MITOS®

SIMPLIFIED MULTISYSTEM INDIVIDUALIZED ORTHODONTIC TREATMENT

POSTULATES

1. use of a total orthodontic treatment philosophy, both in diagnosis and

treatment planning, with a three-dimensional and systematic access,
methodologically analysed in a transverse, vertical, sagital and time basis.

2. implementing a personalised service

2.1. operation “patient appreciation”
2.2. operation “good looking”
2.3. operation “patient coordinator”
2.4. operation “be a star in your office!”
2.5. operation “keep and maintain good facilities”

3. development of a qualified reception of the patients through a wise

management
3.1. management focused on the orthodontic patient
3.1.1. respect for the main complaint/reason for appointment
3.1.2. maximum attention while conducting the patient when:
3.1.2.1.admitted
3.1.2.2.conducted
3.1.2.3.examined
3.1.2.4.studied
3.1.2.5.informed
3.1.2.6.hold responsible
3.1.2.7.prepared
3.1.2.8.placing devices
3.1.2.9.instructed
3.1.2.10.motivated
3.1.2.11.controlled
3.1.2.12.repaired
3.1.2.13.compared
3.1.2.14.ended
3.1.2.15.retained
3.1.2.16.re-evaluated
3.2. management of human resources
3.2.1. developing the team work (“team spirit”)
3.2.1.1.increase ways of relating one another
3.2.1.2.active participation in all predefined aims
3.2.1.3.periodic and planned meetings of the working team
3.2.1.4.continuous assignment and holding responsibility of tasks
3.2.2. training and continuous education
3.2.2.1.say what to do
3.2.2.2.show how to do it
3.2.2.3.perform
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3.2.2.4.evaluate
3.2.2.5.delegate or re-direct
3.2.2.6.praise
3.3. management towards profitability (controlled practice)
3.3.1. win the profession’s paradigms
3.3.2. increase marketing techniques (respect for deontology)
3.3.3. standardization, creating written protocols for every clinical act and
service
3.3.4. control the acceptance index
3.3.5. Informatics integrated system according to the treatment’s global
philosophy
3.3.6. Permanent statistic control
3.3.6.1.excellent management of appointments
3.3.6.2.
3.3.6.3.initial
3.3.6.4.informative
3.3.6.5.early data
3.3.6.6.appliance
3.3.6.7.instruction and hygiene
3.3.6.8.control
3.3.6.9.motivation
3.3.6.10.repair
3.3.6.11.evaluation
3.3.6.12.final
3.3.6.13.post-retention

4. Implementing excellence in communication

4.1. value target appointments

4.2. controlled use of image
4.2.1. permanent offer of image
4.2.2. on screen
4.2.3. educational guide
4.2.4. internet
4.3. written responsibility of the clinical acts
4.4. informed consent
4.4.1. implementing an orthodontic conversation
4.4.2. periodic reports
4.4.3. interprofessional communication

5. Accepting that the orthodontic normal is individual

5.1. respect for the patients individuality

5.2. value the parental analysis
5.3. differentiate between normal deviation and the pathologic
5.4. respect for the shape of the individual dental arch
5.4.1. anatomical and type determination
5.5. cult for the intercanine distance

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6. The case study starts from the craniofacial analysis to the facial
morphovolumetric study

6.1. from the outside to the inside and from the whole to the part
6.2. being clinically more conservative within the unfavourable volumetric
components
6.3. being clinically less conservative within the favourable volumetric
components
6.4. facial harmony dictates the clinical orthodontic action

7. Diagnosis according to the severity of the anomaly

7.1. the level of severity and the type of the malocclusion dictate the
complexity of the data needed for diagnosis

8. The analysis of the diagnosis step by step

8.1. the main complaint
8.2. the main problem
8.3. the aesthetic problem
8.4. the functional problem
8.5. the dental problem
8.6. the bony problem

9. Speed when elaborating the informatic clinical diagnosis based on the

orthodontic examination

10. Usage of the morphovolumetric facial analysis in the treatment’s

prospective visualization

10.1. reference orthogonal system vertically constructed by basion

11. Clinical metric multifactorial determination of therapeutic decisions

11.1. treatment / non-treatment

11.2. orthodontic treatment / multidisciplinary treatment
11.3. treatment with extractions / treatment without extractions
11.4. treatment with interproximal stripping
11.5. orthodontic treatment / surgical orthognatic treatment
11.6. phased treatment

12. Prognosis based on the quantification of the anomaly and type of

decided treatment

13. The regulated objectiveness of treatment

13.1. facial aesthetics

13.2. dental aesthetics
13.3. functional occlusion

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13.4. periodontal health

13.5. stability of the results

14. The treatment’s systematic planning

14.1. main complaint

14.2. main problem
14.3. aesthetic problem
14.4. functional problem
14.5. dental problem
14.6. osseous problem

15. Early treatment as part of the clinical practice

15.1. posterior cross bite

15.2. open bite due to the persistency of anterior swallowing or succional
habits
15.3. severe Class II with large traumatic probability to the upper anterior teeth
15.4. Classes III, mainly in the retromaxilia cases
15.5. anterior cross bite without incisive guidance
15.6. severe crowding when associated to a facial aesthetics which demands
a non-extraction treatment

16. Multidimensional calculus of the beginning and of the treatment’s time

16.1. biological age

16.2. dental age
16.3. clinical age
16.4. type of anomaly to be treated

17. The application of efficiency systems and mechanical simplification

17.1. reduce the dependence from the orthodontist

17.1.1.less repairing and urgent consultation
17.1.2.less consultations per treatment
17.1.3.bigger time spaces between consultations
17.1.4. non dependent devices of the patient’s cooperation
17.2. increasing the prevision of results

18. Correction of the malocclusion in a progressive sequence

18.1. the occlusal construction from the ideal three-dimensional position of the
maxillary incisor
18.2. definition of the occlusal aesthetic plane
18.3. systematic relation between the anchorage needs and the segmental
treatment of the arch
18.4. control of the upper teeth torque since the beginning of the treatment
18.5. construction of the lower teeth adaptative torque

19. Rationalizing the retention

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19.1. the meaning of over treatment

19.2. using Fibrotomy
19.3. the respect for the mandible intercanine distance
19.4. studying the problem of third molars
19.5. criterious and automatic selection of the retention devices according to
the treated malocclusion
19.6. estimation of the retention time based on the initial anomaly
19.7. immediate retention after removal of the devices

20. Self-evaluation as a way of encouraging the system sustainability and

levels of excellence

20.1. evaluating the clinical efficiency

20.1.1.short time
20.1.2.long time
20.2. evaluation of profitability

CONTACTS:

Afonso Pinhão Ferreira, DDS, PhD

Faculty of Dentistry – University of Porto
Rua Dr. Manuel Pereira da Silva
4200-393 Porto
Portugal
aferreira@fmd.up.pt
http://www.fmd.up.pt

Ortopovoa – Clínica de ortodontia da Póvoa de Varzim, Lda.

Rua Visconde de Azevedo, n.º 2 R/C
4490-589 Povoa de Varzim - Portugal
pinhaoferreira@mail.telepac.pt
http://www.ortopovoa.pt