K Number
K021833
Device Name
MODIFICATION TO BLUE SKY DENTAL IMPLANT SYSTEM
Manufacturer
Date Cleared
2002-06-10

(6 days)

Product Code
Regulation Number
872.3640
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
- For Implantation into any area of the fully edentulous maxilla and mandible for the support of a removable or fixed dental prosthesis - For Implantation into any area of the partially edentulous maxilla and mandible for the support of a removable or fixed dental prosthesis - For single tooth or multiple unit prosthesis
Device Description
The modification of the Blue Sky Bio Dental Implant System consists of root form dental implants of various lengths and diameters and associated abutment systems, which provide the clinician with cement retained and overdenture-type restorative options. Modifications to the existing system do not introduce new issues of safety or efficacy. The implants and components are supplied sterile or not sterile and are labeled accordingly. The system is suitable for a one-stage and two-stage protocol. The Implant system is not intended for immediate loading.
More Information

Not Found

Not Found

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

No
The device is a dental implant system used for supporting dental prostheses, which is a restorative rather than therapeutic function.

No

Explanation: The device is described as a dental implant system used for supporting dental prostheses. Its intended use is for implantation and structural support, not for diagnosing conditions or diseases.

No

The device description explicitly states it consists of "root form dental implants of various lengths and diameters and associated abutment systems," which are physical hardware components.

No, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • IVD Definition: In Vitro Diagnostics are medical devices used to perform tests on samples taken from the human body (like blood, urine, tissue) to provide information about a person's health. These tests are performed outside of the body.
  • Device Description: The description clearly states this device is a "root form dental implant system" intended for "Implantation into any area of the fully edentulous maxilla and mandible". This is a device that is surgically placed inside the body.
  • Intended Use: The intended use is for supporting dental prostheses, which is a structural and functional purpose within the body, not for performing diagnostic tests on samples.

The information provided describes a surgical implant, not a diagnostic test performed on a sample.

N/A

Intended Use / Indications for Use

The Blue Sky Bio Dental Implant System is intended for use in either partially or fully edentulous mandibles and maxillae to give support to single or multiple units fixed dental prosthesis. It is also intended to give support to overdentures by means of o-ring abutments or bar-attachments.

  • For Implantation into any area of the fully edentulous maxilla and mandible for the support of a removable or fixed dental prosthesis
  • For Implantation into any area of the partially edentulous maxilla and mandible for the support of a removable or fixed dental prosthesis
  • For single tooth or multiple unit prosthesis

Product codes

DZE, NHA

Device Description

The modification of the Blue Sky Bio Dental Implant System consists of root form dental implants of various lengths and diameters and associated abutment systems, which provide the clinician with cement retained and overdenture-type restorative options. Modifications to the existing system do not introduce new issues of safety or efficacy. The implants and components are supplied sterile or not sterile and are labeled accordingly. The system is suitable for a one-stage and two-stage protocol. The Implant system is not intended for immediate loading.

Mentions image processing

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Mentions AI, DNN, or ML

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Input Imaging Modality

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Anatomical Site

mandibles and maxillae

Indicated Patient Age Range

Not Found

Intended User / Care Setting

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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

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

Not Found

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

Not Found

Predicate Device(s)

Not Found

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

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

JUN 1 0 2002

K021833

5455 N Sheridan Road, #3608 Chicago, IL 60640 Tel: 773-769 2622 Fax: 773-878 8884 Email: azickmann@pol.net

510(K) Summary

General Information

Classification Name:Endosseous Implant
Common Name:Prosthetic Dental Implant System
Trade Name:Blue Sky Bio Dental Implant System
Submitter's Name:Blue Sky Bio
Address:5455 N Sheridan Road, #3608
Chicago, IL 60640
Telephone:773-769 2622
Fax:773-878 8884
Contact:Dr. Albert Zickmann
Date of SummaryMay 2002

Device Description

The modification of the Blue Sky Bio Dental Implant System consists of root form dental implants of various lengths and diameters and associated abutment systems, which provide the clinician with cement retained and overdenture-type restorative options. Modifications to the existing system do not introduce new issues of safety or efficacy. The implants and components are supplied sterile or not sterile and are labeled accordingly. The system is suitable for a one-stage and two-stage protocol. The Implant system is not intended for immediate loading.

Intended Use

The Blue Sky Bio Dental Implant System is intended for use in either partially or fully edentulous mandibles and maxillae to give support to single or multiple units fixed dental prosthesis. It is also intended to give support to overdentures by means of o-ring abutments or bar-attachments.

1

Image /page/1/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo features a stylized eagle head in profile, facing left, with three curved lines representing the body and wings. The words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" are arranged in a circular pattern around the eagle.

Public Health Service

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

JUN 1 0 2002

Dr. Albert Zickmann Blue Sky Bio 5455 N. Sheridan Road, # 3608 Chicago, Illinois 60640

Re: K021833

Trade/Device Name: Blue Sky Bio Dental Implant System Regulation Number: 872.3640 Regulation Name: Endosseous Implant Regulatory Class: III Product Code: DZE and NHA Dated: May 20, 2002 Received: June 4, 2002

Dear Dr. Zickmann:

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.

2

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 A. Ulatowski

Timo Directo Division of Dental, Infection Control and General Hospital Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

3

Dr. Albert Zickmann

5455 N Shericlan Road, #3608 Chicago, IL 60640 Tel: 773-769 2622 Fax: 773-878 8884 Email: azickmann@pol.net

Indications for Use Statement

Page _ 1_ of _ 1_

510(k) Number (if Known): KO2 |833

Device Name: Blue Sky Bio Dental Implant System

Indications for Use:

  • For Implantation into any area of the fully edentulous maxilla and mandible for the support of a . removable or fixed dental prosthesis
  • For Implantation into any area of the partially edentulous maxilla and mandible for the support of ● a removable or fixed dental prosthesis
  • For single tooth or multiple unit prosthesis .

(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)
(Divis
Divis;- Stontrol,
and G
510(k) :K021833
Prescription UseOROver-The-Counter Use
(Per 21 CFR 801.109)(Optional Format 1-2-96)

| Dr. Zickmann 510(k) | Page 10
Proprietary & Confidential | May 20, 2002 |

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