K Number
K014252
Device Name
JETSTREAM
Manufacturer
Date Cleared
2002-02-19

(55 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

The JETSTREAM airpolishing unit is intended to be used to remove stubborn stains, plaque and soft debris. Device applications: Routine polishing especially hard to reach areas, polishing prior to enamel etching and bonding techniques and prior to bonding orthodontic bands and brackets

Device Description

JETSTREAM airpolishing unit

AI/ML Overview

This document is a 510(k) clearance letter from the FDA for a dental device called "JetStream". It does not contain information regarding an acceptance criteria study or performance data, sample sizes, expert qualifications, or ground truth establishment for an AI or imaging device. The letter primarily states that the device is substantially equivalent to legally marketed predicate devices and can be marketed.

Therefore, I cannot provide the requested information based on the input document. The document is not related to the type of study described in the prompt.

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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 is a circular seal with the words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter. Inside the circle is an abstract image of an eagle.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

FEB 1 9 2002

Mr. Alan Edel Deldent Limited 19 Keren Kayemet Street Petach Tikvah, ISRAEL

Re: K014252

Trade/Device Name: JetStream Regulation Number: 872.6080 Regulation Name: AirPolishing Unit Regulatory Class: II Product Code: KOJ Dated: November 27, 2001 Received: December 26, 2001

Dear Mr. Edel

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.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to such additional controls. Existing major regulations affecting vour 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.

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Page 2 - Mr. Edel

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); good manufacturing practice requirements as set forth in the quality systems (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 510(k) premarket notification. The FDA finding of substantial equivalence of your device to a legally marketed predicate device 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 and additionally 21 CFR Part 809.10 for in vitro diagnostic devices), please contact the Office of Compliance at (301) 594-4613 . Additionally, for questions on the promotion and advertising of your device, please contact the Office of Compliance at (301) 594-4639. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). Other general information on your responsibilities under the Act may be obtained from the Division of Small Manufacturers, International and Consumer Assistance at 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,

Tim M. A. Hultquist

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

Enclosure

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LABELING

Page 1 of 1

川华S2 2

510(k) Number (if known): ____________________________________________________________________________________________________________________________________________________

Device Name: ____ JETSTREAM_

Indications for Use:

The JETSTREAM airpolishing unit is intended to be used to remove stubborn stains, plaque and soft debris.

Device applications: Routine polishing especially hard to reach areas, polishing prior to enamel etching and bonding techniques and prior to bonding orthodontic bands and brackets

(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 CFR801.109)

OR

Over-The-Counter Use (Optional Format 1-2-96)

Sugar Plum

"Thision Sign-Off) Ision of Dental, Infection Control, ି ଆଧାରୀ Hospital Devices Number_ KOJLIJAS

§ 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.”