Dental Tribune United Kingdom Edition

page 27DTß treatment procedures that maximise preservation of healthy tissue. 4 “Evidence-Based Ap- proach” — selection of materials and equipment must be based on science. 5 “Keep in Touch” — focus more on regular maintenance, timely repair and strict evalu- ation, which should be under- stood by the patient. As Dr Koirala says, they are simple guidelines to accommo- date every treatment in a dy- namic protocol because science constantly changes. “A good protocol should incorporate changes based on scientific evidence,” he contin- ues. “The philosophical part may be the most difficult be- cause it’s subjective, which is why we give a questionnaire to the patient whereby he de- cides what he wants. We give him the science and inform him about the technique, but he decides what type of aesthetics he wants.” High-quality materials When Koirala published his MiCD protocol in 2009 he not only gained a following among dentists, but also the respect of high-quality dental manufacturers. “I met with Mr Patrick Loke,” Koirala says referring to Shofu’s Asia-Pacific Marketing Direc- tor, “who told me he liked the concept of MiCD because his company is concerned with the health of the patient, and with developing bio-aesthetic prod- ucts in dentistry.” In Shofu he seems to have met his match and you can de- tect his dedication and convic- tion when he says, “I’m very happy using Giomers (a bio- aesthetic restorative material), so much so that it inspired me to write a book,” he adds referring to a new type of restorative materials whose name is a hybrid of the words “glass ionomer” and “compos- ite.” Koirala is now conducting long-term clinical trials using various dental materials, with a focus on the MiCD protocol and its acceptance as a way to ac- complish clinical results. He believes he has developed a concept that is good for the patient, good for the dentist, and good for society. The MiCD protocol is in its preliminary stage worldwide, but the con- ferences he gave in South East Asia and South Asia have been widely accepted. “This is the right time to come out with this new philosophy”, he explains, “so that in four or five years a new generation can start talking about the preservation of health in the long run.” Non-Invasive Health The medical sciences are mov- ing towards non-invasive pro- cedures, and adequate ways of health promotion to avoid oral diseases. In dentistry, however, minimally invasive procedures are being used routinely only in caries management. “In the medical sciences it is inherent not to cut tissue,” Koirala continues. “If patients knew that to place a crown you need to cut the tooth’s enamel, they probably would not accept the treatment.” “You need to start at an early age, like six or severn, in order to detect various smile defects like orthodontic problems,” Koi- rala says. “Everything that can affect oral health, including cos- metics, should be thought at an early age.” “Dentists may use MiCD or not,” Koira- la adds, “but they all agree it’s the right approach. I want to encourage everybody to join the MiCD mis- sion. Our MiCD Global Network (a web-based organisation) is a group of dedi- cated professionals who wish to im- prove the knowl- edge of the clini- cian and the patient. Information technology can help promote these ideas through networks of den- tists, people, and like-minded companies. We need to change our mind-set.” Koirala plans to change the mind-set through more inter- national lectures, collaborating with like-minded clinicians and academicians, creating study clubs to exchange knowledge, and providing internet-based educational seminars. “We are changing protocols for the health of the patient, and ultimately, dentists will win too, because it saves time on procedures and provides aes- thetics and function. The type of material used is secondary to me, as long as it preserves health, a harmonious function (the force component), and pro- motes aesthetics. We are not promoting a company here, but promoting health. And that is our first responsibility as clini- cians. It is something that can be the pride of the profession.” Resources • MiCD Website: www.MiCDg- lobalnetwork.org • MiCD Protocol in “Cosmet- ic Dentistry”: www.dental- tribune.com/articles/content/ id/1749/scope/specialities/re- gion/international SIDEBAR 1 Preserving Health, Enhanc- ing Smiles Patients today are much more educated and demanding re- garding dental treatments. Amalgam is a perfect example. A high-percentage of patients demand not to have amalgam fillings for cavities, but request a tooth-colour material. In the past, a restoration with amal- gam required cutting a lot of tissue, but the new direct tooth- coloured restorative materials cause less damage to the tooth and providebetter aesthetics. “Many patients are now go- ing for direct aesthetics res- torations, non-prep veneers, minimal tooth preparation indi- rect restorations, and mini-im- plants, which are less invasive,” says says Patrick Loke, Shofu’s General Marketing Manager for Asia Pacific. “The trend is grow- ing.” The goal now is achieving good aesthetics with minimal- ly invasive treatment with the support of MiCD instruments and bio-aesthetics material,” adds Loke. “We are the official partner of the MiCD movement, Loke adds, which motto is ‘Preserv- ing Health Enhancing Smiles.’ “We are fully committed to sup- port their educational events for both public and dental profes- sionals, such as workshops, lec- tures and symposia.” Shofu’s advanced restorative materials use S-PRG Technol- ogy (Surface Pre-Reacted Glass ‘In the past, a restoration with amalgam required cutting a lot of tissue, but the new direct tooth-coloured restorative materials cause less damage to the tooth and provide- better aesthetics’ 2-step, self- etching, radiopaque, fluoride releasing adhesive system that provides an excellent bond to both enamel and dentin with a secure marginal seal This advanced second-generation material is a Giomer ideal for anterior and posterior restorations. The developer of the MiCD protocol during the interview with Dental Tribune March 28-April 3, 201128 Clinical United Kingdom Edition