Purpose To develop and test a complex model that captures the individuals’ general well-being and the specific oral-health-related well-being. We were specifically interested, as a specific research question, if self-esteem, dental fear, and the oral health-related well-being are credible predictors for the general well-being. Patients and methods A one-time associative research design measured dental-specific anxiety, self-esteem, oral-health-related specific well-being, and general well-being in 281 participants, 3rd and 6th year dental students ( M Age =22.59 years, SD Age =3.13; 55% females), which completed a battery of relevant questionnaires: the Dental Fear Survey, the Rosenberg Self-Image Scale, the short form of Oral Health Impact Profile, and the Flourishing Scale. The data were subject to structural equation modeling in order to validate potential pathways of influence hypothesized based on previous evidence from the literature. Results We developed and tested a complex structural equations model, in which dental fear influences both the specific oral-health-related well-being and the persons’ self-esteem. In turn, self-esteem mediates the influence pathways between dental fear and oral-health-specific well-being, on the one hand, and the overall well-being, on the other hand. Conclusion Our research contributes directly to strengthening the theoretical basis for future interdisciplinary research, by providing, first, a tested and replicable model that surpasses the simple correlation or prediction, and second, empirical evidence for the significant mutual interdependence between psychological experiences, eg, self-esteem, and the two main aspects of well-being, ie, specific and general. From a practical, clinical viewpoint, our research provides further insights and justification for the importance of educating the patient, on all levels, from the individual clinical practice to community programs and public oral health policies, with respect to the importance of oral health.

PurposeThe purpose of this study was to develop and test a moderated mediation model that was able to describe the relationships between oral health-related attitudes and behaviors, oral health status (OHS), and oral health-related quality of life. The hypothesized relations corresponded to research questions such as “is a person’s oral health predicted by the actions that person takes in order to prevent oral health conditions?” and “do individuals with better oral health also have higher levels of oral health-related quality of life?”.Materials and methodsA cross-sectional correlational study with selected predictor variables was conducted in Cluj-Napoca, Romania, among 191 participants, enrolled in the fourth and sixth years of study at the Dentistry School of the Medicine and Pharmacology, University of Cluj-Napoca. Participants completed the Hiroshima University Dental Behavior Inventory (HUDBI) questionnaire targeting specific behavior and attitude with respect to their dental self-care, Oral Health Impact Profile (OHIP) short questionnaire for measuring oral health-related quality of life, and the current OHS was assessed objectively using Decayed, Missing, Filled Teeth/Surfaces (DMFT) index. Statistical analyses were done using structural equation modeling software.ResultsOur research showed relevant associations between HUDBI, DMFT, and OHIP. The relationship between HUDBI and OHIP was mediated by DMFT. Furthermore, HUDBI worked as a moderator between DMFT and OHIP. Thus, our study revealed a case for moderated mediation, which is usually ignored in similar research.ConclusionThe “straightforward” causality between oral health-related behavior and the actual OHS must be considered with caution, as well as their impact on the oral health-related quality of life. Further research is needed to investigate the interaction between variables, the strength of the interrelations and the magnitude of their interactions, and the confidence that can be placed in these measurements, with respect to the general population and/or those lacking domain-specific education.

Ceramic materials are constantly evolving, achieving good functionality and aesthetics. Bonding to ceramics may be difficult because of high toxicity procedures and risk of surface damage. The review aims to answer several research questions: Is there a golden standard for bonding to ceramic? Are there adhesives or types of photopolymerization lamps that produce a higher bond strength on certain types of ceramics rather than others? Articles focusing on the bonding process of orthodontic attachments to ceramic surfaces searched in Pubmed, Medline and Embase, published between 1990 and 2018 were revised. Exclusions concerned bonding to non-ceramic surfaces, bonding to ceramic surfaces that are not destined for orthodontics or laser usage. Forty-nine articles that matched the inclusion criteria were researched. The following categories of original research articles were compared and discussed: metallic brackets bonding to ceramic surfaces, ceramic brackets to ceramic surfaces, bonding to new types of ceramics, such as zirconia, lithium disilicate, different photopolymerisation devices used on bonding to ceramics. Some types of adhesive may achieve minimal bond strength (6-8 MPa) even on glazed ceramic. Ceramic surface preparation may be done by sandblasting or hydrofluoric acid (60s application and 9.6%) with generally similar results. Studies rarely show any statistical difference and there are reduced number of samples in most studies. Ceramic brackets show better adhesion to ceramic surfaces and the same bonding protocol is advised. A higher bond strength may lead to ceramic surface. Few studies focus on newer types of ceramics; additional research is necessary. There is no clear evidence that a certain type of photopolymerization device produces higher shear bond strength values.