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RETRACTED: Paladugu et al. Liraglutide Has Anti-Inflammatory and Anti-Amyloid Properties in Streptozotocin-Induced and 5xFAD Mouse Models of Alzheimer's Disease. Int. J. Mol. Sci. 2021, 22, 860.

Authors: Paladugu L, Gharaibeh A, Kolli N, Learman C, Hall TC, Li L, Rossignol J, Maiti P, Dunbar GL
Journal: International journal of molecular sciences
mental health psychology open access

Abstract

People living with dementia represent a growing and particularly vulnerable group with substantial unmet oral health needs [-]. Poor oral health in people living with dementia is associated with pain, impaired mastication, malnutrition, social withdrawal, and increased systemic risks, with the highest burden observed among care-dependent individuals [-]. Providing dental care for people living with dementia is frequently complicated by fluctuating cooperation, communication difficulties, behavioral symptoms, reduced tolerance to sensory stimuli, and limited ability to understand or endure sustained intraoral manipulation [,]. These challenges are particularly relevant in hospital or bedside settings, where patients may be medically frail, cognitively impaired, and unable to tolerate prolonged or continuous dental procedures. As a result, even basic intraoral assessment or prosthodontic procedures may become burdensome, delayed, incomplete, or omitted []. Conventional impression procedures can be especially challenging in this context because they require tray insertion, sustained mouth opening, tolerance of intraoral material during setting, and continuous cooperation until removal [,]. Intraoral scanning (IOS) has emerged as a digital alternative to conventional impressions and offers several potential advantages, including improved comfort, reduced gag reflex, shorter or comparable procedure times, and the ability to interrupt and resume data acquisition according to patient tolerance [,]. These characteristics may be particularly relevant for people living with dementia, not primarily because of the technological novelty of IOS, but because the procedure can be performed stepwise, adapted to the patient’s momentary cooperation, and interrupted when signs of distress occur. In patients with reduced cooperation or limited tolerance for intraoral procedures, the ability to pause, redirect, and resume may represent a clinically meaningful advantage over procedures that require continuous completion once initiated. Recent work in nursing home residents has shown that intraoral 3D scans can be used for diagnostic evaluations in long-term care settings, supporting the potential relevance of scan-based oral assessment in older and care-dependent populations []. Evidence from pediatric teledentistry and special care dentistry further suggests that digital intraoral data acquisition may support documentation, remote assessment, and care planning in selected populations [,]. More broadly, teledentistry has been discussed as a strategy to improve access to oral health care, although evidence quality, implementation context, and patient selection remain important considerations []. However, evidence from these populations cannot be directly transferred to hospitalized people living with dementia, whose ability to cooperate may fluctuate within minutes and whose distress responses may require immediate procedural adaptation. Therefore, the central question in dementia care is not whether IOS is generally more comfortable than conventional impressions, but whether it is feasible and tolerable under real-world bedside conditions in patients with cognitive impairment and reduced procedural tolerance. Within the broader field of digital dentistry, intraoral scanners represent one component of digital technologies used to digitize oral structures and support documentation, diagnosis, treatment planning, and communication [-]. According to the FDI Policy Statement on Digital Dentistry, the overarching aim of such technologies is to improve the quality, safety, and efficiency of oral health care []. However, in the context of dementia care, the relevant question is not digitalization per se, but whether digital intraoral data acquisition can be performed with lower procedural burden in patients with reduced cooperation and limited tolerance for sustained intraoral manipulation.