K Number
K030168
Device Name
AGC CEM
Date Cleared
2003-03-21

(63 days)

Product Code
Regulation Number
872.3275
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
AGC®Cem is a dental self-curing compomer cement for the permanent cementation of AGC® SupraCaps in tertiary structures such as secondary telescopic crowns in chrome cobalt substructures, or SupraCaps in implant supraconstructions.
Device Description
AGC Cem is a dental luting material, which can be used by dental technicians to manufacture dental restorations. It is a two-component chemical (self)-curing compomer with a golden yellow color. AGC Cem is especially designed for the permanent luting of AGC SupraCaps, i.e. pure gold caps, which had been electroformed with the AGC® Galvanoforming technique, in tertiary structures to produce removable dentures. Possible uses of the AGC®Cem include luting of AGC® SupraCaps as telescopic crowns in chrome cobalt substructures and luting of AGC SupraCaps in implant supraconstructions. AGC Cem is offered in an Automix-System, that ensures automatic mixing of the two components. It generates a homogeneous material quality and allows direct application of the material. AGC Cem creates an excellent fit owing to its low film thickness and lead to high adhering strengths. Its golden yellow color provides an excellent basis to the dental technician to manufacture aesthetically pleasant dental restorations. AGC Cem fully complies to the international standard ISO 4049:2000 and fulfills the essential requirements of the European directive 93/42/ECC concerning medical devices.
More Information

No
The description focuses on the chemical composition and physical properties of a dental cement, with no mention of AI or ML capabilities.

No
The device is a dental luting material used for permanent cementation of dental restorations, not for treating or rehabilitating a medical condition.

No
The device is a self-curing compomer cement used for the permanent cementation of dental restorations, which is a therapeutic function, not a diagnostic one.

No

The device description clearly states it is a "dental luting material" and a "two-component chemical (self)-curing compomer," indicating it is a physical substance, 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 for the permanent cementation of dental components (AGC® SupraCaps) in tertiary structures within the mouth. This is a direct application within the body for structural support and restoration.
  • Device Description: The device is a dental luting material used by dental technicians to manufacture dental restorations. It's a chemical substance used for bonding within the oral cavity.
  • Lack of Diagnostic Purpose: There is no mention of this device being used to examine specimens derived from the human body to provide information for diagnostic, monitoring, or compatibility purposes.

IVD devices are used to test samples (like blood, urine, tissue) taken from the body to diagnose or monitor a condition. This device is used within the body for a restorative purpose.

N/A

Intended Use / Indications for Use

AGC®Cem is a dental self-curing compomer cement for the permanent cementation of AGC® SupraCaps in tertiary structures such as secondary telescopic crowns in chrome cobalt substructures, or SupraCaps in implant supraconstructions.

Product codes

EMA

Device Description

AGC Cem is a dental luting material, which can be used by dental technicians to manufacture dental restorations. It is a two-component chemical (self)-curing compomer with a golden yellow color. AGC Cem is especially designed for the permanent luting of AGC SupraCaps, i.e. pure gold caps, which had been electroformed with the AGC® Galvanoforming technique, in tertiary structures to produce removable dentures. Possible uses of the AGC®Cem include luting of AGC® SupraCaps as telescopic crowns in chrome cobalt substructures . luting of AGC SupraCaps in implant supraconstructions. AGC Cem is offered in an Automix-System, that ensures automatic mixing of the two components. It generates a homogeneous material quality and allows direct application of the material. AGC Cem creates an excellent fit owing to its low film thickness and lead to high adhering strengths. Its golden yellow color provides an excellent basis to the dental technician to manufacture aesthetically pleasant dental restorations. AGC Cem fully complies to the international standard ISO 4049:2000 and fulfills the essential requirements of the European directive 93/42/ECC concerning medical devices.

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

Dental technicians

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)

Not Found

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

Not Found

Predicate Device(s)

K012316

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 872.3275 Dental cement.

(a)
Zinc oxide-eugenol —(1)Identification. Zinc oxide-eugenol is a device composed of zinc oxide-eugenol intended to serve as a temporary tooth filling or as a base cement to affix a temporary tooth filling, to affix dental devices such as crowns or bridges, or to be applied to a tooth to protect the tooth pulp.(2)
Classification. Class I (general controls). The device is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to § 872.9.(b)
Dental cement other than zinc oxide-eugenol —(1)Identification. Dental cement other than zinc oxide-eugenol is a device composed of various materials other than zinc oxide-eugenol intended to serve as a temporary tooth filling or as a base cement to affix a temporary tooth filling, to affix dental devices such as crowns or bridges, or to be applied to a tooth to protect the tooth pulp.(2)
Classification. Class II.

0

K03014 8

MAR 21 2003
AGC®Cem

Premarket Notification 510(k)

5. 510 (k) Summary

Submitter of 510(k):Wieland Dental + Technik GmbH & Co.
Schwenninger Str. 13
D-75179 Pforzheim
Germany
Phone: +49-7231-3705-0
Contact person:Dr. Gerhard Polzer
Phone:+49-7231-3705-219
Fax:+49-7231-357959
e-mail:gerhard.polzer@wieland-dental.de

Date of Summary: 2003-01-14

AGC®Cem Trade name:

Classification name: Dental cement Product code: EMA C.D.R section: 872.3275 Classification: Class II

Legally marketed equivalent device: Permacem 510(k) number: K012316

Device description

AGC Cem is a dental luting material, which can be used by dental technicians to manufacture dental restorations.

It is a two-component chemical (self)-curing compomer with a golden yellow color.

AGC Cem is especially designed for the permanent luting of AGC SupraCaps, i.e. pure gold caps, which had been electroformed with the AGC® Galvanoforming technique, in tertiary structures to produce removable dentures.

Possible uses of the AGC®Cem include

  • luting of AGC® SupraCaps as telescopic crowns in chrome cobalt substructures .
  • luting of AGC SupraCaps in implant supraconstructions. .

1

AGC Cem is offered in an Automix-System, that ensures automatic mixing of the two components. It generates a homogeneous material quality and allows direct application of the material.

. .

AGC Cem creates an excellent fit owing to its low film thickness and lead to high adhering strengths. Its golden yellow color provides an excellent basis to the dental technician to manufacture aesthetically pleasant dental restorations.

AGC Cem fully complies to the international standard ISO 4049:2000 and fulfills the essential requirements of the European directive 93/42/ECC concerning medical devices.

2

Image /page/2/Picture/1 description: The image is a black and white seal for the U.S. Department of Health & Human Services. The seal is circular with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter. Inside the circle is an abstract image of an eagle with three lines representing its wings and head.

MAR 2 1 2003

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

Dr. Gerhard Polzer Director, Regulatory Affairs Wieland Dental + Technik GmbH & Co. KG Schwenninger Strasse 13 D-75179 Pforzheim GERMANY

Re: K030168

Trade/Device Name: AGC® Cem Regulation Number: 21 CFR 872.3275(2)(b) Regulation Name: Dental Cement Regulatory Class: II Product Codes: EMA Dated: January 14, 2003 Received: January 17, 2003

Dear Dr. Polzer:

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.

3

Page 2 - Dr. Gerhard Polzer

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 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

4

Page 1 of 1

510(k) Number (if known):

AGC®Cem Device Name:

Indications For Use:

, '

AGC®Cem is a dental self-curing compomer cement for the permanent cementation of AGC® SupraCaps in tertiary structures such as secondary telescopic crowns in chrome cobalt substructures, or SupraCaps in implant supraconstructions.

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Kein Mulvey for MSR

(Division Sign-Off) (Division Sign-O'r)
Division of Anesthesiology, General Hospital, Division of Andolmoontal Devices

510(k) Number: K030168

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Prescription Use (Per 21 CFR 801.109) Over-The-Counter Use_..._

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(Optional Formal 1-2-96)