K Number
K013237
Device Name
STATUSBLUE
Manufacturer
Date Cleared
2001-10-22

(24 days)

Product Code
Regulation Number
872.3660
Panel
DE
Reference & Predicate Devices
Predicate For
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

StatusBlue is indicated for use as a dental impression material in the following applications:

  • Situation impressions of any kind;
  • Impressions for the preparation of provisionals;
  • Impressions for orthodontic models;
  • Impressions of the opposing jaw;
  • Impressions for the manufacture of model cast dentures
Device Description

The StatusBlue dental impression material is a dimensionally stable polyvinyl siloxane material designed as an alternative to alginate impression materials. It will be supplied in prefilled, ready-to-use MixStar cartridges. StatusBlue is intended for use in commercially available impression trays.

AI/ML Overview

The provided text states: "Substantial equivalence for this device was based solely on design and technical specifications; no performance or safety data was included in this premarket notification." Therefore, the document does not contain information about acceptance criteria or a study proving the device meets them.

§ 872.3660 Impression material.

(a)
Identification. Impression material is a device composed of materials such as alginate or polysulfide intended to be placed on a preformed impression tray and used to reproduce the structure of a patient's teeth and gums. The device is intended to provide models for study and for production of restorative prosthetic devices, such as gold inlays and dentures.(b)
Classification. Class II (Special Controls).