Paolo Boffano, Elena Canciani, Valeria Nikolovska, Francesca Santeusanio, Andrea Melle

International Arab Journal of Dentistry

Objectives: Ageism is a common type of discrimination and prejudice that consists in the stereotyping and discrimination against individuals or groups on the basis of their age.The purpose of this study was to assess dental hygienists and dental hygiene students’ attitudes toward geriatric patients, the perceptions of curriculum suitability, and their confidence in treating geriatric patients, together with an assessment of ageism in the study population.

Methods: A survey was conducted among dental hygienists and dental hygiene students. The first part of the questionnaire contained questions related to demographics, and regarding their opinion on treatment in the geriatric population. The …

Three-Dimensional Evaluation Of Torque Expression In Maxillary Incisors: Influence Of Crown Shape And Collum Angle, Isha Singh, Achint Juneja, Divya Shetty, Monis Raza, Payal Sharma, Udit Chaudhary

International Arab Journal of Dentistry

Objectives: To evaluate the influence of crown morphology and collum angle of maxillary incisors on torque expression at common bracket-bonding landmarks using cone-beam computed tomography (CBCT).

Methods: Twenty CBCT scans of individuals aged 18–27 years were analyzed. For each central and lateral incisor, the height of maximum labial contour (HMC), height of the labial anatomic (LA) point, collum angle (CA), and alpha angle at both HMC (αc) and LA (αLA) were measured. Stone casts confirmed LA points. Independent and paired t-tests assessed inter- and intra-tooth differences (α = 0.05).

Results: The HMC was located 2.6 ± 0.3 mm (centrals) and …

Artificial Intelligence, An Aid In Teledentistry: A Review, Kavery Ittira Kuttappa, Mamatha Shetty, Upasana Reddy, Srilakshmi Mahadevan

International Arab Journal of Dentistry

The central question is whether teledentistry can effectively access and provide treatment to dental patients. This review seeks to examine how teledentistry improves oral health services through the use of various enabling technologies. This explores the integration of artificial intelligence in teledentistry in modern oral healthcare. Teledentistry expands its access to dental services, especially in remote and undeserved communities through synchronous, asynchronous and remote patient monitoring while reducing costs, logistical barriers and chairside time. It shifts its dynamic from a curative model to a proactive preventive one which focuses on patient centered care. Artificial Intelligence (AI) includes machine learning, deep …

The Effect Of Loading On The Success Of Dental Implants After Immediate Extraction Compared To Delayed Dental Implants: A Systematic Review, Hassen Merzouk, Samir Habibi, Ben Ali Boutabout

International Arab Journal of Dentistry

Introduction: The study focuses on dental implants, which are used to replace missing teeth. A key decision in implant dentistry is when to place the implant relative to tooth extraction. This review compares two main approaches: immediate implant placement (placing the implant during the same surgery as tooth removal) and delayed implant placement (placing the implant after the extraction site has healed, typically 6 to 12 months later).

Objectives: The study aims to compare the success rates and complications associated with these two-timing strategies, especially concerning the implant’s ability to withstand chewing forces. The primary objective was to compare post-extraction …

Severe Drug-Induced Gingival Overgrowth In A 21-Year-Old: A Rare Presentation And Its Surgical Resolution, Raagul Somasundaram, Sumit Malhotra, Rahul Chopra, Gaurav Das

International Arab Journal of Dentistry

Gingival overgrowth is well documented side effect associated with three major classes of drugs viz, anticonvulsants, calcium channel blockers, and immunosuppressants. Dental Surgeons need to discuss this issue with their medical colleagues and to practice care while prescribing the drugs associated with gingival overgrowth. The aim of present article is to report a rare case of gingival enlargement with long term Drug history. Drug-induced gingival enlargement often occurs due to patient’s lack of awareness about the side effects of prescribed medications. This case report presents with an unusual rare instance of massive drug-induced gingival overgrowth in a 21-year-old male, successfully …

Management Of Anterior Teeth Affected By Molar Incisor Hypomineralization Using Resin Infiltration Technique: A Case Report, Atika Bouabid, Selsebil Laajimi, Yamina Elelmi, Fatma Masmoudi, Ahlem Baaziz

International Arab Journal of Dentistry

Background: Molar-Incisor Hypomineralization (MIH) is a developmental enamel defect affecting first permanent molars and often incisors, presenting unique restorative challenges. In line with minimally invasive dentistry, the “Würzburg concept” promotes conservative management strategies with resin infiltration.

Objectives: This case report investigates the impact of modifications to the ICON resin infiltration protocol on esthetic outcomes and adhesion in MIH-affected anterior teeth.

Method: Three clinical cases involving MIH lesions on anterior teeth were treated using the Icon® resin infiltration system by DMG (Hamburg, Germany).

Results: Preconditioning hypomineralized enamel with 5.25% sodium hypochlorite followed by resin infiltration enhances the physical integrity of composite …

Comparative Evaluation Of The Solubility Of Three Commonly Used Root Canal Sealers When Exposed To Xylene And Endosolv: An In Vitro Study, Aparna Palekar, Piyush Mantri, Basawaraj Biradar, Mukund Singh, Vaidehi Joshi, Pushpal Ingle

International Arab Journal of Dentistry

Objectives: This in vitro study compared the solubility of three root canal sealers, AH Plus (epoxy resin-based), MTA Fillapex (MTA-based), and Cerafill RCS (bioceramic), in two solvents: Xylene and Endosolv.

Methods: Sixty standardized cylindrical specimens were prepared using the three sealers of interest. The specimens were divided into six groups (n = 10) and immersed in either Xylene or Endosolv for 10 minutes. Solubility was assessed by calculating the percentage weight loss before and after immersion. Data were analysed using one-way ANOVA and Tukey’s post hoc test (α= 0.05).

Results: All sealers exhibited statistically significant solubility in both solvents (p …

Effect Of Red Wine Immersion On The Flexural Strength Of Glass Ionomer Cement: An In Vitro Study, Niyola Crasta, Upasana Reddy, Jayaprakash Kukkila

International Arab Journal of Dentistry

Background: Alcoholic beverages such as red wine are widely consumed for social and cultural reasons. Ethanol and other constituents in red wine might alter the physical properties of dental restorative materials, particularly those exposed in the oral environment. Glass ionomer cements (GICs) are commonly used in restorative dentistry for their beneficial properties, but their mechanical strength under exposure to acidic or alcoholic solutions is a concern.

Objectives: To evaluate how exposure to red wine over time affects the flexural strength of glass ionomer cement (Shofu FX Ultra Mini).

Methods: Thirty rectangular specimens of glass ionomer cement (Shofu FX Ultra Mini), …

Interdisciplinary Full-Mouth Rehabilitation Addressing Midline Shift And Gingival Discrepancies Through Crown Lengthening And Root Reshaping Procedures: A Case Report, Ghida Lawand, Roudy Khayat, Stephanie Khalaf, Tamara Rebeiz, Hani Tohme

International Arab Journal of Dentistry

This report describes a minimally invasive approach to address midline deviation and gingival discrepancies in a 50-year-old patient seeking rapid aesthetic results. Treatment included prosthetic crown lengthening, selective root modification, and biologic shaping to correct a 3 mm midline shift. Digital smile design and CAD/CAM technology guided the fabrication of zirconia restorations, achieving improved midline alignment, gingival harmony, and smile aesthetics with high patient satisfaction. This technique provides an efficient alternative for complex aesthetic cases.

Efficacy Of Autologous Platelet-Rich Fibrin (Prf) In Promoting Soft Tissue Healing And Bone Regeneration Following Extraction In The Anterior Maxilla: A Digital And Radiological Study, Anthony El Rai, Abdallah Menhall, Joseph Zaarour, Robin Jalkh, Joseph Bassil

International Arab Journal of Dentistry

Objectives: The main objective of this study was to evaluate the effectiveness of PRF in promoting soft tissue healing and bone regeneration after extraction in the anterior maxillary region. A secondary objective was to correlate soft tissue change with underlying bone structure variation. Finally, the study also aimed to compare soft and hard tissue alteration based on different types of extracted teeth.

Methods: The sample included five adult patients requiring the extraction of at least two symmetrical teeth in the anterior maxilla, totaling fourteen teeth. Participants underwent CBCT scans and digital impressions before extraction. Concerned teeth were then …

Effect Of Ingot Thickness And Translucency Of Lithium Disilicate Glass-Ceramic And Final Shade: An In Vitro Study, Rami Shurbaji Mozayek, Even Hanifi, Hiba Al Helou, Mohammed Yamen Al Shorbaji Al Moziek, Nour Al Deen Kharboutly

International Arab Journal of Dentistry

Introduction: laminate veneers can alter the final shade depending on factors like resin cement shade or material used. Other factors such as ceramic thickness and translucency will be discussed in this study.

Methods: The study sample consists of 60 discs made of lithium disilicate glass ceramic divided into four groups (HT, LT, MO, HO) according to their translucency, each group was subsequently divided into three subgroups (1, 0.75, 0.5 mm) according to their thickness. L, a,b values were measured for each disc. One-Way ANOVA was carried out with 95% confidence interval.

Results: Statistical analysis showed significant difference …

Comparative Evaluation Of Heat-Treated Retreatment Files On Canal Transportation And Dentin Thickness In Endodontically Treated Teeth: An In Vitro Cbct Study, Monisha Bhate, Pradeep Solete, Aparna Mohan

International Arab Journal of Dentistry

Introduction: Non-surgical retreatment is a conservative approach for managing recurrent endodontic infections requiring efficient removal of obturating material while preserving dentin. Retreatment file systems,through their design and function,plays a vital role in ensuring effective cleaning and minimal structural compromise.

Methods: Forty-five extracted mandibular molars were decoronated and obturated at a standardized root length of 16 mm in both mesial canals. Samples were divided into three groups (n=15): Group 1 – SoliteRS3, Group 2 – Dentsply Protaper Universal Retreatment Files and Group 3 – Neoendo Retreatment Files. Pre- and postoperative CBCT scans were used to assess remaining dentin thickness, …

Cytotoxicity And Osteogenic Potentials Of Mesenchymal Stem Cells Via A Novel Formulation Of Mineral Trioxide Aggregate: An In Vitro Study, Ahmed Elgendi, Ehab Hassanien, Mohamed Nagy, Iman Fathy, Ashraf Abu Seida, Elhassan Hassanein

International Arab Journal of Dentistry

Objectives: Root perforations can lead to periodontitis and alveolar bone loss. This study compared cytotoxicity and osteogenic potential of zirconia-containing mineral trioxide aggregate (MTA) Matreva (MAT group) to MTA Angelus (ANG group) as root perforation repair materials.

Methods: Bone marrow mesenchymal stem cells (BM-MSCs) were extracted from two albino rats and cultivated. The cytotoxicity of the studied materials was determined using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay at three time points: 3, 7, and 14 days. The evaluated materials were employed to guide the osteogenic differentiation of BM-MSCs into osteoblasts. The osteogenic impact was evaluated by assessing calcium …

Evaluation Of The Remineralizing Agents After Orthodontic Bracket Debonding: A Sem-Edx Investigation, Bassant Ashraf Badr, Medhat Elzainy, Noha Ibrahim, Hend El Messiry

International Arab Journal of Dentistry

Objectives: To compare the remineralizing efficacy of (Fluoride (Fl) Varnish, Nanohydroxyapatite (n-HAp) serum and NovaMin-containing toothpaste) on premolars subjected to orthodontic debonding and a pH-cycling model.

Methods: 60 human premolars were divided into six groups (n=10). Group IA, sound enamel, IB, orthodontically treated premolars, IC, orthodontically treated premolars subjected to demineralization cycles. Three experimental groups included orthodontically treated premolars subjected to demineralization cycles and treated with Fl varnish (IIA), n-HAp serum (IIB), and NovaMin toothpaste (IIC). Surface topography and mineral content were evaluated using SEM-EDX analysis, and data were statistically analyzed using ANOVA test and Tukey’s post-hoc test. …

Evaluation Of Anti-Bacterial Efficacy Of Ginger, Resin Gum, And Nigella Sativa Irrigants Against Enterococcus Faecalis: An In Vitro Study, Iman El Ghazzawy, Leen Imad Hasbini, Reem Chamseddine, Wael Betbout, Roula Abiad

International Arab Journal of Dentistry

Objectives: To evaluate the antibacterial efficacy of Ginger, Resin Gum, and Nigella Sativa, against Enterococcus Faecalis.

Methods: Thirty-eight extracted single-rooted premolars were inoculated with E.faecalis, except the negative control, and incubated for 4 weeks. After instrumentation samples were divided into 4 groups (n=7) according to final irrigation: NaOCl+EDTA (Group A), Nigella sativa (B), Resin Gum (C), Ginger (D), plus 2 control groups (n=5): Saline (E), and Saline without bacterial inoculation (F). Cultures were collected at baseline and after irrigation.

Results: One-way ANOVA showed that in groups A-D a statistically significant reduction of bacterial load was observed at …

Management Of A Periapical Cyst In An 8-Year-Old Patient With Challenging Etiology: A Case Report With Three-Year Follow-Up, Nancy Nochahrly, Claire El Hachem, Josephine El Balaa, Elie Khoury, Christelle Abdel Nour, Marlene Khoury

International Arab Journal of Dentistry

The success of pulp therapy in primary teeth depends on accurate diagnosis and effective treatment. Periapical inflammation due to bacterial infection or pulpal necrosis can result in granulation tissue and may activate epithelial rests of Malassez, leading to a periapical cyst. In large cysts, especially in children, marsupialization is preferred to preserve developing teeth and minimize damage to surrounding structures. This case report describes an 8-year-old presenting with spontaneous pain in the lower right jaw. Radiographic examination revealed a round welldefined radiolucency over 1 cm around tooth #84 with root canal treatment and #85 with pulpotomy, with dental bud displacement. …

Allergy In Dentistry: Mechanisms Of Development And Effective Treatment Methods, Maria Zofia Lisiecka

International Arab Journal of Dentistry

Objectives: This study is conducted to analyse the mechanisms of allergic reaction development in dentistry and the effectiveness of their treatment methods.

Methods: During it, a review of current scientific sources on allergology, immunology, dentistry, pharmacology, and materials science is conducted, mechanisms for the development of allergies of various types are established, the effectiveness of treatment methods is evaluated, and clinical recommendations for allergy therapy in dentistry are formed.

Results: The results show that the development of allergic reactions occurs by two mechanisms. Immediate-type immunoglobulin E-mediated (IgE-mediated) responses are triggered by the release of histamine, serotonin, and …

Impact On Oral Health Of The Post-Covid-19 Infections: A Systematic Review, Aouatif Aouidate, Hanane Ouddoud, Loubna Bahije

International Arab Journal of Dentistry

Introduction: The COVID-19 pandemic has been associated with a diverse range of oral health implications, including mucosal lesions, periodontitis, and disruptions of the oral microbiota. Since airborne particles primarily transmit COVID-19, understanding its potential impact on oral health is crucial for dental care and infection control.

Objectives: This systematic review aimed to evaluate the effects of post-COVID-19 infections on oral health, highlighting clinical manifestations, periodontal disease associations, and microbiota disturbances.

Methods: Electronic literature searches were conducted between January 2020 and July 2024 by one author across several databases, including PubMed/MEDLINE, Scopus, Cochrane Library, EMBASE, ScienceDirect, Google Scholar, …

Impact Of Systemic Statins On Periodontal Health: A Retrospective Study In A Lebanese Population, Elsa Boustany, Georgio Saad, Wassim Al Manhal

International Arab Journal of Dentistry

Introduction: Statins, primarily used for cholesterol management, have shown potential in improving periodontal health due to their anti-inflammatory and bone-regenerative properties.

Methods: A retrospective study was conducted on 30 patients under statin medication. A control group of 30 non-statin users was selected using propensity score matching (PSM) to minimize bias. Data on pocket depth, attachment loss, and radiographic bone loss were collected at two time points: T0 and T1. Statistical analysis was performed using RStudio, with a significance threshold set at p < 0.05.

Results: The study revealed significant decrease in pocket depth (p = 0.0027), attachment loss (p …

Assessment Of External Root Resorption During The First Stage Of The Orthodontic Treatment: A Prospective Cone-Beam Tomography Study, Eliana Pineda Vélez

International Arab Journal of Dentistry

Introduction: predisposition to root resorption as a result of a dental movement may be a consequence of clinical, biological, and biomechanical factors that should lead the clinician to objectively assess each patient to reduce associated risk factors.

Objectives: to establish an association between clinical and tomographic findings related to external root resorption (ERR) using cone beam tomography (CBCT) on maxillary incisors during the first stage of the orthodontic treatment. Methods: an observational, follow-up, cohort study that analyzed the association between clinical and radiographic variables on maxillary incisors using CBCT before placing fixed orthodontic appliances and finishing the first …

Sickle Cell Anemia And Its Impact On The Oral Cavity: Integrative Review, Fernanda Leal, Maria Inês Guimarães, Ambre Natbeth, Inês Lopes Cardoso

International Arab Journal of Dentistry

Introduction: Sickle cell anemia, a hereditary disease, results from a mutation in the β-globin coding gene that makes up hemoglobin, leading to the deformation of erythrocytes. Numerous oral manifestations result from this disease; however, some may not be specific.

Objectives: This study’s objective is to recognize these clinical manifestations of the disease to be able to manage oral health in sickle cell anemia patients.

Methods: this integrative review analyzes scientific literature on the impact of sickle cell anemia on oral cavity. A bibliographic search was performed in PubMed, ScienceDirect, CINAHL Plus (via EBSCO host), Web of Science …

Full-Arch Rehabilitation Of Post-Mucormycosis Edentulous Maxilla Using Quad Zygomatic Implants: A Clinical Case Report, Akansha Bansod, Sweta Kale Pisulkar, Arushi Beri, Mony Behera, Pragya Manushree, Utkarsh Umre, Michael Subal Pramanik

International Arab Journal of Dentistry

Rehabilitating the maxilla in the patient who has had surgical resection for mucormycosis poses a distinctive set of anatomical, surgical, and prosthetic challenges. The extensive maxillary bone loss after aggressive debridement often makes traditional implant-supported prosthetic options impossible. In these circumstances, zygomatic implants have proven to be a predictable, graftless solution, especially in patients with extremely atrophic maxillae. Where the bone loss is severe, the quad zygoma procedure—two implants for each zygomatic arch—is possible to support full arch rehabilitation with a fixed prosthesis. This report presents the successful rehabilitation of oral function and appearance in a patient with post-mucormycosis edentulous …

A Clinical Investigation Of The Correlation Of Black Stains With Oral Cavity Ph And Dental Caries Presence In Children: A Cross-Sectional Study, Maguy Sfeir, Nada Chedid

International Arab Journal of Dentistry

Introduction: Black stains (BS) on teeth often lead to dental visits in children due to their esthetic impact. Beyond cosmetic concerns, black stains may play a role in oral health, potentially suggesting a lower risk of dental caries through the regulation of oral microbiota and pH levels. Understanding the association of black stains with oral pH and caries presence can offer insights into protective and preventive strategies in pediatric dentistry.

Objectives: the purpose of this study is to assess the correlation between black stains, oral cavity pH, and the presence of caries in a sample of 6-to 8- …

The Impact Of Scan Spans On The Accuracy Of Three Intraoral Scanners: A Comparative Study, Lynn Labban, Louis Hardan, Cynthia Kassis

International Arab Journal of Dentistry

Objectives: In modern dentistry, intraoral scanners (IOSs) have become indispensable tools for capturing accurate digital impressions of patients’ dentition, facilitating the design and fabrication of various dental restorations. However, the accuracy of these scanners can be influenced by factors such as scan span, which refers to the extent of the area scanned during impression taking. Understanding the impact of scan span on scanner accuracy is crucial for optimizing clinical outcomes and ensuring the reliability of digital models. The aim of this study was to evaluate and compare the accuracy, encompassing both trueness and precision, of intraoral scanners (IOSs) across different …

Effect Of Gingival Pigmentations And Anterior Crown Heights On Smile Attractiveness Regarding Gingival Exposure Assed By Orthodontists, Dentists, And Laypeople: A Randomized Controlled Trial, Ziad Tannoury, Marianne Moussallem, Joseph Ghoubril, Adib Kassis, Elie Khoury

International Arab Journal of Dentistry

Objectives: The purpose of this study was to evaluate the effect of gingival pigmentations and anterior crown heights in conjunction with the maxillary gingival display on the perception of smile attractiveness assessed by orthodontists, dentists, and laypersons.

Methods: Frontal intraoral photograph of ideally aligned teeth was modified to generate 3 levels of gingival smile exposure (2 mm, 3 mm, and 4 mm) with 4 different degrees of gingival pigmentation index according to DOPI and 5 different central incisors crown heights (7.7 mm, 8.7 mm, 9.7 mm, 10.7 mm, and 11.7 mm). Attractiveness of these 24 smiles was evaluated by orthodontists …

A Comparison Of Shear Bond Strength Of Denture Teeth To Denture Base Using Different Means Of Retention: An In Vitro Pilot Study, Dima Taha El Baba, Paul Boulos

International Arab Journal of Dentistry

Objectives: The objective of this work is to evaluate the shear bond strength between denture base resin and three different acrylic artificial denture teeth. The latter was subjected to three different surface modifications on the ridge lap area and compared to unmodified acrylic artificial denture teeth.

Methods: In this experimental in vitro study, twenty-four maxillary central incisor acrylic teeth were used from each of three manufacturers; namely Major®, Ivoclar® and Myerson®. The teeth were additionally divided into four test groups with six specimens in each: a control group, a chemical retention group, a mechanical retention group, and a …

The Effects Of Mouthguard And Physiotherapy On Bruxism: An Emg And Posture Angle Analysis—A Pilot Clinical Study, Nathalie Yared, Pascal El Braidy, Romy Slaiby, Amine El Zoghby

International Arab Journal of Dentistry

Objectives: The purpose of this research was to determine whether a clinical trial to assess the impact of physiotherapy and mouthguards on bruxism was feasible. This included assessing participant recruitment, carrying out the interventions, and gathering data with appropriate techniques. The study focused on using posture angle analysis to evaluate changes in posture linked to bruxism and electromyography (EMG) to detect muscular activity. By exploring these elements, the study aimed to provide the groundwork for a more extensive, larger clinical trial.

Methods: Participants were recruited from the USJ dental clinics after their consultations. They were screened for bruxism using a …

Comparison Of Treatment Outcome Of Occlusal Splints And Physiotherapy Regarding Their Effect On Posture: An In Vivo Pilot Study, Bouchra El Fassih, Amine El Zoghbi, Pascal El Braidy

International Arab Journal of Dentistry

Objectives: The primary objective of the research is to assess occlusal splints and physical exercise effect on posture. The secondary objective is to compare which treatment option has more positive feedback regarding posture adjustment.

Methods: twenty patients with temporomandibular disorders (TMD) were divided into two groups equally, one receiving occlusal splints as a treatment for TMD and the other group receiving physical therapy exercises. They underwent a clinical and postural examination at baseline, after 1 week, after 1 month and after 2 months of treatment. Postural stability was assessed using a force platform (SATEL). Subjects were evaluated in …

Effect Of Adaptation Time On Retention Of Maxillary 3d-Printed Denture Versus Conventional Heat-Cured Acrylic Denture: A Randomized Controlled Trial, Ahmed Hebeshi, Moataz Elmahdy, Sayed Elmasry, Hala Abdelhameed

International Arab Journal of Dentistry

Objectives: The study aimed to investigate the effect of adaptation time on the retention of 3d printed versus conventional heat-cured acrylic maxillary complete dentures.

Methods: 20 patients were distributed into: Group A received ten conventional complete heatcured acrylic dentures and Group B received ten printed complete dentures. Denture retention was measured at 0, 1 , and 3 months.

Results: For acrylic denture and printed denture groups, Mean values in denture retention increased with time but this increase was statistically non-significant. The change in denture retention over time (difference in retention between the third month and at the …

Three-Dimensional Analysis Of Dental Arch Form In Relation To The Vertical Facial Pattern In Class I Patients: A Cross-Sectional Study, Ahmad Ghassan Droubi, Islam Gad, Aly Osman

International Arab Journal of Dentistry

Introduction: Understanding the relationship between dental arch form and vertical facial pattern is crucial in orthodontic diagnosis and treatment planning. Variations in vertical facial morphology can influence dental arch form, which in turn impacts the effectiveness and stability of orthodontic interventions.

Objectives: The study explores the associations between dental arch form with the different vertical facial patterns, including hyperdivergent, normodivergent, and hypodivergent patterns in skeletal Class I patients.

Methods: A cross-sectional observational design was employed to examine a sample of 48 patients with skeletal Class I seeking orthodontic treatment; of which 24 males and 24 females. Each …