K Number
K050658
Device Name
RESO-PAC PERIODONTAL DRESSING
Date Cleared
2005-05-27

(74 days)

Product Code
Regulation Number
872.3275
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
For use as a periodontal wound dressing to protect injured periodontal tissue by forming a barrier to avoid further irritation.
Device Description
The product is a periodontal wound dressing. It is intended for use only by dental practitioners; and will not be offered for OTC use. It contains materials that pose no health hazard when used according to directions.
More Information

Not Found

No
The summary describes a physical wound dressing and contains no mention of AI, ML, image processing, or data analysis.

Yes
The device is described as a "periodontal wound dressing" used to "protect injured periodontal tissue" and "forming a barrier to avoid further irritation," which are therapeutic actions.

No
The device is a "periodontal wound dressing" used to protect injured tissue by forming a barrier, not to diagnose a condition. Its function is therapeutic, not diagnostic.

No

The device description explicitly states it is a "periodontal wound dressing," which is a physical material applied to tissue, 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 to protect injured periodontal tissue by forming a barrier. This is a physical action on the body, not a diagnostic test performed on samples taken from the body.
  • Device Description: The description reinforces its use as a wound dressing applied directly to the tissue.
  • Lack of IVD Characteristics: There is no mention of analyzing samples (blood, urine, tissue, etc.), detecting biomarkers, 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

For use as a periodontal wound dressing to protect injured periodontal tissue by forming a barrier to avoid further irritation.

Product codes

EMA

Device Description

The product is a periodontal wound dressing. It is intended for use only by dental t no productioners; and will not be offered for OTC use. It contains materials that pose no health hazard when used according to directions. Reso Pac has received approval for marketing in the European Community.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

periodontal tissue

Indicated Patient Age Range

Not Found

Intended User / Care Setting

dental t no productioners

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)

K881422, K864720

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

Image /page/0/Picture/1 description: The image shows a handwritten string of characters. The characters appear to be 'K050658'. The characters are written in a dark ink on a white background. The handwriting is somewhat messy and the characters are not perfectly formed.

510(k) Summary

Submitted by:

Daniel J. Manelli Manelli, Denison & Selter, P.L.L.C. 2000 M Street, NW (Suite 700) Washington, DC 20036

Telephone: 202-261-1000

On behalf of Hager Worldwide, Inc. 510(k) Submission: Reso-Pac April 28, 2005

The product is a periodontal wound dressing. It is intended for use only by dental t no productioners; and will not be offered for OTC use. It contains materials that pose no health hazard when used according to directions. Reso Pac has received approval for marketing in the European Community. It is substantially equivalent to other manoling in the Larry - including PCA Periocare Periodontal Dressing (Pulpdent Corp. ponodental arobong of aboratories - K881422) and Barricaid (Dentsply International - K864720), which are intended to protect injured periodontal tissue by forming a temporary physical barrier to avoid further irritation.

Reso Pac should not be used with patients who are allergic to petrolatum products or oil derivatives.

1

Image /page/1/Picture/1 description: The image shows the seal of the Department of Health and Human Services (HHS). The seal features a stylized eagle with three heads facing right, representing the department's focus on health, services, and people. The words "DEPARTMENT OF HEALTH AND 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

MAY 2 7 2005

Hager Worldwide, Incorporated C/O Mr. Daniel J. Manelli Manelli Denison & Selter PLLC 2000 M. Street N.W. 7th Floor Washington, DC 20036-3307

Re: K050658

Trade/Device Name: Hager Reso Pac Periodontal Dressing Regulation Number: 872.3275 Regulation Name: Dental Cement Regulatory Class: II Product Code: EMA Dated: March 11, 2005 Received: March 15, 2005

Dear Mr. Manelli:

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 approvisions 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 (1 Nr.), I har be found in the Code of Federal Regulations, Title 21, Parts 800 to 898. In your device a may publish further announcements concerning your device in the Federal Register.

2

Page 2 - Mr. Manelli

Please be advised that FDA's issuance of a substantial equivalence determination does not I least that FDA has made a determination that your device complies with other requirements mean that I Driver and regulations administered by other Federal agencies. or the rive of any 1 eder 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 and insure (s 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) I mis letet 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 (240) 276-0115. 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/industry/support/index.html.

Sincerely yours,

Chiu Lin, Ph.D.

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

Enclosure

3

510(k) Number (if known): ____________________________________________________________________________________________________________________________________________________

Device Name:

Indications for use:

For use as a periodontal wound dressing to protect injured periodontal tissue by forming a barrier to avoid further irritation.

(Please Do Not Write Below This Line - Continue On Another Page if Needed)

Concurrence of CDRH, Office of Device Evaluation (ODE)

Susan Renoe

(Civision Sign-Off) Civision of Anesthesiclogy, General Hospital, Intection Control, Dental Devices

510(k) Number: Ka5di6s7

Prescription Use √
(Per 21 CFR 801.109)

OR

Over-The-Counter Use _________________________________________________________________________________________________________________________________________________________