K Number
K020949
Device Name
APOLLO, MODEL 1124525
Manufacturer
Date Cleared
2002-04-04

(10 days)

Product Code
Regulation Number
872.3060
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
Precious alloy for use in Crown and Bridge dental restorations.
Device Description
Apollo is a yellow Crown and Bridge Alloy.
More Information

(k)905326,(k)923720,(k)895069

Not Found

No
The summary describes a dental alloy, a material used in restorations, with no mention of software, algorithms, or any technology that would typically incorporate AI/ML. The submission type and predicate devices also point to a traditional material-based device.

No.
The device is a material (alloy) used for dental restorations, which is a structural component and not a device that administers therapy or provides a therapeutic effect.

No
Explanation: The "Intended Use / Indications for Use" states that the device is a "Precious alloy for use in Crown and Bridge dental restorations," which are materials used for repair or replacement, not for identifying a disease or condition. The "Device Description" further clarifies it as a "yellow Crown and Bridge Alloy," confirming it's a restorative material.

No

The device description clearly states it is a "yellow Crown and Bridge Alloy," which is a physical material, not software.

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

Here's why:

  • Intended Use: The intended use is "Precious alloy for use in Crown and Bridge dental restorations." This describes a material used in the body for a restorative purpose, not a test performed on a sample taken from the body to diagnose a condition.
  • Device Description: The description "Apollo is a yellow Crown and Bridge Alloy" further reinforces that it's a material for dental restorations.
  • Lack of IVD Characteristics: The document lacks any mention of typical IVD characteristics such as:
    • Analyzing samples (blood, urine, tissue, etc.)
    • Detecting or measuring substances in samples
    • Providing diagnostic information
    • Using reagents or test kits

Therefore, based on the provided text, this device is a dental material and not an In Vitro Diagnostic.

N/A

Intended Use / Indications for Use

Precious alloy for use in Crown and Bridge dental restorations.

Product codes

EJT

Device Description

Apollo is a yellow Crown and Bridge Alloy.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Not Found

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

This submission is an Special 510(k): Abbreviated 510(k) as described in FDA's guidance document entitled "The New 510(k) Paradigm - Alternate Approaches to Demonstrating Substantial Equivalence in Premarket Notifications." In support of this 510(k), Sterngold has provided information to demonstrate conformity with FDA's guidance document entitled Guidance Document for the Preparation of Premarket Notifications [510(k) 3] for Dental Alloys).

Key Metrics

Not Found

Predicate Device(s)

(k)905326, (k)923720, (k)895069

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 872.3060 Noble metal alloy.

(a)
Identification. A noble metal alloy is a device composed primarily of noble metals, such as gold, palladium, platinum, or silver, that is intended for use in the fabrication of cast or porcelain-fused-to-metal crown and bridge restorations.(b)
Classification. Class II (special controls). The special control for these devices is FDA's “Class II Special Controls Guidance Document: Dental Noble Metal Alloys.” The devices are exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 872.9. See § 872.1(e) for availability of guidance information.

0

K020949

Sterngold Special 510(k) Premarket Notification: Abbreviated 510(k)

APR = 4 2002

March 15, 2002 Apollo

510(k) Summary

Pursuant to 512(i)(3)(A) of the Food, Drug and Cosmetic Act, Sterngold is required to submit with this Premarket Notification either an " ... adequate summary of any information respecting safety and effectiveness or state that information will be made available upon request of any person." Sterngold chooses to submit a summary of the safety and effectiveness information. The summary is as follows:

Trade Name:Apollo
Sponsor:Sterngold
23 Frank Mossberg Drive
P.O. Box 2967
Attleboro, MA 02703-0967
Registration #2921595
Device Generic Name:Dental Alloy
Classification:According to Section 513 of the Federal Food, Drug, and
Cosmetic Act, the device classification is Class II.

Predicate Devices:

Alloy Name510(k)Manufactured By
Minigold(k)905326Ivoclar North America
Suncast(k)923720Jelenko
Select 40(k)895069Leach & Dillon Co.

Product Description:

Apollo is a yellow Crown and Bridge Alloy.

Indications for Use:

Precious alloy for use in Crown and Bridge dental restorations.

Safety and Performance:

This submission is an Special 510(k): Abbreviated 510(k) as described in FDA's guidance document entitled "The New 510(k) Paradigm - Alternate Approaches to Demonstrating Substantial Equivalence in Premarket Notifications." In support of this 510(k), Sterngold has provided information to demonstrate conformity with FDA's guidance document entitled Guidance Document for the Preparation of Premarket Notifications [510(k) 3] for Dental Alloys).

Conclusion:

Based on the indications for use, technological characteristics, and comparison to predicate devices, Apollo has been shown to be safe and effective for its intended use.

1

DEPARTMENT OF HEALTH & HUMAN SERVICES

Food and Drug Administration. 9200 Corporate Boulevard Rockville MD 20850

Ms. Maria Rao Quality Manager Sterngold 23 Frank Mossberg Drive Attleboro, Massachusetts 02703-0967

APR = 4 2002

Re: K020949

Trade/Device Name: Apollo Regulation Number: 872.3060 Regulation Name: Gold-Based Alloys and Precious Metal Alloys for Clinical Use Regulatory Class: Class II Product Code: EJT Dated: March 15, 2002 Received: March 25, 2002

Dear Ms. Rao:

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 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.

2

Page 2 - Ms. Rao

Please be advised that FDA's issuance of a substantial equivalence determination does not r least 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. or the recor any 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 and insting (2) see t 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,

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

Enclosure

3

Sterngold Special 510(k) Premarket Notification: Abbreviated 510(k)

Page 1 of

510(k) Number (if known):

Device Name: Apollo

Indications for Use:

Precious Alloy for use in Crown and Bridge Dental Restorations.

(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) Over-the -Counter Use __

OR

(Division Sign-Off) Division of Dental, Infection Control and General Hospital Devices 510(k) Number J