K Number
K032605
Device Name
METAPASTE CALCIUM HYDROXIDE WITH BARIUM SULFATE TEMPORARY ROOT CANAL FILLING
Date Cleared
2003-10-08

(44 days)

Product Code
Regulation Number
872.3820
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
For use, as a temporary root canal filling after endodontic surgery. Metapaste can be used on its own and for vital pulpdectomies in decidious teeth. Metapaste is intended for use by qualified healthcare personnel trained in its use.
Device Description
Metapaste calcium hydroxide with Barium Sulfate is a device consisting of a temporary root canal sealer paste contained within a plastic syringe, packaged with disposable applicator tips and a plastic ring rotator for direction control of the tip. It is a device intended for use by qualified healthcare personnel trained in its use. The Metapaste device is similar in design, materials and intended use to other 510(k) cleared devices which are in commercial distribution.
More Information

Not Found

No
The summary describes a physical paste for root canal filling and does not mention any software, algorithms, or data processing that would indicate AI/ML.

No
The device is a temporary root canal filling, which is a dental material used in endodontic procedures, not a therapeutic device in the sense of treating a disease or condition through physical, chemical, or biological means that would typically classify it as a therapeutic device. It supports a medical procedure rather than being a therapy itself.

No
The device is a temporary root canal filling material, not a diagnostic tool. Its intended use is for treatment, not for identifying a condition or disease.

No

The device description explicitly states it is a "temporary root canal sealer paste contained within a plastic syringe, packaged with disposable applicator tips and a plastic ring rotator". This describes physical components, 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 temporary root canal filling after endodontic surgery and for vital pulpdectomies in deciduous teeth. This is a therapeutic and restorative use within the body, not a diagnostic test performed on samples outside the body.
  • Device Description: The device is a paste intended for placement within the root canal. This is consistent with a medical device used for treatment, not for analyzing biological samples.
  • Lack of IVD Characteristics: There is no mention of analyzing biological samples (blood, urine, tissue, etc.), detecting specific analytes, or providing diagnostic information.

IVD devices are specifically designed to examine specimens derived from the human body to provide information for diagnostic, monitoring, or compatibility purposes. This device does not fit that description.

N/A

Intended Use / Indications for Use

Metapaste is a biocompatible root canal sealer used for the temporary filling of root canals after endodontic surgery. Metapaste can be used on its own and for vital pulpdectomies in decidious teeth.

Metapaste is intended for use by qualified healthcare personnel trained in its use.

Product codes (comma separated list FDA assigned to the subject device)

KIF

Device Description

Metapaste calcium hydroxide with Barium Sulfate is a device consisting of a temporary root canal sealer paste contained within a plastic syringe, packaged with disposable applicator tips and a plastic ring rotator for direction control of the tip. It is a device intended for use by qualified healthcare personnel trained in its use.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

root canals

Indicated Patient Age Range

Not Found

Intended User / Care Setting

qualified healthcare personnel

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): If the device was cleared using the 510(k) pathway, identify the Predicate Device(s) K/DEN number used to claim substantial equivalence and list them here in a comma separated list exactly as they appear in the text. List the primary predicate first in the list.

K022734, K944945

Reference Device(s): Identify the Reference Device(s) K/DEN number and list them here in a comma separated list exactly as they appear in the text.

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information for the subject device only (e.g. presence / absence, what scope was granted / cleared under the PCCP, any restrictions, etc).

Not Found

§ 872.3820 Root canal filling resin.

(a)
Identification. A root canal filling resin is a device composed of material, such as methylmethacrylate, intended for use during endodontic therapy to fill the root canal of a tooth.(b)
Classification. (1) Class II if chloroform is not used as an ingredient in the device.(2) Class III if chloroform is used as an ingredient in the device.
(c)
Date PMA or notice of completion of a PDP is required. A PMA or a notice of completion of a PDP is required to be filed with the Food and Drug Administration on or before December 26, 1996 for any root canal filling resin described in paragraph (b)(2) of this section that was in commercial distribution before May 28, 1976, or that has, on or before December 26, 1996 been found to be substantially equivalent to a root canal filling resin described in paragraph (b)(2) of this section that was in commercial distribution before May 28, 1976. Any other root canal filling resin shall have an approved PMA or a declared completed PDP in effect before being placed in commercial distribution.

0

K032605

OCT - 8 2003

1510(k) Summary
1.1Date of Summary Preparation:June 26, 2003
1.2Submitter/Contact Person:Jenny Sohn, Official Correspondent
TEL (718)-639-7460
FAX (718)-639-7408
Meta Dental Co.
41-19, 77 th Street
Elmhurst, NY 11373
1.3Trade Name/Common Name:Metapaste Calcium Hydroxide with Barium
Sulfate Temporary Root Canal Filling
1.4Common Name:Temporary Root Canal Sealer

Classification Name, Product Code, Class, Classification Reference: 1.5

Classification NameProduct CodeClass21CFR §
Root Canal Filling ResinKIFII872.3820

Standards/Special Controls: 1.6

ISO 6876 Dental root canal sealing materials.

Indications for Use: 1.7

Metapaste is a biocompatible root canal sealer used for the temporary filling of root canals after endodontic surgery. Metapaste can be used on its own and for vital pulpdectomies in decidious teeth.

Metapaste is intended for use by qualified healthcare personnel trained in its use.

1.8 Device Description:

Metapaste calcium hydroxide with Barium Sulfate is a device consisting of a temporary root canal sealer paste contained within a plastic syringe, packaged with disposable applicator tips and a plastic ring rotator for direction control of the tip. It is a device intended for use by qualified healthcare personnel trained in its use.

The Metapaste device is similar in design, materials and intended use to other 510(k) cleared devices which are in commercial distribution.

Substantially Equivalent Commercially Available Devices: 1.9

1

The Metapaste device is substantially equivalent to the predicate device described hercin with respect to indications for use, device design, materials, and method of manufacture:

Pulpdent Calcium Hydroxide Preparation - K022734

Pulpdent Calcium Hydroxide Preparations -- K944945 (Device Listing: Tempcanal-Temporary Calcium Hydroxide Root Canal Treatment 21 CFR § 872.3250)

The predicate devices are commercially available and a marketed Class II device indicated for use as a temporary root canal sealer.

1.10 Substantial Equivalence Comparison:

Metapaste is similar to commercially available device with respect to intended use, material, design and operational principles as follows:

MetapastePulpdent CalciumPulpdent Calcium
Hydroxide PreparationHydroxide Preparation
(Tempcanal K944945)(K022734)
LabellingTemporary root canal
sealerTemporary root canal sealerTemporary or permanent root
canal sealer
Intended UseMetapaste is a
biocompatible root
canal sealer used for the
temporary filling of
root canals after
endodontic surgery.
Metapaste can be used
on its own and for vital
pulpdectomics in
decidious teeth.
Metapaste is intended
for use by qualified
healthcare personnel
trained in its use.A calcium hydroxide cavity
liner material intended to be
applied to the interior of a
prepared cavity before
insertion of restorative
material, such as amalgam, 10
protect the pulp of a tooth.A biocompatible
polydimethylsiloxane based
root canal sealer used for the
temporary and permanent
filling of root canals after
endodontic surgery. Can be
used on its own, in
conjunction with Gutta Percha
and for vital pulpdectomies in
deciduous tecth.
Human
FactorsDispensed ready to useDispensed ready to useDispensed ready to use
SimilarISO 6876 Fluidity.ISO 6876 Fluidity, WorkingISO 6876 Fluidity, Working
PhysicalWorking Time, FilmTime, Film Thickness,Time, Film Thickness,
PropertiesThickness, Radiopacity,
Solubility &Radiopacity, Solubility &
disintegrationRadiopacity, Solubility &
disintegration
disintegration
Biocompatibil
ityFreedom from toxicity
per ISO/TR 7405 Agar
diffusion testFreedom from toxicity per
ISO/TR 7405 Agar diffusion
ાટડાBiocompatible
Biocompatible per ISO
10993-11 Acute
intervenous applicationBiocompatible per ISO 10993-
11 Acute intervenous
application

2

| | Metapaste | Pulpdent Calcium
Hydroxide Preparation
(Tempcanal K944945) | Pulpdent Calcium
Hydroxide Preparation
(K022734) |
|----------------------------------------|--------------------------------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------------------|
| Design,
Construction,
Components | Premixed paste,
packaged in plastic
syringe ready to be
dispensed through
disposable tips into root
canal | Premixed paste, packaged in
plastic syringe ready to be
dispensed through disposable
tips into root canal | Premixed paste, packaged in
plastic syringe ready to be
dispensed through disposable
tips into root canal |

1.11 Indications and Contraindications:

Relative indications and contraindications for Metapaste and commercially available devices for similar intended uses are the same.

1.12 Conclusion:

In accordance with the Federal Food, Drug and Cosmetic Act and 21 CFR Part 807, and based on the information provided in this pre-market notification, Meta Biomed Co., Ltd concludes that the new device, Metapaste root canal sealer, is safe, effective and substantially equivalent to the predicate device as described herein.

3

Image /page/3/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo features a stylized depiction of an eagle or bird with three curved lines forming its body and wings. The logo is encircled by the text "DEPARTMENT OF HEALTH & HUMAN SERVICES • USA" in a circular arrangement.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

OCT - 8 2003

Meta Biomed Company Limited Institute C/O Mr. Ned Devine Responsible Third Party Official Entela, Incorporated 3033 Madison Avenue, SE Grand Rapids, Michigan 49548

Re: K032605

Trade/Device Name: Metapaste Calcium Hydroxide with Barium Sulfate Root Canal Filling Regulation Number: 872.3820 Regulation Name: Root Canal Filling Resin Regulatory Class: II Product Code: KIF Dated: September 22, 2003 Received: September 23, 2003

Dear Mr. Devine:

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.

4

Page 2 - Mr. Devine

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 (OS) 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 vou desire specific advice for your device on our labeling regulation (21 CFR Part 801). please contact the Office of Compliance at (301) 594-4613. 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 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,

Clues

Chiu Lin, Ph.D. Director Division of Anesthesiology, General Infection Control and Dental Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

5

K 032605

Indications for Use

Page 1_of_1

510(k) Number:

Device Name : Metapaste Calcium Hydroxide with Barium Sulfate Root Canal Filling

Indications for Use:

For use, as a temporary root canal filling after endodontic surgery. Metapaste can be used on its own and for vital pulpdectomies in decidious teeth.

Metapaste is intended for use by qualified healthcare personnel trained in its use.

Susan Runno

510(k) Number:

(Division Sign-Off)
Division of Anesthesiology, General Hospital,
Infection Control, Dental Devices

(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