K Number
K040857
Device Name
MODIFICATION TO ADPER PROMPT
Date Cleared
2004-05-10

(38 days)

Product Code
Regulation Number
872.3200
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
Bonding between dentin/enamel and composite filling materials Bonding between dentin/enamel and compomer filling matcrials Bonding mediator for fissure sealing Desensitization of hypersensitive arcas of tecth
Device Description
Adper Prompt is classified as Resin Tooth Bond Agent ( 21 C.F.R. § 872.3200) because it is a device intended to be painted on the interior of a prepared cavity of a tooth to improve retention of restorative materials (compomer amd composite restorative material). Additionally, as recent results show, Adper Prompt can be used to seal dentinal tubules of exposed dentin surfaces to prevent from dentinal hypersensitivity.
More Information

K 020946, K 992292

K 020946, K 992292

No
The device description and performance studies focus on the chemical and physical properties of a resin bonding agent, with no mention of AI or ML technologies.

No
The device is primarily a bonding agent for dental restorations. While it can desensitize hypersensitive areas of teeth, this is a secondary function and its main purpose is not to treat a disease but to aid in the bonding of dental materials.

No

The device description indicates that Adper Prompt is a resin tooth bond agent intended to improve retention of restorative materials and to seal dentinal tubules to prevent dentinal hypersensitivity. These are treatment-oriented functions, not diagnostic ones.

No

The device description clearly identifies Adper Prompt as a "Resin Tooth Bond Agent," which is a physical material applied to teeth, not a software program.

Based on the provided information, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • Intended Use/Indications for Use: The intended uses listed are all related to bonding materials to teeth and desensitizing teeth. These are direct treatments applied to the patient's body (in vivo).
  • Device Description: The description clearly states it's a "Resin Tooth Bond Agent" intended to be "painted on the interior of a prepared cavity of a tooth." This is an application within the patient's mouth.
  • Anatomical Site: The anatomical site is the "Tooth, dentin/enamel," which is part of the patient's body.
  • Lack of IVD Characteristics: There is no mention of analyzing samples taken from the body (like blood, urine, tissue) to diagnose a condition or provide information about a physiological state.

IVD devices are used to examine specimens derived from the human body to provide information for diagnostic purposes. This device is used directly on the human body for therapeutic and restorative purposes.

N/A

Intended Use / Indications for Use

Bonding between dentin/enamel and composite filling materials
Bonding between dentin/enamel and compomer filling materials
Bonding mediator for fissure sealing
Desensitization of hypersensitive arcas of tecth

Product codes

KLE, EMA

Device Description

Adper Prompt is classified as Resin Tooth Bond Agent ( 21 C.F.R. § 872.3200) because it is a device intended to be painted on the interior of a prepared cavity of a tooth to improve retention of restorative materials (compomer amd composite restorative material).

Additionally, as recent results show, Adper Prompt can be used to seal dentinal tubules of exposed dentin surfaces to prevent from dentinal hypersensitivity. 3M ESPE submits this 510(k) premarket notification to seek clearance for this new indication for use.

Performance and comparative testing of Adper Prompt has been carried out. The results suggest that Adper Prompt is a suitable agent to reduce fluid movement and to prevent from dentinal hypersensitivity.

The chemical composition of Adper Prompt remained unchanged in comparison to 510(k) K 020946. Performance data for Adper Prompt as a dental bonding agent are, therefore, not subject of this 510(k) submission.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Dentinal tubules of exposed dentin surfaces, prepared cavity of a tooth, dentin/enamel

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)

Performance and comparative testing of Adper Prompt has been carried out. The results suggest that Adper Prompt is a suitable agent to reduce fluid movement and to prevent from dentinal hypersensitivity.

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

Not Found

Predicate Device(s)

K 020946, K 992292

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 872.3200 Resin tooth bonding agent.

(a)
Identification. A resin tooth bonding agent is a device material, such as methylmethacrylate, intended to be painted on the interior of a prepared cavity of a tooth to improve retention of a restoration, such as a filling.(b)
Classification. Class II.

0

MAY 1 0 2004

K040857

510(k) SUMMARY OF SAFETY AND EFFECTIVENESS

Submitter

Company:3M ESPE AG
Street:ESPE Platz
ZIP-Code, City:D-82229 Seefeld
Federal State:Bavaria
Country:Germany
Establishment Registration Number:9611385
Official Correspondent:Dr. Andreas Petermann,
Manager U.S. Regulatory Affairs
Phone:011-49-8152-700 1395
Fax:011-49-8152-700 1869
E-mail:Andreas.Petermann@mmm.com
Date:March 30, 2004
Name of Device
Proprietary Name:Adper Prompt
Classification Name:Resin Tooth Bond Agent
Common Name:Dental Adhesive
Predicate Devices:
Adper Prompt by 3M ESPEK 020946
Gluma Comfort Bond + DesensitizerK 992292
by Heraeus Kulzer

,一次,一次, 510(k) Adper Prompt

1

Description for the Premarket Notification

Adper Prompt is classified as Resin Tooth Bond Agent ( 21 C.F.R. § 872.3200) because it is a device intended to be painted on the interior of a prepared cavity of a tooth to improve retention of restorative materials (compomer amd composite restorative material).

Additionally, as recent results show, Adper Prompt can be used to seal dentinal tubules of exposed dentin surfaces to prevent from dentinal hypersensitivity. 3M ESPE submits this 510(k) premarket notification to seek clearance for this new indication for use.

Performance and comparative testing of Adper Prompt has been carried out. The results suggest that Adper Prompt is a suitable agent to reduce fluid movement and to prevent from dentinal hypersensitivity.

The chemical composition of Adper Prompt remained unchanged in comparison to 510(k) K 020946. Performance data for Adper Prompt as a dental bonding agent are, therefore, not subject of this 510(k) submission.

The data provided in this 510(k) submission show that Adper Prompt is substantially equivalent to the predicate devices.

2

Image /page/2/Picture/1 description: The image is a seal for the Department of Health & Human Services - USA. The seal is circular and contains the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter. In the center of the seal is an abstract image of an eagle.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

MAY 1 0 2004

Dr. Andreas Petermann Manager, U.S. Regulatory Affairs 3M ESPE AG ESPE Platz Seefeld, D-82229 GERMANY

Re: K040857

Trade/Device Name: AdperTM PromptTM Regulation Number: 21 CFR 872.3200 Regulation Name: Resin Tooth Bonding Agent Regulatory Class: II Product Codes: KLE and EMA Dated: March 30, 2004 Received: April 07, 2004

Dear Dr. Petermann:

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.

3

Page 2 - Dr. Andreas Petermann

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.

Chido S. Nwafor, Ph.D.

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

Enclosure

4

Indications for Use

04085 510(k) Number (if known): Device Name: Adper Prompt, Adper Prompt L-Pop Indications For Use Bonding between dentin/enamel and composite filling materials Bonding between dentin/enamel and compomer filling matcrials Bonding mediator for fissure sealing Desensitization of hypersensitive arcas of tecth

Prescription Use
(Part 21 CFR 801 Subpart D)

AND/OR

Over-The-Counter Use (21 CFR 807 Subpart C)

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

Concurrence of CDRH. Office of Device Evaluation (ODE)

Susa Runoer

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

510(k) Number. K041657

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