K Number
K030036
Device Name
TRIPLE-CURE PASTE/PASTE RESIN-REINFORCED GLASS IONOMER CEMENT
Date Cleared
2003-03-12

(68 days)

Product Code
Regulation Number
872.3750
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
PULPDENT Triple-Cure™ Paste / Paste Resin-Reinforced Glass lonomer Cement is used to adhere orthodontic brackets and bands to teeth, to cement metallic restorations and as a base and liner under restorations. It combines the advantages of a glass ionomer cement with the added strength of dental resin technology. Triple-Cure™ Paste is a fluoride-releasing, light-cure, self-cure, glass ionomer dental cement in two paste form. It is not recommended for post cementation or veneer cementation.
Device Description
PULPDENT Triple-Cure™ Paste / Paste Resin-Reinforced Glass Ionomer Cement is used to adhere orthodontic brackets and bands to teeth, to cement metallic restorations and as a base and liner under restorations. It combines the advantages of a glass ionomer cement with the added strength of dental resin technology. Triple-Cure™ Paste / Paste is a fluoride-releasing, light-cure, self-cure, glass ionomer dental cement in two paste form. It is not recommended for post cementation or veneer cementation.
More Information

Not Found

Not Found

No
The description focuses on the material properties and intended uses of a dental cement, with no mention of AI or ML capabilities.

No
The device is a dental cement used for adhesion of dental devices like orthodontic brackets and bands or restorations, which is a functional purpose, not a therapeutic one aimed at treating a disease or condition.

No
This device is a dental cement used for adhesion and cementation, not for diagnosis.

No

The device description clearly states it is a "Paste / Paste Resin-Reinforced Glass Ionomer Cement," 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 clearly states that the device is a dental cement used to adhere materials to teeth and as a base/liner under restorations. This is a direct application within the body (in vivo), not a test performed on samples taken from the body (in vitro).
  • Device Description: The description reinforces its use as a dental cement for direct application to teeth.
  • Lack of Diagnostic Purpose: There is no mention of the device being used to diagnose, monitor, or treat a disease or condition based on the analysis of biological samples.

IVD devices are typically used to perform tests on samples like blood, urine, tissue, etc., to provide information for diagnosis, monitoring, or treatment decisions. This dental cement does not fit that description.

N/A

Intended Use / Indications for Use

PULPDENT Triple-Cure™ Paste / Paste Resin-Reinforced Glass Ionomer Cement is used to adhere orthodontic brackets and bands to teeth, to cement metallic restorations and as a base and liner under restorations. It combines the advantages of a glass ionomer cement with the added strength of dental resin technology. Triple-Cure™ Paste is a fluoride-releasing, light-cure, self-cure, glass ionomer dental cement in two paste form. It is not recommended for post cementation or veneer cementation.

Product codes

DYH, EMA

Device Description

PULPDENT Triple-Cure™ Paste / Paste Resin-Reinforced Glass Ionomer Cement is used to adhere orthodontic brackets and bands to teeth, to cement metallic restorations and as a base and liner under restorations. It combines the advantages of a glass ionomer cement with the added strength of dental resin technology. Triple-Cure™ Paste / Paste is a fluoride-releasing, light-cure, self-cure, glass ionomer dental cement in two paste form. It is not recommended for post cementation or veneer cementation.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

teeth

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)

According to the NIH Technology Assessment Conference on Effects and Side-Effects of Dental Restorative Materials: "General usage of these materials over about 20 years indicates a high benefitto-risk ratio...both composites and glass ionomers are relatively trouble-free. There is no evidence of short-term or long-term risk...There is no suspicion of any problems after virtually billions of procedures in the United States. In addition, the predicate products listed above have been given 510 (k) premarket approval as Class II Dental Devices under CFR 872.3750.

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

Not Found

Predicate Device(s)

Pulpdent Triple-Cure™ Reinforced Glass Ionomer Orthodontic Cement, GC Fuji Ortho LC (light-cure), GC Fuji Ortho Self-cure, Pulpdent Band-Rite

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 872.3750 Bracket adhesive resin and tooth conditioner.

(a)
Identification. A bracket adhesive resin and tooth conditioner is a device composed of an adhesive compound, such as polymethylmethacrylate, intended to cement an orthodontic bracket to a tooth surface.(b)
Classification. Class II.

0

Pulpdent Triple-Cure™ Paste/Paste Resin Reinforced Glass Ionomer Cement

EXHIBIT 2

2030036

SUMMARY OF SAFETY AND EFFECTIVENESS DATA

MAR 1 2 2003

Kenneth J. Berk 80 Oakland Street PO Box 780 Watertown. MA 02472 USA Telephone: Fax:

617-926-6666 617-926-6262

DEVICE

Trade Name: PULPDENT Triple-Cure™ Paste / Paste Resin-Reinforced Glass Ionomer Cement Classification Name: Adhesive, Bracket and Tooth Conditioner, Resin FDA Product Code: DYH, 21 CFR Part 872.3750

PREDICATE DEVICES

Pulpdent Triple-Cure™ Reinforced Glass Ionomer Orthodontic Cement GC Fuji Ortho LC (light-cure) GC Fuji Ortho Self-cure Pulpdent Band-Rite

DESCRIPTION AND INTENDED USE

PULPDENT Triple-Cure™ Paste / Paste Resin-Reinforced Glass Ionomer Cement is used to adhere orthodontic brackets and bands to teeth, to cement metallic restorations and as a base and liner under restorations. It combines the advantages of a glass ionomer cement with the added strength of dental resin technology. Triple-Cure™ Paste / Paste is a fluoride-releasing, light-cure, self-cure, glass ionomer dental cement in two paste form. It is not recommended for post cementation or veneer cementation.

COMPARISON WITH PREDICATE PRODUCTS:

PULPDENT Triple Cure Paste / Paste is substantially equivalent in composition and intended use to the predicate products listed above. Please see Exhibit 4 for the entire comparison.

SAFETY AND EFFECTIVENESS:

According to the NIH Technology Assessment Conference on Effects and Side-Effects of Dental Restorative Materials: "General usage of these materials over about 20 years indicates a high benefitto-risk ratio...both composites and glass ionomers are relatively trouble-free. There is no evidence of short-term or long-term risk...There is no suspicion of any problems after virtually billions of procedures in the United States. In addition, the predicate products listed above have been given 510 (k) premarket approval as Class II Dental Devices under CFR 872.3750.

1

Image /page/1/Picture/11 description: The image is a black and white seal for the Department of Health & Human Services - USA. The seal is circular with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" arranged around the top half of the circle. In the center of the seal is a stylized image of three human profiles facing to the right, with flowing lines connecting them.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

MAR 1 2 2003

Mr. Kenneth J. Berk Director Pulpdent Corporation 80 Oakland Street Watertown, Massachusetts 02472

Re: K030036

Trade/Device Name: Pulpdent Triple-Cure™ Paste/Paste Resin Reinforced, Glass Ionomer Cement Regulation Number: 21 CFR 872.3750 Regulation Name: Bracket Adhesive Resin and Tooth Conditioner Regulatory Class: II Product Codes: DYH and EMA Dated: December 27, 2002 Received: January 03, 2003

Dear Mr. Berk:

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 - Mr. Kenneth J. Berk

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. 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), 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) you may obtain. 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,

Susan Roaner

Susan Runner, DDS, MA Interim Director Division of Anesthesiology, General Hospital, Infection Control and Dental Devices Office of Device Evaluation Center for Devices and Radiological Health

3

INDICATIONS FOR USE STATEMENT

K030036

510 (k) Number (if known)

Triple-Cure™ Paste/Paste Resin-Reinforced Glass Ionomer Cement Device Name

Indications for Use:

PULPDENT Triple-Cure™ Paste / Paste Resin-Reinforced Glass lonomer Cement is used to adhere orthodontic brackets and bands to teeth, to cement metallic restorations and as a base and liner under restorations. It combines the advantages of a glass ionomer cement with the added strength of dental resin technology. Triple-Cure™ Paste is a fluoride-releasing, light-cure, self-cure, glass ionomer dental cement in two paste form. It is not recommended for post cementation or veneer cementation.

Please do not write below this line. Continue on another page if needed.

Concurrence of CDRH, Office of Device Evaluation (ODE)

Prescription UseXorOver-The-Counter Use
(Per 21 CFR 801.109)

Keim Muly for MSR

(Division Sign-Off)

Division of Anesthesiology, General Hospital,

Infection Control, Dental Devices

510(k) Number:K030036
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