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Journal of Baghdad College of Dentistry College of dentistry/ University of baghdad
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ISSN: 1817-1869
eISSN: 2311-5270
Statistics
No. of publications: 814
No. of views: 12019
No. of Scopus citations: 625
No. of Crossref citations: 822
SNIP 2024: 0.669
SJR 2024: 0.428
CiteScore 2024: 1.9
CiteScore 2025: 2.8
Publication Date
Sat Dec 15 2018
Journal Name
Journal Of Baghdad College Of Dentistry
Clinicopathological and Immunohistochemical Analysis of 21 cases of Traumatic Ulcerative Granuloma with Stromal Eosinophilia Using CD30, CD68 and TGF-β1
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Background: Traumatic ulcerative granuloma with stromal eosinophilia is an impressive benign chronic ulcerative lesion of the oral mucosa with vague etiopathogenesis. It was supposed to represent an oral counterpart of primary cutaneous CD30+ lymphoproliferative disorder. Histopathologically, it is characterized by mixed inflammatory infiltrate predominated by histiocytes, lymphocytes and eosinophils along with presence of scattered large atypical mononuclear cells. It has worrisome clinical presentation. It may heal spontaneously, but in most occasions it persists and never heal unless removed surgically (incisional or excisional biopsy). A rare subset may show worrisome immunohistochemical features. Follow up is highly recommended. Mat

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Publication Date
Thu Dec 04 2025
Journal Name
Journal Of Baghdad College Of Dentistry
An Extrafollicular Cystic Adenomatoid Odontogenic Tumor of the Mandible Associated with Clear Cell Calcifying Epithelial Odontogenic Tumor: A Rare Case Report
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Background: The adenomatoid odontogenic tumor is a relatively rare benign epithelial odontogenic tumor. It contains both epithelial and mesenchymal components. Few cases presented as an extrafollicular lesion or involve the mandible or associated with other odontogenic lesions. This paper represents a rare case of an extrafollicular AOT. Case presentation: A 24-year-old female had a painless swelling on the right side of the lower jaw since one-month duration. Intraorally there was a well defined fluctuant-blue swelling in the right alveolar premolar region measuring 1×2 cm obliterating the right lower buccal vestibule. Grade II mobility in the vital 44 and 45 teeth were observed. Panoramic radiographs showed a well-defined pear shaped

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Publication Date
Thu Dec 04 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Surface area measurements of upper dental cast with different final impressionss
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Background : surface area anatomy is a proportional point to the retention of complete denture, in past there was no quantitative method to evaluate the surface area, nowadays the size and shape of maxillary arch is measured by different electronically and mathematical devices. A study was therefore, undertaken to measure surface area of upper dental cast that was taken by different final impressions. Materials and methods: twenty patients were examined. All of them had a healthy palate with no singe of injury, trauma, or deformity. Casts were taken by three different final impressions; zinc oxide, additional silicon, and poly ether. And two different devices were used; the computerized one and the Aluminum foil measure. Age, se

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Publication Date
Thu Dec 04 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Hard palate bone density and thickness determination using CT scan and their relationships with body compositions measured by bioelectrical impedance analysis for Iraqi adult sample
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Background: This study was conducted to evaluate the hard palate bone density and thickness during 3rd and 4th decades and their relationships with body mass index (BMI) and compositions, to allow more accurate mini-implant placement. Materials and method: Computed tomographic (CT) images were obtained for 60 patients (30 males and 30 females) with age range 20-39 years. The hard palate bone density and thickness were measured at 20 sites at the intersection of five anterioposterior and four mediolateral reference lines with 6 and 3 mm intervals from incisive foramen and mid-palatal suture respectively. Diagnostic scale operates according to the bioelectric impedance analysis principle was used to measure body weight; percentages of body fa

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Publication Date
Thu Dec 04 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Force decay of orthodontic elastomeric chains by using three different mechanisms simulating canine retraction
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Background: The ideal force-delivery system must: provide optimal tooth moving forces that elicit the desired effects, be comfortable and hygienic for the patient, require minimal operator manipulation and patient cooperation and provide rapid tooth movement with minimal mobility during orthodontic therapy, the elastomeric chains have the greatest potential to fulfill these requirements. Materials and Methods: This in vitro study was designed to determine the effect of three different mechanisms for canine retraction : (6-3 , 6-5-3 and chain loop ) on the load relaxation behavior of three types of elastomeric chains : (maximum clear , maximum silver and extreme silver) from the same company (Ortho Technology company) with two different bran

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Publication Date
Thu Dec 04 2025
Journal Name
Journal Of Baghdad College Of Dentistry
The effect of different oral hygiene regimens on the quantity of cariogenic plaque on orthodontic bands with different attachments (A clinical photographic study)
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Background: Fixed orthodontic appliances impede the maintenance of oral hygiene and result in plaque accumulation leads to enamel demineralization caused by acids produced by bacteria. Studies on plaque control strategies in orthodontic populations are limited. This might be caused by difficulties in the quantitative evaluation of dental plaque because the teeth have various levels of bracket coverage, and different tooth sizes and malocclusions, making the traditional categorical indices complex. The present study aims to evaluate the effect of different hygiene protocols on plaque quantity on bands with different attachments. Materials and method: Twenty patients had four bands within the orthodontic appliance. Then randomly divided into

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Publication Date
Wed Sep 14 2016
Journal Name
Journal Of Baghdad College Of Dentistry
Immunohistochemical Expression of MMP2, VEGF and D2-40 as Biological Markers of Local Invasion Potential, Angiogenesis and Lymphangiogenesis in Oral Squamous Cell Carcinoma and Verrucous Carcinoma
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Background: Verrucous carcinoma (VSCC) is considered as a rare well differentiated carcinoma variant of SCC with no metastatic potential. The aim of this study is to evaluate the Immunohistochemical expression MMP-2, VEGF and D2-40 expression in OSCC and VSCC. Materials and methods: Thirty formalin fixed paraffin embedded tissue blocks of OSCC and another twelve VSCC were collected and Four micrometer thick sections were cut from each block and mounted on positively charged slides and stained immunohistochemically with monoclonal antibodies to MMP-2, VEGF and D2-40. Results: there is no statistical difference between SCC and VSCC regarding the immunoexpression of MMP-2 and VEGF. While the lymphatic vessels density were higher in SCC than V

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Publication Date
Thu Dec 04 2025
Journal Name
Journal Of Baghdad College Of Dentistry
An Impairment of Salivary Gland Function in Rheumatoid Arthritis: Association with Change in Salivary Biomarkers and Disease Activity
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Background: Rheumatoid arthritis is a chronic inflammatory autoimmune disease characterized by joint inflammation, involvement of exocrine salivary and lacrimal glands may occur as extra-articular mani¬festations in this disease. This study aimed to provide evidence of altered in function and composition of salivary gland in patients with rheumatoid arthritis by determine salivary flow rate and some biochemical parameters(total protein, amylase, peroxidase) and to investigate the relationship between disease activity and changes in function and composition of salivary gland. Materials and Methods: Fifty five patients with RA (7 males and 48 females) were enrolled in this study with age range (20-69) years. The patients were separated int

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Publication Date
Thu Dec 04 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Evaluating the effect of silver nanoparticles incorporation on antifungal activity and some properties of soft denture lining material
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Background: Colonization of soft denture liners by Candida albicans and other microorganisms continued to be a serious problem. The aim of this study was to evaluate the effect of incorporating silver nanoparticles into heat cured acrylic-based soft denture liner on the antifungal activity, and on water sorption, solubility, shear bond strength and color change of the soft lining material. Furthermore, evaluating the amount of silver released. Materials and methods: Silver nanoparticles were incorporated into soft denture liner in different percentages (0.05%, 0.1% and 0.2% by weight). Four hundred and twenty specimens were prepared and divided into five groups according to the test to be performed. The antifungal activity of the soft liner

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Publication Date
Thu Dec 04 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Dental caries, Mutans Streptococci, Lactobacilli and salivary status of type1 diabetic mellitus patients aged 18-22 years in relation to Glycated Haemoglobin
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Background: diabetic mellitus is one of the serious systemic diseases that may cause general systemic changes, which may be reflected in the oral cavity. The aims of this study were to assess the severity of dental caries, Mutans Streptococci and Lactobacilli in addition to flow rate and pH among uncontrolled and controlled diabetic groups in comparison with non-diabetic control group. Materials and Methods: Study groups consisted of 25 uncontrolled diabetic patients (HbA1c > 7), 25 controlled diabetic patients (HbA1c ? 7), in addition to 25 non-diabetic healthy looking individuals. Their age was (18-22) years from both genders. The diagnosis and recording of dental caries was according to severity of dental caries lesion through the applic

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Publication Date
Thu Dec 04 2025
Journal Name
Journal Of Baghdad College Of Dentistry
A Comparison of the Effectiveness of Reciprocating System with Continuous Rotary Systems in Non-Surgical Endodontic Retreatment (An In vitro study)
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Background: Optimal root canal retreatment was required safe and efficient removal of filling material from root canal. The aim of this in vitro study was to compare the efficacy of reciprocating and continuous motion of four retreatment systems in removal of root canal filling material. Materials and Methods: Forty distal roots of the mandibular first molars teeth were used in this study, these roots were embedded in cold clear acrylic,roots were instrumented using crown down technique and rotary ProTaper systemize Sx to size F2 ,instrumentation were done with copiousirrigation of 2.5% sodium hypochlorite and 17% buffered solution of EDTA was used as final irrigant followed by distilledwater, roots were obturated with AH26 sealer and Prota

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Publication Date
Fri Sep 15 2017
Journal Name
Journal Of Baghdad College Of Dentistry
The Effect of Enamel Protective Agent on Shear and Tensile Bond Strength of Stainless Steel Brackets by Using Different Adhesive Agents (In Vitro Study)
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Background: Decalcification of surface enamel adjacent to fixed orthodontic appliances, in the form of white spot lesions, is a wide spread and familiar well-known side effect of orthodontic treatment. The present study was carried out to evaluate the effect of enamel protective agent (Clinpro white varnish) on shear and tensile bond strength of Dentaurum orthodontic stainless steel brackets by using 3M Unitek and Ormco as orthodontic adhesive agents. Materials and methods: Sixty-four extracted human upper first premolar teeth were selected and randomly divided into two groups with 32 teeth each, representing the shear and tensile bond strength testing groups. Then according to the type of bonding adhesive and the addition of Clinpro before

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Publication Date
Thu Dec 04 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Biomechanical evaluation of porous titanium implants (CpTi) fabricated by powder technology
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Background: It may be an important prospective clinical use of manufacturing of porous implant for clinical situations, such as cases of limitation in bone height, low bone density .The small segment of porous implant an effective osseointegration allows increasing in contact area provided for small segmented porous provided by its surface configuration. This study was done to Fabricate porous titanium implants by powder technology, as well as the observation of removal torque values of porous titanium implants compared to smooth titanium implants. Materials and methods: Twenty porous titanium implants (3.2mm in diameter and 8mm in length) were manufactured by powder technology using commercially pure titanium powder of ≤75um part

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Publication Date
Thu Dec 04 2025
Journal Name
Journal Of Baghdad College Of Dentistry
The Uses of Pedicled buccal Pad of Fat Flap in Reconstruction of Intra Oral Defects
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Introduction: Different surgical techniques used for closure of various oral defects. While each one of these techniques has its limitation; the buccal pad of fat used in last quarter of last century as pedicle or free graft in reconstruction of small to medium, congenital and acquired defects showed good potentials for success. The present study used the BPF as pedicled flap to reconstruct intra oral defects. The study aimed to evaluate of the success of buccal pad of fat pedicled flap in the reconstruction of intra oral defects. Outlining its indications, limitations and complications. Materials and Methods: The study included 19 patients (17 males and 2 females) with age range between (1- 70 years), all patients were treated with pedic

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Publication Date
Thu Dec 04 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Enamel defect of primary and permanent teeth in relation to nutrients daily intake among Down's syndrome children in comparison to normal children
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Background: Any child with Down's syndrome does not develop in the same manner as normal child. Therefore, the child should not be viewed as being like everyone else. Developmental enamel defects in primary teeth have been found at least twice as frequently in disabled children as in control children. Down's syndrome consumed protein more than the recommended daily allowance compared to other disabled groups. Therefore, the aim of this study was to investigate developmental defects of enamel and their relations to nutrient intake among Down's syndrome children in comparison to normal children. Materials and Methods: A sample consisted of fifty institutionalized Down's syndrome children (study group) and 50 normal children (control group)

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Publication Date
Thu Dec 04 2025
Journal Name
Journal Of Baghdad College Of Dentistry
The Marginal Fitness of CAD/CAM All Ceramic Crowns Constructed by Two Typesof Direct Digitization Techniques (An In Vitro Study)
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Background: In capturing a negative image, the digital impression secures a digital record for the purposeof designing and creating restorations. The introduction of scanning system presents a paradigm shift in the way of the dental impression procedure and encourages the accuracy of obtained restoration especially in the marginal area as a result of producing accurate final impression The digital system offers many advantages over the Conventional method.. The objective of this present in vitro study was to evaluate the marginal fitness of all ceramic crowns fabricated by direct digital scanning of the prepared tooth using two types of intra-oral cameras (Bluecam camera with strip light projection technique and Omnicam camera with video sa

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Publication Date
Thu Dec 04 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Dental caries and salivary physiochemical characteristics among osteoporotic old adult women
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Background: Osteoporosis is a systemic skeletal disorder affects general health in addition to effect on salivary physical and chemical composition which lead to an adverse effect on oral health status. This study was conducted to evaluate the concentration of glycoprotein (osteonectin) in saliva and its effect on dental caries in relation to salivary flow rate and viscosity among osteoporotic women and compared to control group. Materials and Methods: The total sample composed of 60 females aged 60-65 years attending Al-Yarmook Teaching Hospital, 30 females diagnosed with osteoporosis by measuring bone density at the spine and femur with a dual-energy X-ray absorptiometry at T-score of >2.5, and 30 women without osteoporosis with T-score o

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Publication Date
Wed Sep 14 2016
Journal Name
Journal Of Baghdad College Of Dentistry
The Efficacy of Polidocanol foam Sclerotherapy in Treatment of Infantile Hemangioma and Slow-Flow Vascular Malformation
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Background: Sclerotherapy is a simple treatment modality for treatment of infantile hemangioma and slow-flow vascular malformations; Polidocanol is a mild sclerosing agent that is traditionally used in treatment of varicose veins. This study aims to evaluate the effectiveness, treatment outcome, and complications of polidocanol foam sclerotherapy for infantile hemangioma and slow-flow vascular malformations. Materials and methods: Between March 2013 and December 2014, seventeen patients with infantile hemangioma and slow-flow vascular malformations treated with polidocanol 1% foam sclerotherapy. Foam was prepared by Tessari’s method. Injection performed under general or local anesthesia, injections were repeated (if necessary) on mon

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Publication Date
Thu Dec 04 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Effect of gender, age and tooth loss on the dimensions of incisive canal, and buccal bone anterior to the canal (Computed Tomography study)
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Background: The incisive canal is an anatomical structure with an important location in the anterior maxilla, analyzing this canal and its relation to the bone anterior to the canal is necessary during dental implant. Aim of this study is evaluated effect of gender, age and tooth loss in area of maxillary central incisors teeth on the dimensions of incisive canal and buccal bone anterior to the canal using spiral computed tomography. Materials and Methods: Sample consists of prospective study for 156 subjects for both gender, they divided into two groups, 120 dentate group (60 male and 60 female) with age ranging from (20-70) and 36 edentate group (with missing maxillary central incisors) (18 male and 18 female) with age ranging from (50-70

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Publication Date
Thu Dec 04 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Effect of certain chemical surface treatments on repair bond strength of some denture base materials
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Background: Fracture of different types of acrylic denture base is a common problem associated with dental prosthesis. Studies suggested that the repair strength may be improved by several means including surface treatment with chemical agents. The aim of the study was to evaluate the effect of surface treatment with acrybond-bonding agent and monomer on fractured denture base in respect to transverse, tensile and shear bond strength and evaluation of the mode of failure by light microscope. Materials and methods: Two hundred seventy specimens were prepared and divided into 3 groups according to the material used (regular conventional, rapid simplified and high impact) heat cure acrylic. The specimen in each groups were prepared specificall

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Publication Date
Wed Dec 15 2021
Journal Name
Journal Of Baghdad College Of Dentistry
Evaluation of Cytotoxicity and Biocompatibility of Ti2AlC in Rabbits
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Background: The Titanium and its alloys are suitable for dental implant and medical applications. Biocompatibility of the materials is a major factor in determining the success of the implant and has a great impact on their rate of osseointegration. The aim of this study was to evaluate the biocompatibility and cytotoxicity of Ti2AlC in comparison to CPTi & Ti6Al7Nb in rabbits. Materials and Methods: 10 male New Zealand White rabbits, weighing (2-2.5 kg), aged (10-12 months) were used in this study. Cylindrical implants were prepared from the study materials (CPTi, Ti6Al7Nb and Ti2AlC) with (8mm) height and (3mm) diameter for the evaluation of tissue response and disc specimens were prepared with (6 mm) diameter and (2 mm) thickness for ev

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Publication Date
Wed Jun 15 2022
Journal Name
Journal Of Baghdad College Of Dentistry
Effects of various analgesics on pain perception and rate of tooth movement: a randomized controlled clinical study
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Background: Pain is one of the most reported side effects of orthodontic treatment despite the advanced technology in orthodontics. Many analgesics have been introduced to control orthodontic pain including acetaminophen and selective and nonselective nonsteroidal anti-inflammatory drugs. The great concern about these drugs is their adverse effect on rate of teeth movement. Aims: The purpose of this study was to evaluate and compare the effect of acetaminophen, ibuprofen and etoricoxib on pain perception and their influence on the rate of teeth movement during leveling and alignment stage. Methods: Forty patients were evenly and randomly distributed in a blinded way to one of four groups: placebo (starch capsules), acetaminophen 500mg th

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Publication Date
Thu Dec 04 2025
Journal Name
Journal Of Baghdad College Of Dentistry
The role of low level laser therapy on the expression of IL_1 beta in wound healing
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Background: Low-level laser therapy (LLLT) has been extensively applied to improve wound healing due to some biostimulatory properties presented by laser arrays apparently able to accelerate the repair of soft tissue injuries. However, the role of proinflammatory interlukines not been studied yet. IL_1 ? represent one of the most important poroinflammatory interlukines that involved in wound healing. The goal of this study was to investigate the effect of 790-805nm diode laser on the expression of IL_1 ? during wound healing in mice. Materials and Methods: Standard-sized wounds (1.5cm) were carried out in the face of 96 white albino mice. Half of them underwent LLLT treatment (360 J/cm 2) at 790-805 nm delivered immediately after wound pro

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Publication Date
Mon Mar 13 2017
Journal Name
Journal Of Baghdad College Of Dentistry
Buccal Cortical Bone Thickness in Iraqi Arab Adults by Cone Beam Computed Tomography for Orthodontic Mini-Implants
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ABSTRACT Background: Cortical bone thickness is important for the stability of mini implants. Placing mini implants in sites of favorable cortical bone thickness would guarantee better initial stability and long-term success. The aim of this study was to investigate gender, side and jaw differences of the buccal cortical bone thickness as a guide for orthodontic mini screw placement. Materials and Methods: The sample was selected from the patients attending the Specialized Health Center in Al-Sadr City / 3D department. Thirty patients (15 males and 15 females) were selected and cone beam computerized tomographic images were done. Then the buccal cortical bone thickness was measured at thirteen inter radicular sites in the maxilla and mandib

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Publication Date
Wed Dec 14 2016
Journal Name
Journal Of Baghdad College Of Dentistry
Clinical and Sonographic Changes of Parotid Gland in Patients with Type I and Type II Diabetes Mellitus and Its Effect on Physical Properties of Saliva
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Background: Sialosis described as a specific consequence of diabetes. In diabetic sialosis, the increased volume of the glands is due to the infiltration of adipose in the parenchyma. The B-scan ultrasonography is a generally accepted tool for determining parotid gland enlargement. Oral health is, to a greater extent, dependent on quality and quantity of saliva, both of which may be altered in diabetics. This study was established to detect the enlargement of parotid gland in diabetic patient and study the changes in physical properties of saliva and its relation with the salivary gland enlargement. Subjects, Materials and Methods: A cross-sectional study with highly specified criteria with ages ranged (20-65) years, male and female subject

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Publication Date
Thu Dec 04 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Root resorption and anti-dentine antibody level in serum and saliva of well-controlled type ? diabetic patients undergoing orthodontic treatment
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Background: Diabetic mellitus type ? is a metabolic disorder of diverse etiological factors, characterized by hyperglycemia resulting from an absolute deficiency of insulin affected childhood and adolescent. Some of these patients seek an orthodontic care .The orthodontist who is treating these medically compromised patients should have a working knowledge of the multitude of medically complex problems. This information will support and enable for delivery of high standards of dental care in general and orthodontic care in particular. The aim of this study was to analyze serum IgG levels and salivary secretory IgA (sIgA) levels in human dentine extract (HDE) before (T0) and 6 months after (T6) orthodontic treatment and to correlate anti-HDE

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Publication Date
Thu Dec 04 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Beta angle in a sample of Iraqi adults with Class I skeletal and dental relations and its correlation with other craniofacial measurements
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Background: This study aimed to determine the value of Beta angle for a sample of Iraqi adults with class I skeletal and dental relations and to verify the existence of sexual dimorphism and to find out the relation between this angle and other craniofacial measurements. Materials and Methods: Sixty dental students (23 males and 37 females) with an age ranged between 20-31 years old and having class I skeletal and dental relations were chosen for this study. Each student was subjected to clinical examination and digital true lateral cephalometric radiograph. The radiographs were analyzed using AutoCAD 2007 computer program to measure the angular and linear variables. Descriptive statistics were obtained for the measurements for both genders

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Publication Date
Thu Dec 04 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Computed tomographic measurement of maxillary sinus volume and dimension in correlation to the age and gender (comparative study among individuals with dentate and edentulous maxilla)
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Background : Although development and progress in various diagnostic methods, but still identification of remnants of skeletal and decomposing parts of human is one of the most difficult skills in forensic medicine . Gender and age estimation is also considering an important problem in the identification of unknown skull. The aims of study: To estimate volume and dimension of maxillary sinus in individuals with dentate and edentulous maxillae using CT scan, and to correlate the maxillary sinus volume in relation to gender and age. Materials and Methods : This study included 120 patients ranged from (40-69 years), divided into two groups, dentate group with fully dentate maxilla and edentulous group with complete edentulous maxilla, and e

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Publication Date
Sun Dec 15 2019
Journal Name
Journal Of Baghdad College Of Dentistry
Evaluation of Crestal Bone Resorption around Dental Implants in Flapped and Flapless Surgical Techniques Depending on Cone Beam CT Scan (Comparative Study)
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Background: The long term survival of dental implants is evaluated by the amount of crestal bone loss around the implants. Some initial loss of bone around dental implants is generally expected. There is reason to believe that reflecting a mucoperiosteal flap promotes crestal bone loss in the initial phase after an implant has been inserted. The surgical placement of a dental implant fixture is constantly changing and in recent years, there has been some interest in developing techniques that minimize the invasive nature of the procedure, with flapless implant surgery being advocated. The purpose of this study was to compare the radiographic level of the peri- implant bone after implant placement between traditional flapped surgery and f

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Publication Date
Thu Dec 04 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Risk Factors of Oral Cancer and Potentially malignant disorders (PMDs) – Developing a High / Low Risk Profiling System
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Background: Oral squamous cell carcinoma (OSCC) remains a lethal and deforming disease, with a significant mortality and a rising incidence in younger and female patients. It is thus imperative to identify potential risk factors for OSCC and oral PMDs and to design an accurate data collection tool to try to identify patients at high risk of OSCC development. 14 factors consistently found to be associated with the pathogenesis of OSCC and oral PMDs. Eight of themwere identified as high risk (including tobacco, alcohol, betel quid, marijuana, genetic factors, age, diet and immunodeficiency) and 6 low risk (such as oral health, socioeconomic status, HPV, candida infection, alcoholic mouth wash and diabetes) were stratified according to severit

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