K Number
K163088
Device Name
TSIII BA Fixture
Date Cleared
2017-04-21

(168 days)

Product Code
Regulation Number
872.3640
Panel
Dental
Reference & Predicate Devices
Predicate For
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

TSIII BA Fixture is indicated for use in partially or fully edentulous mandibles and maxillae, in support of single or multiple-units restorations including; cemented retained, screw retained, or overdenture restorations, and final or temporary abutment support for fixed bridgework. It is intended for delayed loading.

Device Description

TSIII BA Fixture has features of single threads, internal hex connection, taper body, and BA surface treatment. TSIII BA Fixture System is permanent dental implant made with Pure Titanium Grade 4 (ASTMF67-06). The proposed device is sandblasted, acid etched, coated with calcium phosphate by immersing and then finally coated with hydrophilic materials (glucose and NaCl with saline concentrations). Intended to be surgically placed in the bone of the upper or lower jaw arches. Fixture is supplied sterile.

AI/ML Overview

This document is a 510(k) premarket notification for a medical device called the "TSIII BA Fixture," which is an endosseous dental implant. This type of submission focuses on demonstrating "substantial equivalence" to a legally marketed predicate device, rather than providing extensive clinical study data with specific acceptance criteria and performance metrics in the way a PMA (Premarket Approval) submission would.

Therefore, the requested information regarding detailed acceptance criteria, a study proving the device meets those criteria, sample sizes for test/training sets, expert qualifications, adjudication methods, MRMC studies, standalone performance, and ground truth definitions is largely not present in this document because it is not typically required for a 510(k) submission that relies on substantial equivalence.

Based on the provided text, here's what can be extracted and inferred:

1. A table of acceptance criteria and the reported device performance

The document does not provide a table with quantitative acceptance criteria (e.g., specific thresholds for success/failure rates, stress values, etc.) that the device must meet, nor does it present "reported device performance" in terms of clinical outcomes or performance metrics from a dedicated study. Instead, the device's characteristics are compared to those of predicate devices to establish substantial equivalence.

The table below summarizes the comparison points for substantial equivalence:

Feature/TestAcceptance Criteria (Implied by Substantial Equivalence)Reported Device Performance (Comparison to Predicates)
BiocompatibilityMaterials and manufacturing processes must be biologically safe, equivalent to predicate devices."Biocompatibility testing on the TSIII BA Fixture was previously conducted. As the material of construction and manufacturing processes are the same as the predicate device, ETIII Bio-SA Fixture (K151626) exactly. Therefore, no additional testing is required to support the biological safety of the subject devices."
Sterilization Validation (Radiation)Must achieve a Sterility Assurance Level (SAL) of $10^{-6}$. Minimum dose 25 kGy. Packaging must maintain sterility for shelf life and be stable under radiation."The substantiated 25 kGy sterilization dose for $10^{-6}$ SAL is accepted as the bioburden of 1.000 cfu/unit & the verification test performed by the verification dose is met the acceptance criteria. In accordance with ISO11137 VDmax 25, therefore allows use of minimum dose 25 kGy as a routine sterilizing dose. The results of the evaluation on the material stability show that the packaging materials was inherently less affected by radiation in the maximum acceptable dose 40 kGy."
LAL Testing (Endotoxin)Must meet established endotoxin limits (Guidance Document: "Submission and Review of Sterility Information...")."LAL testing of the subject device and information per the FDA Guidance Document..." (Implicitly, the testing met the requirements, as no issues were raised.)
Surface Treatment CharacterizationSurface treatment (BA surface) must be identical to the predicate device (ETIII Bio-SA Fixture). Manufacturing and surface treatment processes must be unchanged."TSIII BA Fixture has BA... surface treatment that is exactly same with the predicate devices, ETIII Bio-SA Fixture (K151626). There has been no change to the manufacturing or surface treatment processes since then; therefore, additional characterization testing is not required."
Fatigue TestMaterial, shape, and dimension (excluding surface treatment) must be identical to the relevant predicate (TS Fixture System)."TSIII BA Fixture is exactly same with predicate, TS Fixture System, K121995 in material, shape and dimension except surface treatment. Therefore additional Fatigue testing is not required."
Indication for UseMust be substantially equivalent to predicates."Indication for use of subject device is almost same with Predicate devices." (Detail provided in the table on page 4).
Design Features (Threads, Taper, Connection)Must be same as predicate ETIII Bio-SA Fixture System (K151626)."Same with ETIII Bio-SA Fixture System (K151626)" (listed as Single Thread, Taper body Type, Self tapping, Submerged fixture).
Raw MaterialMust be same as predicate ETIII Bio-SA Fixture System (K151626), Pure Titanium Grade 4 (ASTM F67-06)."Same with ETIII Bio-SA Fixture System (K151626)" (listed as Pure Titanium Grade 4 (ASTM F67-06)).
Shelf LifeMust demonstrate a 5-year shelf life, validated according to ASTM F1980."Validation for the packaging was conducted on the TS Fixture System (K121995) according to ASTM F1980 by accelerated aging and validated a 5 year shelf life. No additional shelf-life validation was performed on the subject device." (Implies the subject device shares this validated shelf life due to identical packaging.)
Overall Substantial Equivalence (S.E.)The subject device should be almost identical in shape, dimension, intended use, technological characteristics, principles of operation, connection structure, and material to the primary predicate, such that any differences do not raise new questions of safety or effectiveness."Subject devise, TSIII BA Fixture is almost same with Primary Predicate, ETIII Bio-SA Fixture in shape, dimension, intended for use and they have same Technological Characteristics, principles of operation, same connection structure and material And subject device and Primary predicate device. Although manufacturer of Primary predicate is different from subject device, all subject device and predicate devices are designed by OSSTEM R&D Center. Therefore, TSIII BA Fixture is substantially equivalent to the predicate devices."

2. Sample size used for the test set and the data provenance (e.g. country of origin of the data, retrospective or prospective)

  • Sample Size for Test Set: Not applicable/not explicitly stated in the context of clinical or performance testing on the subject device. The document states "No clinical studies are submitted." Nonclinical tests were primarily based on equivalence to predicate devices, not on new testing of a "test set" of the subject device in the way a clinical trial would. For sterilization, bioburden was 1.000 cfu/unit; for packaging validation, the predicate device was tested.
  • Data Provenance: The document does not specify data provenance in terms of country of origin for any "test set" data for the subject device, as most testing was waived or referenced predicate devices.

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts (e.g. radiologist with 10 years of experience)

Not applicable. No clinical or performance studies requiring ground truth from experts for a "test set" of the subject device were submitted.

4. Adjudication method (e.g. 2+1, 3+1, none) for the test set

Not applicable. No studies requiring adjudication by experts were submitted.

5. If a multi reader multi case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance

Not applicable. This device is a dental implant, not an AI-assisted diagnostic tool.

6. If a standalone (i.e. algorithm only without human-in-the loop performance) was done

Not applicable. This device is a dental implant, not an AI algorithm.

7. The type of ground truth used (expert consensus, pathology, outcomes data, etc)

Not applicable. No new clinical or performance studies requiring ground truth for the subject device were submitted. The basis for approval is substantial equivalence to legally marketed devices, verified through nonclinical tests where applicable (e.g., sterilization dose verification, biocompatibility, LAL testing, material and design comparisons).

8. The sample size for the training set

Not applicable. This is not an AI/machine learning device.

9. How the ground truth for the training set was established

Not applicable. This is not an AI/machine learning device.

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Image /page/0/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a circular seal with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" arranged around the perimeter. Inside the circle is a stylized image of three human profiles facing right, layered on top of each other, creating a sense of depth and unity.

Food and Drug Administration 10903 New Hampshire Avenue Document Control Center - WO66-G609 Silver Spring, MD 20993-0002

April 21, 2017

Osstem Implant Co., Ltd. c/o Mr. David Kim Manager Hiossen Inc. 85 Ben Fairless Dr. Fairless Hills. Pennsylvania 19030

Re: K163088

Trade/Device Name: TSIII BA Fixture Regulation Number: 21 CFR 872.3640 Regulation Name: Endosseous Dental Implant Regulatory Class: Class II Product Code: DZE Dated: March 21, 2017 Received: March 21, 2017

Dear David Kim:

We have reviewed your Section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food, Drug, and Cosmetic Act (Act) that do not require approval of a premarket approval application (PMA). You may, therefore, market the device, subject to the general controls provisions of the Act. The general controls provisions of the Act include requirements for annual registration. listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you, however, that device labeling must be truthful and not misleading.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.

Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencies. You must comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); medical device reporting (reporting of medical devicerelated adverse events) (21 CFR 803); good manufacturing practice requirements as set forth in

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the quality systems (OS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please contact the Division of Industry and Consumer Education at its toll-free number (800) 638-2041 or (301) 796-7100 or at its Internet address

http://www.fda.gov/MedicalDevices/ResourcesforYou/Industry/default.htm. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to

http://www.fda.gov/MedicalDevices/Safety/ReportaProblem/default.htm for the CDRH's Office of Surveillance and Biometrics/Division of Postmarket Surveillance.

You may obtain other general information on your responsibilities under the Act from the Division of Industry and Consumer Education at its toll-free number (800) 638-2041 or (301) 796-7100 or at its Internet address

http://www.fda.gov/MedicalDevices/ResourcesforYou/Industry/default.htm.

Sincerely.

Michael J. Ryan -S

for Tina Kiang, Ph.D. Acting Director Division of Anesthesiology, General Hospital, Respiratory, Infection Control, and Dental Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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Image /page/2/Picture/1 description: The image shows the logo and contact information for OSSTEM Implant Co., Ltd. The logo includes the company name in bold, black font, with the word "OSSTEM" in a stylized orange font to the left. Below the company name is the address: 66-16, Bansong-ro 513beon-gil, Haeundae-gu, Busan, Republic of Korea. The image also includes the telephone number: +82 51 850-2500, fax number: +82 51 850-4341 and website: www.osstem.com.

Indications for Use Statement

Indications for Use

510(k) Number ______________________________________________________________________________________________________________________________________________________________________________

Device Name: TSIII BA Fixture

Indication for Use:

TSIII BA Fixture is indicated for use in partially or fully edentulous mandibles and maxillae, in support of single or multiple-units restorations including; cemented retained, screw retained, or overdenture restorations, and final or temporary abutment support for fixed bridgework. It is intended for delayed loading.

Prescription Use X (Per 21CFR801 Subpart D) OR Over-The-Counter Use (Per 21CFR807 Subpart C)

(PLEASE DO NOT WRITE BELOW THIS LINE – CONTINUE ON ANOTHER PAGE IF NEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)

QS-QI-505-2(Rev.0)

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Image /page/3/Picture/1 description: The image contains the logo for Osstem Implant. The word "OSSTEM" is in orange, and the word "IMPLANT" is in gray. The logo is simple and modern.

'EM Implant Co., Ltd

Haeundae-gu, Busan, Republic of Korea Tel: +82 51 850-2500 Fax: +82 51 850-4341 www.osstem.com

510(k) Summary

Date: April 18, 2017

  1. Company and Correspondent making the submission:
- Submitter's Name:OSSTEM Implant Co., Ltd.
- Address:66-16, Bansong-ro 513beon-gil, Haeundae-gu, Busan, Republic of Korea
- Contact:Mr. Hee Kwon Son
- Phone:+82 51 850 2575
- Correspondent's Name:HIOSSEN Inc.
- Address:85 Ben Fairless Dr. Fairless Hills, PA 19030
- Contact:DAVID KIM
- Phone:267 759 7031
    1. Device:
      Trade or (Proprietary) Name : TSIII BA Fixture Common or usual name : Dental Implant Classification Name : Endosseous Dental Implant Regulation Number : 21CFR872.3640 Device Classification: Class || Product Code: DZE
    1. Predicate Device:
      Primary Predicate K151626, ETIII Bio-A Fixture System, HIOSSEN Inc.

Reference predicate K121995, TS Fixture System, OSSTEM Implant Co., Ltd.

    1. Device Description:
      (1) Design Features (Same with ETIII Bio-SA Fixture System (K151626)) TSIII BA Fixture has features of single threads, internal hex connection, taper body, and BA surface treatment.

(2) Raw material used (Same with ETIII Bio-SA Fixture System (K151626)) TSIII BA Fixture System is permanent dental implant made with Pure Titanium Grade 4 (ASTMF67-06).

QS-QI-505-3(Rev.0)

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Image /page/4/Picture/1 description: The image shows the logo for Osstem Implant. The logo is orange and gray. The word "OSSTEM" is in orange, and the word "IMPLANT" is in gray.

OSSTEM Implant Co., Ltd.

66-16, Bansong-ro 513beon-gil, Haeundae-gu, Busan, Republic of Korea Tel: +82 51 850-2500 Fax: +82 51 850-4341 www.osstem.com

(3) BA Surface treatment (Same with ETIII Bio-SA Fixture System (K151626)) The proposed device is sandblasted, acid etched, coated with calcium phosphate by immersing and then finally coated with hydrophilic materials (glucose and NaCl with saline concentrations). Surface treatment of TSIII BA Fixture is exactly same with ETIII Bio-SA Fixture System (K151626) in Surface treatment method and material, etc.

The proposed device, TSIII BA Fixture System is substantially equivalent to commercially and legally available medical devices (ETIII Bio-SA Fixture System (K151626)) based on the intended use, the technology used, the claims, the material used and performance characteristics.

DeviceDescriptionIntended to be surgically placed in the bone of the upper or lower jaw arches. Fixture is supplied sterile.
MaterialPure Titanium (ASTM F 67)
SurfaceBA surface treatment
Diameter (mm)Length (mm)
3.778.5
3.7510.0, 11.5, 13.0
4.257.0, 8.5
4.010.0, 11.5, 13.0
Dimension4.657.0
4.638.5
4.610.0, 11.5, 13.0
5.16.2, 7.0
5.088.5
5.0510.0, 11.5, 13.0
  • TSIII BA Fixture

- Substantial Equivalence Matrix

Primary PredicateReference predicateSummary ofdifference
TSIII BA FixtureETIII Bio-SAFixtureTS Fixture System(TSIII SA Fixture &TSIII SA Ultra WideFixture)
510(K) No.New DeviceK151626K121995-
ManufacturerOSSTEM ImplantCo., Ltd.HIOSSEN Inc.OSSTEM ImplantCo., Ltd.Same withReferencepredicate
Indication foruseTSIII BA Fixture isindicated for use inpartially or fullyedentulousmandibles andmaxillae, in supportof single orThe ETIII Bio-SAFixture System isindicated for use inpartially or fullyedentulousmandibles andmaxillae. in supportIndication foruse of subjectdevice isalmost samewith Predicatedevices
multiple-unitsrestorationsincluding; cementedretained, screwretained, oroverdenturerestorations, andfinal or temporaryabutment support forfixed bridgework. Itis intended fordelayed loading.of single or multiple-unit restorationsincluding ;cementedretained, screwretained, or over-denture restorations,and terminal orintermediate abut-ment support forfixed bridgework.The ETIII Bio-SAFixture System isfor single and twostage surgical pro-cedures. It isintended for delayedloading.The TS FixtureSystem is indicatedfor use in partially orfully edentulousmandibles andmaxillae, in supportof single or multiple-unit restorationsincluding; cementedretained, screwretained, oroverdenturerestorations, andfinal or temporaryabutment support forfixed bridgework. Itis intended fordelayed loading. TSFixture System iscompatible withabutment in theET/SS ImplantSystem.
Surgery typeOne or two stageSurgeryOne or two stageSurgeryOne or two stageSurgerySame
Structure-Single Thread-Taper body Type-Self tapping-Submerged fixture-Single Thread-Taper body Type-Self tapping-Submerged fixture-Single Thread-Taper body Type-Self tapping-Submerged fixtureSame
Body Diameter(D) (mm)3.75, 3.77, 4.2, 4.25,4.6, 4.63, 4.65, 5.05,5.08, 5.13.75, 3.77, 4.25, 4.64.65, 4.63, 5.05,5.08, 5.13.75, 3.77, 4.2, 4.25,4.6, 4.63, 4.65, 5.05,5.08, 5.1, 6, 5.95,5.92, 6.8Same withReferencepredicate
Length (mm)7.0, 8.0, 8.5, 9.5,10.0, 11.0, 11.5,12.5, 13.07.2 , 8.7, 10.2, 11.7,13.2, 15.27.0, 8.0, 8.5, 9.5,10.0, 11.0, 11.5,12.5, 13.0, 15.0,
Material ofFixturePure Titanium Grade4 (ASTM F67)Pure Titanium Grade4 (ASTM F67)Pure Titanium Grade4 (ASTM F67)Same
Tel: +82 51 850-2500 Fax: +82 51 850-4341 www.osstem.com
SurfaceTSIII BA Fixture issandblasted, acidetched, coated withcalcium phosphateby immersing andthen finally coatedETIII Bio-SAFixture System issandblasted, acidetched, coated withcalcium phosphateby immersing andSA (Sandblasting andAcid etching, treated.)Same withPrimaryPredicate

QS-QI-505-3(Rev.0)

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K163088

Image /page/5/Picture/1 description: The image shows the logo for Osstem Implant. The word "OSSTEM" is written in orange, with a small degree symbol next to it. Below that, the word "IMPLANT" is written in gray.

OSSTEM Implant Co., Ltd.

OSSTEM Implant Co., Ltd.
66-16, Bansong-ro 513beon-gil, Haeunda-gu, Busan, Republic of Korea
Tel: +82 51 850-2500 Fax: +82 51 850-4341 www.osstem.com

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Image /page/6/Picture/0 description: The image shows the logo for Osstem Implant. The logo is orange and gray. The word "OSSTEM" is in orange, and the word "IMPLANT" is in gray. There is a small orange circle in the upper right corner of the logo.

EM Implant Co.

Haeundae-gu, Busan, Republic of Korea Bansong-ro 513beon

K163088

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Image /page/7/Picture/0 description: The image shows the logo for Osstem Implant. The logo is orange and features the word "OSSTEM" in a bold, sans-serif font. Below the word "OSSTEM" is the word "IMPLANT" in a smaller, sans-serif font. To the right of the word "OSSTEM" is a small, raised circle.

EM Implant Co., L

Haeundae-on Busan Republic of +82 51 850-2500 Fax: +82 51 850-4341 www.osstem.com

with hydrophilicmaterials (glucoseand NaCl with salineconcentrations)then finally coatedwith hydrophilicmaterials (glucoseand NaCl with salineconcentrations)
SterilizationRadiation SterileRadiation SterileRadiation SterileSame
Shelf life5years5years8yearsSame withPrimaryPredicate
S ES.ESubject devise, TSIII BA Fixture is almost same with Primary Predicate, ETIII Bio-SA Fixture in shape, dimension, intended for use and they have same TechnologicalCharacteristics, principles of operation, same connection structure and material Andsubject device and Primary predicate device.Although manufacturer of Primary predicate is different from subject device, allsubject device and predicate devices are designed by OSSTEM R&D Center.Therefore, TSIII BA Fixture is substantially equivalent to the predicate devices.

5. Indication for use

TSIII BA Fixture is indicated for use in partially or fully edentulous mandibles and maxillae, in support of single or multiple-units restorations including; cemented retained, screw retained, or overdenture restorations, and final or temporary abutment support for fixed bridgework. It is intended for delayed loading.

6. Summary of nonclinical testing

The following nonclinical testing data were provided or relied upon in support of the Substantial equivalence determination.

Biocompatibility

Biocompatibility testing on the TSIII BA Fixture was previously conducted. As the material of construction and manufacturing processes are the same as the predicate device, ETIII Bio-SA Fixture (K151626) exactly.

Therefore, no additional testing is required to support the biological safety of the subject devices.

Sterilization validation

The sterilization validation of the dental implant (TSIII BA Fixture) was carried out according to the protocol relating to the requirements described in ISO 11137-2:2006. The substantiated 25 kGy sterilization dose for 106 SAL is accepted as the bioburden of 1.000 cfu/unit & the verification test performed by the verification dose is met the acceptance criteria. In accordance with ISO11137 VDmax 25, therefore allows use of minimum dose 25 kGy as a routine sterilizing dose.

The results of the evaluation on the material stability show that the packaging materials was

QS-QI-505-3(Rev.0)

{8}------------------------------------------------

Image /page/8/Picture/1 description: The image contains the logo for Osstem Implant. The word "OSSTEM" is written in orange, with a small circle above the "M". Below the word "OSSTEM" is the word "IMPLANT" written in gray. The logo is simple and modern.

TEM Implant Co., Lt

Haeundae-gu. Busan. Republic of Korea +82 51 850-2500 Fax: +82 51 850-4341 www.osstem.com

inherently less affected by radiation in the maximum acceptable dose 40 kGy.

The packaging is the same as the predicate. Validation for the packaging was conducted on the TS Fixture System (K121995) according to ASTM F1980 by accelerated aging and validated a 5 year shelf life. No additional shelf-life validation was performed on the subject device.

LAL Testing

LAL testing of the subject device and information per the FDA Guidance Document entitled, "Submission and Review of Sterility Information in Premarket Notification (510(k)) Submissions for Devices Labeled as Sterile," issued January 21, 2016.

Surface treatment characterization testing

TSIII BA Fixture has BA (sandblasted, acid etched, coated with calcium phosphate by immersing and then finally coated with hydrophilic materials (glucose and NaCl with saline concentrations)) surface treatment that is exactly same with the predicate devices, ETIII Bio-SA Fixture (K151626). There has been no change to the manufacturing or surface treatment processes since then; therefore, additional characterization testing is not required.

Fatigue test

TSIII BA Fixture is exactly same with predicate, TS Fixture System, K121995 in material, shape and dimension except surface treatment. Therefore additional Fatigue testing is not required.

    1. Summary of clinical testing No clinical studies are submitted

8. Conclusions

In accordance with the Federal Food, Drug and Cosmetic Act, 21 CFR Part 807, and based on the information provided in this premarket notification Osstem Implant Co., Ltd. concludes that the TSIII BA Fixture is substantially equivalent to the predicate devices as described herein.

§ 872.3640 Endosseous dental implant.

(a)
Identification. An endosseous dental implant is a prescription device made of a material such as titanium or titanium alloy that is intended to be surgically placed in the bone of the upper or lower jaw arches to provide support for prosthetic devices, such as artificial teeth, in order to restore a patient's chewing function.(b)
Classification. (1) Class II (special controls). The device is classified as class II if it is a root-form endosseous dental implant. The root-form endosseous dental implant is characterized by four geometrically distinct types: Basket, screw, solid cylinder, and hollow cylinder. The guidance document entitled “Class II Special Controls Guidance Document: Root-Form Endosseous Dental Implants and Endosseous Dental Implant Abutments” will serve as the special control. (See § 872.1(e) for the availability of this guidance document.)(2)
Classification. Class II (special controls). The device is classified as class II if it is a blade-form endosseous dental implant. The special controls for this device are:(i) The design characteristics of the device must ensure that the geometry and material composition are consistent with the intended use;
(ii) Mechanical performance (fatigue) testing under simulated physiological conditions to demonstrate maximum load (endurance limit) when the device is subjected to compressive and shear loads;
(iii) Corrosion testing under simulated physiological conditions to demonstrate corrosion potential of each metal or alloy, couple potential for an assembled dissimilar metal implant system, and corrosion rate for an assembled dissimilar metal implant system;
(iv) The device must be demonstrated to be biocompatible;
(v) Sterility testing must demonstrate the sterility of the device;
(vi) Performance testing to evaluate the compatibility of the device in a magnetic resonance (MR) environment;
(vii) Labeling must include a clear description of the technological features, how the device should be used in patients, detailed surgical protocol and restoration procedures, relevant precautions and warnings based on the clinical use of the device, and qualifications and training requirements for device users including technicians and clinicians;
(viii) Patient labeling must contain a description of how the device works, how the device is placed, how the patient needs to care for the implant, possible adverse events and how to report any complications; and
(ix) Documented clinical experience must demonstrate safe and effective use and capture any adverse events observed during clinical use.