K Number
K955050

Validate with FDA (Live)

Manufacturer
Date Cleared
1996-03-07

(125 days)

Product Code
Regulation Number
872.6080
Panel
Dental
Reference & Predicate Devices
N/A
Predicate For
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

Cavity Preparation Removal of decayed and sound tooth structure Removal of restoration materials Prep for pit and fissure sealant Modification of enamel and dentin for increased bond strength

Device Description

The Jetstream System is a pneumatic device which combines pressurized air and aluminum oxide powder to produce a high velocity stream of particles to perform dental restorative procedures, including preparation for pit and fissure sealant and composite restorations. The Jetstream is capable of removing dental caries, old composite restoration materials, as well as healthy enamel and dentin to prepare the tooth surface for subsequent adhesion of restorative materials. The abrasive particulate is delivered via a small handpiece which is approximately the size of a highspeed dental drill. The Jetstream consists of a console, handpiece, and a footswitch. Specifications for the Jetstream System are provided in the table below. The console houses the system pneumatics, simple, easy to use controls, and canisters for holding the particulate supply. The system is designed for easy service and maintenance with easily accessed and refillable canisters for the particulate supply.

AI/ML Overview

This document does not contain the information requested for acceptance criteria and study details.

The provided text is a "Summary of Safety and Effectiveness Information" (a 510(k) premarket notification) for a dental device called the "Jetstream Cavity Preparation System." This type of document is used to demonstrate substantial equivalence to existing devices, not to present a detailed study proving the device meets specific acceptance criteria in the way you've described.

Here's why the information is missing:

  • Acceptance Criteria/Performance Table: The document provides a comparison table of features between the Jetstream and predicate devices, but this is a comparison of specifications, not a table of pre-defined acceptance criteria (e.g., sensitivity, specificity, accuracy, precision) and the performance of the device against those criteria.
  • Study Details (Sample Size, Ground Truth, Experts, Adjudication, MRMC, Standalone): The document explicitly states: "As of September 1995, Dove Systems, Inc. conducted a database search of the published literature to identify adverse use experience with cavity preparation systems. This literature review revealed the following adverse event experience with cavity preparation systems." This indicates a literature review was performed for adverse events, not a dedicated study to assess the Jetstream's performance against specific metrics. There is no mention of a test set, training set, ground truth establishment, expert involvement, or any form of a comparative effectiveness study.
  • Training Set Sample Size/Ground Truth: Not applicable as no specific study of the device's diagnostic or performance metrics is described.

Instead, the document focuses on demonstrating substantial equivalence to existing, legally marketed predicate devices by comparing technical specifications (e.g., cutting material, velocity settings, operating modes) and noting similar indications for use and adverse event profiles. The conclusion is based on this comparison, not on a new clinical performance study.

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K953050

MAR - 7 1996

Appendix V Summary of Safety and Effectiveness Information

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Section 510(k) Premarket Notification

Summary of Safety and Effectiveness Information

Requlatory Authority: Safe Medical Devices Act of 1990, 21 CFR 807.92

Company Name:

Dove Systems, Inc. 4280 Higuera Road San Jose, CA 94328 (408) 223-2418

Company Contact Requlatory Affairs:

Arthur Vassiliadis, Ph.D. Dove Systems, Inc. 4280 Higuera Road San Jose, CA 94328 (408) 223-2418

Device Name:

Jetstream Cavity Preparation System.

Predicate Devices:

KCP 2000 Cavity Preparation System (American Dental Laser, Trov, Michigan) Microprep Cavity Preparation System (Sunrise Technologies, Inc.) Kv-1 Cavity Preparation System (Kreativ, Inc.)

Device Description:

The Jetstream System is a pneumatic device which combines pressurized air and aluminum oxide powder to produce a high velocity stream of particles to perform dental restorative procedures, including preparation for pit and fissure sealant and composite restorations .

The Jetstream is capable of removing dental caries, old composite restoration materials, as well as healthy enamel and dentin to prepare the tooth surface for subsequent adhesion of restorative materials. The abrasive particulate is delivered via a small handpiece which is approximately the size of a highspeed dental drill.

The Jetstream consists of a console, handpiece, and a footswitch. Specifications for the Jetstream System are provided in the table below. The console houses the system pneumatics, simple, easy to use controls, and canisters for holding the particulate supply. The system is designed for easy service and maintenance with easily accessed and refillable canisters for the particulate supply.

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Comparison With Predicate Device:

FEATUREJetstreamMicroprepKv-1KCP 2000SE?
Cutting materialAluminum OxidePowder 50µ particlesAluminum OxidePowder 50µ particlesAluminum OxidePowder 27µ & 50µparticlesAluminum OxidePowder 27µ & 50µparticlesYes
Velocity settingsContinuously Variable40-120 psiContinuously Variable80-120 psiContinuouslyVariable 40-120 psiSlow, Medium, High(40-120-140) psiYes
Delivery mediumCompressed Air - WallsourceCompressed Air -Internal CompressorCompressed Air -Wall sourceCompressed Air -Wall sourceYes
Operating modesPulse & ContinuousPulse & ContinuousPulse & ContinuousContinuous OnlyYes
EvacuationOther EvacuatorProprietary -"Quickevac"Other EvacuatorBuilt InYes
Electrical100-240V, 50/60 Hz110-220-240V 50/60 Hz100-240V, 50/60 Hz110VYes
ControlsTouch Pad MembraneSwitchesTouch Pad MembraneSwitchesTouch PadMembrane SwitchesTouch PadMembrane SwitchesYes
Delivery systemHandpiecesHandpiecesHandpiecesHandpiecesYes
IndicationsCavity PreparationRemoval of decayedand sound toothstructureRemoval of restorationmaterialsPrep for pit and fissuresealantModification of enameland dentin forincreased bondstrengthCavity PreparationRemoval of decayedand sound toothstructureRemoval of restorationmaterialsPrep for pit and fissuresealantModification of enameland dentin for increasedbond strengthCavity PreparationRemoval of decayedand sound toothstructureRemoval ofrestoration materialsPrep for pit andfissure sealantModification ofenamel and dentin forincreased bondstrengthCavity PreparationRemoval ofdecayed and soundtooth structureRemoval ofrestoration materialsPrep for pit andfissure sealantModification ofenamel and dentinfor increased bondstrengthYes
K-NumberPendingK932997K940776K921748Yes

Summary of Adverse Product Experience:

As of September 1995, Dove Systems, Inc. conducted a database search of the published literature to identify adverse use experience with cavity preparation systems. This literature review revealed the following adverse event experience with cavity preparation systems.

  • Cutting of adjacent soft tissue. 1.
  • Subcutaneous injection of air and/or air and abrasive particles. 2.
  • Etching of adjacent tooth surface. 3.
  • Reduced effect on existing gold or amalgam restorations ব .
    1. Infection

Additional Information

A bibliography of selected articles is available from Dove Systems, Inc. upon request.

Conclusions:

3

Based on the comparison of the technical specifications of the Jetstream Cavity Preparation System with the KCP 2000 Kinetic Cavity Preparation System, the Microprep Cavity Preparation System, and with the Kv-1 Cavity Preparation System, the company concludes that the Jetstream Cavity Preparation System is substantially equivalent. Dove Systems, Inc. believes that the Jetstream Cavity Preparation System may reasonably be expected to be safe and effective when used according to its labeling by properly trained individuals. The adverse events identified with the use of the Jetstream are the same or similar to the adverse events associated with the use of the referenced equivalent devices.

§ 872.6080 Airbrush.

(a)
Identification. An airbrush is an AC-powered device intended for use in conjunction with articulation paper. The device uses air-driven particles to roughen the surfaces of dental restorations. Uneven areas of the restorations are then identified by use of articulation paper.(b)
Classification. Class II. The special control for this device is International Electrotechnical Commission's IEC 60601-1-AM2 (1995-03), Amendment 2, “Medical Electrical Equipment—Part 1: General Requirements for Safety.”