K Number
K013682
Device Name
MODIFICATION TO BASIC DENTAL IMPLANT SYSTEM
Date Cleared
2001-11-28

(21 days)

Product Code
Regulation Number
872.3640
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
The Implant for dental purposes, used to replace missing dental organs (teeth). The Implant is self-tapping (threads) and is screwed into a pilot bore formed in the jawbone. Upon healing, the Implant receives a post, which has a stem, and is adapted to carry dental suprastructures (false teeth).
Device Description
The BASIC Dental Implant is an endosseous dental implant.
More Information

Not Found

No
The summary describes a mechanical dental implant and does not mention any AI or ML components or functionalities.

Yes
The device is used to replace missing dental organs (teeth) and is implanted into the jawbone, directly addressing a health issue (missing teeth) and improving physiological function (chewing, speaking).

No
Explanation: This device is an implantable medical device used to replace missing dental organs. Its purpose is mechanical restoration, not diagnosis. It does not collect or analyze data to provide diagnostic information about a patient's condition.

No

The device description clearly states it is an "endosseous dental implant," which is a physical hardware device implanted into the jawbone.

Based on the provided information, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • Intended Use: The intended use is to replace missing dental organs by being implanted into the jawbone. This is a surgical procedure performed directly on the patient's body.
  • Device Description: The device is described as an endosseous dental implant, which is a physical object implanted into bone.
  • Lack of IVD Characteristics: IVD devices are used to examine specimens (like blood, urine, or tissue) in vitro (outside the body) to provide information about a person's health. The provided description does not mention any such use or interaction with biological specimens outside the body.

Therefore, this device falls under the category of a medical device used for surgical implantation, not an in vitro diagnostic device.

No

The provided clearance letter for the BASIC Dental Implant does not contain any language or specific sections indicating the device is authorized under a Predetermined Change Control Plan (PCCP). PCCPs are a relatively recent framework for certain types of artificial intelligence/machine learning (AI/ML)-enabled medical devices, and this device, identified as a dental implant, does not appear to incorporate AI/ML or the iterative modification capabilities that PCCPs address.

Intended Use / Indications for Use

The Implant for dental purposes, used to replace missing dental organs (teeth). The Implant is self-tapping (threads) and is screwed into a pilot bore formed in the jawbone. Upon healing, the Implant receives a post, which has a stem, and is adapted to carry dental suprastructures (false teeth).

Product codes (comma separated list FDA assigned to the subject device)

DZE

Device Description

The BASIC Dental Implant is an endosseous dental implant.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

jawbone

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Not Found

Description of the training set, sample size, data source, and annotation protocol

Not Found

Description of the test set, sample size, data source, and annotation protocol

Not Found

Summary of Performance Studies (study type, sample size, AUC, MRMC, standalone performance, key results)

None

Key Metrics (Sensitivity, Specificity, PPV, NPV, etc.)

Not Found

Predicate Device(s): If the device was cleared using the 510(k) pathway, identify the Predicate Device(s) K/DEN number used to claim substantial equivalence and list them here in a comma separated list exactly as they appear in the text. List the primary predicate first in the list.

K960868

Reference Device(s): Identify the Reference Device(s) K/DEN number and list them here in a comma separated list exactly as they appear in the text.

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information for the subject device only (e.g. presence / absence, what scope was granted / cleared under the PCCP, any restrictions, etc).

Not Found

§ 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.

0

NOV 2 8 2001

Attachment I 510(K) Summary BASIC Dental Implant System Implant

KOBESQ

This 510(K) Summary of safety and effectiveness for the BASIC Dental Implant is submitted in accordance with the requirements of the SMDA 1990 and following guidance concerning the organization and content of a 510(K) summary.

Applicant:BASIC Dental Implant Systems, Inc.
Address:3321 Columbia NE
Albuquerque, New Mexico 87107
USA
Contact Person:Dan Blacklock, Vice-President
Telephone / Fax / Email505.881.1376 - Phone
505.884.1923 - Fax
Preparation Date:October 30, 2001
Device Trade Name:BASIC Dental Implant System Implant
Common Name:Dental implant
Classification:DZE
Legally Marketed Predicate Device:BASIC Dental Implant System
K960868
Description of the Implant:The BASIC Dental Implant is an endosseous dental implant.
Intended use:The Implant for dental purposes, used to replace missing
dental organs (teeth). The Implant is self-tapping (threads)
and is screwed into a pilot bore formed in the jawbone.
Upon healing, the Implant receives a post, which has a stem,
and is adapted to carry dental suprastructures (false teeth).
Performance Data:None
Results of Clinical Study:None
Conclusion:The BASIC dental implant is substantially equivalent to
previous BASIC dental implants in commercial distribution.

1

Public Health Service

Image /page/1/Picture/2 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a circular seal with the words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" arranged around the perimeter. Inside the circle is a stylized depiction of an eagle or other bird-like figure, with its wings spread and tail feathers flowing downwards.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

NOV 2 8 2001

Mr. Dan Blacklock Vice President Basic Dental Implant Systems, Incorporated 3321 Columbia, N.E. Albuquerque, New Mexico 87107-2001

Re: K013682

R015062
Trade/Device Name: Modification To Basic Dental Implant System Regulation Number: 872.3640 Regulation Name: Dental Implant Regulatory Class: III Product Code: DZE Dated: October 30, 2001 Received: November 7, 2001

Dear Mr. Blacklock:

We have reviewed your Section 510(k) premarket notification of intent to market the device We nave reviewed your becaler of the device is substantially equivalent (for the referenced above and have determined the active is emarketed predicate devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Interstate Collinetee prior to that have been reclassified in accordance with the provisions of Amendinents, of to devices that nave oose (Act) that do not require approval of a premarket the Federal Food, Drug, and Cosment 1 10 (110) - market the device, subject to the general approval application (1 Miry) - 1 Sue general controls provisions of the Act include confors provisions of the rec. The genting of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration.

If your device is classified (see above) into either class II (Special Controls) or class III II your device is classified (see aso voy into controls. Existing major regulations affecting (PMA), it may of subject to such adament. Could Regulations, Title 21, Parts 800 to 898. In the Colors of your device can be found in the South one one ming 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 mean that I DA nas made a actes and regulations administered by other Federal agencies.

2

Page 2 - Mr. Blacklock

You must comply with all the Act's requirements, including, but not limited to: registration You must comply with an the Fict b requirements) and manufacturing practices
and listing (21 CFR Part 807); labeling (21 CFR Part 801); good manufacturing practice and listing (21 CFR Part 607), laceming (21 cms (QS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

This letter will allow you to begin marketing your device as described in your Section I hus letter will anow you to begin main the your substantial equivalence of your device to 510(K) premarket noutleated. " The results in a classification for your device and thus, permits your device to proceed to the market.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801 II you desire specific ad not 100 for in vitro diagnostic devices), please contact the and additionally 21 CFR Part 609110113. Additionally, for questions on the promotion and
Office of Compliance at (301) 594-4613. Additionally, for questions on the promotio Office of Comphanoo at (301) as contact the Office of Compliance at (301) 594-4639. advertising or your the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). Other general information on your responsibilities under nothication (210) It it a r 0779).
the Act may be obtained from the Division of Small Manufacturers, International and ull Act may be obtained in its toll-free number (800) 638-2041 or (301) 443-6597 or at its Internet address http://www.fda.gov/cdrh/dsma/dsmamain.html

Sincerely yours,

Timothy A. Ulatowski Director Division of Dental, Infection Control and General Hospital Devices Office of Device Evaluation Center for Devices and Radiological Health

3

INDICATION FOR USE STATEMENT

KO13682

510(k) Number: _______________________________________________________________________________________________________________________________________________________________

Device Name: BASIC Dental Implant System Dental Implant

Indications for Use:

The Implant for dental purposes, used to replace missing dental I ne Inipiant for dental parphant is self-tapping (threads) and is organs (tectif). The Iniptarmed in the jawbone. Upon healing, serewed into a post, which has a stem, and is adapted to carry dental suprastructures (false teeth).

(Please do not write below this line - Continue on another page if needed)

Concurrence of CDRH, Office of Device Evaluation (ODE)

Prescription Use
(per 21 CFR 801.109)

OR

Over-the-Counter Use__________________________________________________________________________________________________________________________________________________________

Susan Runno

(Division Sign-Off) -vision of Dental, Infection Control, ് r Long Number