K Number
K021367
Manufacturer
Date Cleared
2002-05-16

(16 days)

Product Code
Regulation Number
872.3060
Panel
Dental
Reference & Predicate Devices
N/A
Predicate For
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

Precious alloy for use in Crown and Bridge dental restorations.

Device Description

Sterngold 66 is a White Crown and Bridge Alloy.

AI/ML Overview

This is a traditional 510(k) submission for a dental alloy, not an AI/ML device. Therefore, the requested information regarding acceptance criteria, study design, expert involvement, and ground truth for an AI/ML device is not available in the provided documents.

The submission focuses on demonstrating substantial equivalence to predicate dental alloys based on material properties and intended use. The "Safety and Performance" section states:

"This submission is a 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) s] for Dental Alloys)."

This indicates that the "acceptance criteria" for a dental alloy would relate to its physical, chemical, and biological properties (e.g., biocompatibility, corrosion resistance, mechanical strength) as defined in relevant consensus standards or FDA guidance documents for dental alloys, rather than performance metrics for an AI/ML algorithm. The "study" would involve material testing to show these properties meet established benchmarks or are comparable to predicate devices.

Since the provided information is for a physical medical device (dental alloy), AI/ML-specific questions like sample size for test/training sets, data provenance, number/qualifications of experts for ground truth, adjudication methods, MRMC studies, or standalone algorithm performance are not applicable.

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K021367

April 15, 2002
Sterngold 66

510(k) Summary

MAY 1 6 2002

Pursuant to 512(i)(3)(A) of the Food, Drug and Cosmetic Act, Sterngold is required on story the this Premarket Pursuant to 312(1)(3)(A) of the Food, Drag and Ossinfornition respecting safety and effectives or state that Notitication either an " ...adequale summalled responsible submit and of the safety and effectiveness information. The summary is as follows:

Trade Name:

Sterngold 66

Sponsor:

Sterngold 23 Frank Mossberg Drive P.O. Box 2967 Attleboro, MA 02703-0967 Registration #2921595

Dental Alloy Device Generic Name:

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
Symphony(k) 923714Jelenko
Select White(k) 895070Leach & Dillon
Palliag NF III(k) 883036Degussa Dental

Product Description:

Sterngold 66 is a White Crown and Bridge Alloy.

Indications for Use:

Precious alloy for use in Crown and Bridge dental restorations.

Safety and Performance:

This submission is a 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) s] for Dental Alloys).

Conclusion:

Based on the indications for use, technological characteristics, and comparison to predicate devices, Stemgold 66 has been shown to be safe and effective for its intended use.

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DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/1/Picture/1 description: The image shows the seal of the Department of Health & Human Services (HHS). The seal features the department's name encircling a symbol. The symbol consists of a stylized caduceus, with three lines representing the branches of government and two intertwined snakes representing medicine and public health.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

MAY 1 6 2002

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

Re: K021367

Trade/Device Name: Sterngold 66 Regulation Number: 872.3060 Regulation Name: Gold-Based Alloys and Precious Metal Alloys for Clinical Use Regulatory Class: Class II Product Code: EJS Dated: April 15, 2002 Received: April 30, 2002

Dear Ms. Rao:

We have reviewed your Section 510(k) premarket notification of intent to market the device wo nave rollowed your end 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 mendments, 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 approvisions of the Act. The general controls provisions of the Act include controls providers 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 (1 1/2 ), is and 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.

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Page 2 - Ms. Maria Rao

Please be advised that FDA's issuance of a substantial equivalence determination does not mean Please be advised that FDA's issuance of a subscribe only in the requirements of the Act
that FDA has made a determination that your device and other requirements. You must that FDA has made a determination inal your diviser of other Federal agencies. You must
or any Federal statutes and regulations administered by one limited to: registration or any Federal statutes and regulations administered by registration and listing (21
comply with all the Act's requirements, including, but not ice registration and isting (2 comply with all the Act's requirements, including, out its arequirements as set
CFR Part 807); labeling (21 CFR Part 801); good manufacturing practice requirements as set CFR Part 807); labeling (21 CFR Patt 801); good manufacture, prix familicable, the electronic
forth in the quality systems (QS) regulation (21 CFR Part 820); and 11 ftPR 1000 forth in the quality systems (QS) regulation (21 OF RT Carver, 21 CFR 1000-1050.
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)
I has begally and the first of a line of a leater tal equivalence of your device This letter will allow you to begin market as uses as assesses of your device to a legally
premarket notification. The FDA finding of substantial equive and this nermits yo premarket notification. The PDA Induig of substantal equivation on thus, permits your device to proceed to the market.

If you desire specific advice for your device on our labeling regulation (21 CPR Part 801 and If you desire specific advice for your device on on stice devices), please contact the Office of
additionally 21 CFR Part 809.10 for in the same services on the remomotion an additionally 21 CFR Part 809.10 for mile unserver constion and advertising of
Compliance at (301) 594-4613. Additionally, for questions on the promotion and advertising of Compliance at (301) 594-4613. Additionally, for questics of 994-4639. Also, please note the your device, please contact the Office of Companse and ification" (21CFR Part 807.97).
regulation entitled, "Misbranding by reference to premise at may be obtained from the regulation entitled, "Misoranding by receited or pronder the Act may be obtained from the Other general information on your responsional and Consumer Assistance at its toll-free number Division of Small 11001) 443-6597 or at its Internet address (800) 056-2014 11:12:14 gov/cdrh/dsma/dsmamain.html

Sincerely yours,

Patacio Cucenite /fo

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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Sterngold Sterngold
510(k) Premarket Notification - Abbreviated

of Page

510(k) Number (if known): K021367

Device Name: Sterngold 66

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) OR

Over-the -Counter Use

Sven Rump

(Division Sign-Off) (Division Sign-Only)
Division of Dental, Infection Control, Division of Dentrol, رائيري والعمل المعادل المعمل مع . Kumber -

§ 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.