Staff Report Loose Bands or Cemented Appliance ▫▫ After the cement has been removed from the loose band, does the band appliance fit loosely? If so, a smaller size band is indicated. ▫▫ Are proper isolation techniques consistently being used? Working in the posterior is often challenging for a single operator. Avoid shortcuts and ensure adequate isolation during cementation. ▫▫ Is the cement mixed/prepared properly? Various techniques get various results. Consistent preparation according to instruction guidelines is paramount. ▫▫ Were the bands fully lined with cement? Cement doesn't always flow exactly where you want it. Full coverage is a guarantee. ▫▫ Was the band damaged due to abuse? It is amazing how a band can be damaged due to patient neglect. In addition to placing a new band, discussing the issue with the patient and parent may prevent further occurrences. Summer 2020 PCSO Bulletin ▫▫ Has the cement cured long enough before pressure is placed? Is the cement that was used recommended for this type of appliance? Some materials need a certain amount of time to cure. Light-cure adhesive requires the four points of light-cure position. Proper procedure is always paramount. Discussion & Prevention Action Plan:____________ ___________________________________________ ___________________________________________ ___________________________________________ With any improvement strategy, knowing where you are (correct tracking) and where you want to go (reduce repairs to less than 3%) sets the stage for effective resolution of avoidable problems. Clinical "think tank" meetings, ongoing education and training, and dedication by everyone on the team to resolve these issues can result in a happier team, doctor, patients, and parents. 73