(141 days)
The Spectra Dental Implant System consists of one-piece implants for single-stage or twostage surgical procedures that are intended for use in partially or fully edentulous mandibles and maxillae, in support of single or multiple-unit restorations and terminal or intermediate abutment support for fixed bridgework. They may be placed in immediate function if initial implant stability can be established.
The ScrewDirect 3.0mm implant is indicated for:
- An artificial root structure for single tooth replacement of mandibular central and lateral incisors and maxillary lateral incisors.
- Multiple tooth replacements or denture stabilization.
The Screw Redirect implant is intended for support and retention of fixed single tooth and fixed partial denture restorations in the premolar, cuspid, and incisor regions of the partially edentulous maxillary jaw. It is indicated for immediate functional loading when four or more implants are splinted together in the endentulous upper or lower jaw.
The Screw Indirect implant is indicated for the support and retention of bar overdentures or as a terminal or intermediary attachment for screw-retained fixed bridgework. It is indicated for immediate functional loading when four or more implants are splinted together in the edentulous upper or lower jaw. This implant model is not indicated for use with abutments, only with a 2mm extender.
Spectra-System is substantially equivalent to the predicate devices; has comparable technological characteristics, identical intended use and are similar in terms of material, size, and basic design features. The overall implant product designs of the Spectra System are similar to the predicate devices.
The provided text is a 510(k) summary for the Spectra-System dental implants. This type of submission focuses on demonstrating substantial equivalence to previously cleared devices rather than proving safety and effectiveness through clinical trials with specific acceptance criteria. Therefore, much of the requested information regarding acceptance criteria, study details, and performance metrics for a novel medical device is not applicable or cannot be extracted from this document.
However, I can provide information based on the comparison analysis presented to demonstrate substantial equivalence to predicate devices.
Table of Acceptance Criteria and Reported Device Performance
As this is a 510(k) submission based on substantial equivalence, there are no explicit "acceptance criteria" in the sense of predefined performance thresholds for a clinical study. Instead, the device's performance is demonstrated by its comparable technological characteristics to predicate devices. The "reported device performance" is essentially the alignment of the Spectra-System's features with those of the predicate devices.
The acceptance criteria here are implicitly:
- Identical Intended Use: The Spectra-System must have the same intended use as the predicate devices.
- Similar Technological Characteristics: The Spectra-System must be similar in terms of material, size, and basic design features to the predicate devices.
Here's a summary of the comparison analysis that serves as the "reported device performance" in this context:
| Acceptance Criteria (Implicit) | Reported Device Performance (Spectra-System, based on comparison) |
|---|---|
| 1. Identical Intended Use | The Spectra-System's intended use (e.g., surgical implantation in edentulous mandibles or maxillae for attachment of complete denture prostheses, or as a terminal or intermediary attachment for fixed or removable bridgework, or as a freestanding single tooth replacement, with immediate load indications) is explicitly stated as identical to the predicate devices. The ScrewDirect 3.0mm implant is for single tooth replacement of mandibular central/lateral and maxillary lateral incisors, and multiple tooth replacements or denture stabilization. The Screw Redirect implant is for fixed single tooth/partial denture restorations in premolar, cuspid, and incisor regions of partially edentulous maxillary jaw, with immediate functional loading when four or more are splinted. The Screw Indirect implant is for support/retention of bar overdentures or screw-retained fixed bridgework, with immediate functional loading when four or more are splinted. |
| 2. Similar Technological Characteristics (Material, Size, Basic Design) | The submission explicitly states: "Spectra-System is substantially equivalent to the predicate devices; has comparable technological characteristics, identical intended use and are similar in terms of material, size, and basic design features." Specific comparisons across various implant types (ScrewPlant, Legacy, RePlant, Screw Direct, Screw Indirect, ScrewPlus) against multiple predicate devices (Tapered Screw-Vent, Astra-Tech Implants Dental System, Advent and SwissPlus, Nobel Biocare Replace One-Piece Implant, Lifecore PrimaSolo One-Piece Implant System) show high similarity across: - General Design: All are threaded, root form implants. - Placement Method: Predominantly two or single-stage surgery, aligning with predicates. - Material: Primarily Titanium alloy, identical or comparable to CP4 Titanium or commercially pure titanium of predicates. - Implant Body Type: Threaded body, often with micro-threads at the collar section, similar to predicates (some predicates have smooth collars or grooves). - Body Diameter: Ranges (e.g., 3.0mm to 6.0mm) are comparable to or overlap with predicate devices. - Lengths: Ranges (e.g., 8mm to 19mm) are comparable to or overlap with predicate devices. - Platform Diameter: Ranges are generally comparable. - Implant Surface: Roughened (HA blasted) or plasma HA coated, comparable to predicate devices which use HA coated, roughened, or micro-roughened surfaces. - Packaging: Inner sleeve/vial system with components (carrier, cover screw, extender, coping), consistent with predicate packaging (double vial, carrier-based). - Sterilization: Gamma irradiation, consistent with predicate devices. |
1. Sample sized used for the test set and the data provenance (e.g. country of origin of the data, retrospective or prospective)
Not applicable. This is a 510(k) based on substantial equivalence to predicate devices, not on a clinical "test set" with patient data. No clinical studies are presented in this summary document with sample sizes or data provenance.
2. Number of experts used to establish the ground truth for the test set and the qualifications of those experts (e.g. radiologist with 10 years of experience)
Not applicable. There was no clinical "test set" requiring ground truth establishment by experts.
3. Adjudication method (e.g. 2+1, 3+1, none) for the test set
Not applicable. There was no clinical "test set" requiring adjudication.
4. If a multi reader multi case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance
Not applicable. This document pertains to dental implants, not an AI-assisted diagnostic or imaging device. No MRMC study was conducted or presented.
5. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done
Not applicable. This document pertains to dental implants, not a standalone algorithm.
6. The type of ground truth used (expert concensus, pathology, outcomes data, etc)
Not applicable. The "ground truth" in this context is the regulatory clearance status and established technological characteristics of the predicate devices, against which the new device is compared.
7. The sample size for the training set
Not applicable. There was no "training set" as this is not a machine learning or AI device submission.
8. How the ground truth for the training set was established
Not applicable.
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| SEP 2 9 2006 | ||
|---|---|---|
| K061319 | ||
| 510(k) SUMMARY | ||
| Company Name: | Implant Direct LLC27030 Malibu Hills RoadCalabasas Hills CA 91301 | |
| Phone Number: | 818 444-3300 | |
| Fax Number: | 818 444-3408 | |
| Registration Number: | 3001617766 | |
| Submitter's Name: | Gerald A. Niznick, DMD, MSD | |
| Contact Persons: | Patty McMahon | |
| Date Summary Prepared: | May 10, 2006 | |
| Classification Name: | Implant, Endosseous, Root Form | |
| Regulation Description: | Endosseous Dental Implant | |
| Common/Usual Name: | Endosseous Dental Implant and Abutment | |
| Device Trade Name: | Spectra-System | |
| Predicate Devices: | ||
| The Spectra-System was compared to the following devices previously cleared through a 510(k) Premarket Notification: | ||
| Tapered Screw-Vent (K013227) | ||
| Screw-Vent Dental Implant System (K011028) | ||
| Astra-Tech Implants Dental System Immediate Function (K041492) | ||
| Nobel Biocare Groovy Implants (K050258) | ||
| Advent and SwissPlus Dental Implant Systems (K011245) | ||
| Nobel Biocare Replace One-Piece Implant (K023952) | ||
| Lifecore PrimaSolo One-Piece Implant System (K050506) |
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escriptio
ん
tended Use
K0613 0(k) Number: Spectra Dental Implant evice Name:
dications for i
tra Dental Implant System onstrator of two-piece implans for single-stage or two-stage or two-stage or two-stage or
es that are internedials a fully edentlus suport for fixed
irect 3.0mm implant is indicated
- icial root structure for single tooth replacement of mandibular central and lateral
tillary lateral incisors.
{2}------------------------------------------------
| 2. Multiple tooth replacements or denture stabilization. | K061319 |
|---|---|
| Screw Redirect implant is intended for support and retention of fixed single tooth and fixed partial denture restorations inpremolar, cuspid, and incisor regions of the partially edentulous maxillary jaw. It is indicated for immediate functionalloading when four or more implants are splinted together in the endentulous upper or lower jaw. | |
| Technological Characteristics: | |
| Spectra-System is substantially equivalent to the predicate devices; has comparable technological characteristics, identicalintended use and are similar in terms of material, size, and basic design features. | |
| Comparison Analysis: | |
| The overall implant product designs of the Spectra System are similar to the predicate devices. Tables 1, 2, 3, and 4 in the followingpages summarize the predicate device comparison analyses for the implants within the Spectra-System. |
:
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KDG
1319
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| TechnologicalCharacteristics | ScrewPlant and LegacyImplants | Predicate Device:Tapered Screw-Vent(K013227) | Predicate Device:Astra-Tech ImplantsDental System ImmediateFunction(K041492) | TechnologicalCharacteristics | RePlant Implants | Predicate Device:Tapered Screw-Vent (K013227) |
|---|---|---|---|---|---|---|
| Intended Use | Intended for surgicalimplantation in edentulousmandibles or maxillae for | Intended for surgicalimplantation in edentulousmandibles or maxillae for | Intended to provide supportfor prosthetic constructionsfor fully and partiallyedentulous arches using oneor two stage surgicalprocedures. | Intended Use | Intended for surgical implantation in edentulous mandibles or maxillae for attachment of complete denture prostheses, or as a terminal or intermediary attachment for fixed or removable bridgework, or as a freestanding single tooth replacement. | Intended to be surgically placed in the bone of the upper or lower jaw arches to provide support for prosthetic devices for single or multiple unit restorations in splinted or non-splinted applications. |
| attachment of completedenture prostheses, or as aterminal or intermediaryattachment for fixed orremovable bridgework, or as afreestanding single toothreplacement. | attachment of completedenture prostheses, or as aterminal or intermediaryattachment for fixed orremovable bridgework, or asa freestanding single toothreplacement. | Indication | Immediate Load | Immediate Load | ||
| Indication | Immediate Load | Immediate Load | Immediate Load | General Design | Threaded, root form implant | Threaded, root form implant |
| GeneralDesign | Threaded, root form implant | Threaded, root form implant | Threaded, root form implant | Placement Method | Two or single stage surgery | Two or single stage surgery |
| PlacementMethod | Two or single stage surgery | Two or single stage surgery | Two or single stage surgery | Material | Titanium alloy | CP4 Titanium |
| MaterialImplant BodyType | Titanium alloyThreaded body with micro-threads at the collar section | Titanium alloyThreaded body with smoothcollar | Commercially pure titaniumThreaded body with micro-threads at the collar section | Implant Body Type | Threaded body with micro-threads at the collar section | Threaded body with groves at the collar section |
| Body Diameter | 3.7mm, 4.7mm, 5.7 mm | 3.7mm, 4.7mm, 6.0mm | 3.5, 4.0 mm | Body Diameter | 3.5mm, 4.3mm, 5.0mm, 6.0mm | 3.5mm, 4.3mm, 5.0mm, 6.0mm |
| Lengths | 8mm – 16mm | 8mm – 16mm | 8mm – 19 mm | Lengths | 8mm – 16mm | 8mm – 16mm |
| PlatformDiameter | ScrewPlant: 3.7, 4.7, 5.7mmLegacy: 3.5, 4.5, 5.7mm | 3.5, 4.5, 5.7mm | 3.5, 4.0, 4.5, 5.0mm | Platform Diameter | 3.5mm, 4.3mm, 5.0mm, 6.0mm | 3.5mm, 4.3mm, 5.0mm, 6.0mm |
| ImplantSurface | Roughened (HA blasted) orRoughened (HA blasted) and | HA coated./Roughened orRoughened - HA Blasted | Micro-roughened surface | Implant Surface | Roughened (HA blasted) | Roughened surface |
| plasma HA coated | Packaging | Inner sleeve to suspend the implant assembled with a plastic carrier or titanium fixture mount inside an outer vial sealed with a cap. Packaging may include surgical cover screw, extender, and coping. | Outer vial and cap | |||
| Packaging | Inner sleeve to suspend theimplant assembled with aplastic carrier or titanium | Double vial system. Theimplant/fixture-mountassembly is suspended andsnaps inside the inner vial.The packaging also offers asurgical cover screw. | Implants are packaged witha carrier. | Sterilization | Gamma irradiation | Gamma irradiation |
| Sterilization | fixture mount inside an outervial sealed with a cap.Packaging may includesurgical cover screw,extender, and coping. | Gamma irradiation | Unknown | |||
| Gamma irradiation |
:
Table 1: Two-Stage Implants -- ScrewPlant and Legac
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| Table 3: One-Stage Implants | Body Diameter | 3.7, 4.7, and 5.7mm | 3.7, 4.7, and 5.7mm | 3.7, 4.7, and 6.0mm | collar section3.5, and 4.0mm | TechnologicalCharacteristics | Screw DirectImplants | Screw RedirectImplants | Predicate Device:Replace One-PieceImplant(K023952) | Predicate Device:Lifecore PrimaSoloOne-Piece ImplantSystem (K050506) | |||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ScrewPlusImplants | ScrewIndirectImplants | Predicate Device:Advent and SwissPlusDental ImplantSystems (K011245) | PredicateDevice:Astra-TechImp.ImmediateFunction(K041492) | Lengths | 8mm – 16mm | 8mm – 16mm | 8mm – 16mm | 8mm – 19 mm | Intended Use | Intended for singlestage surgicalprocedures andcemented restorations. | Intended for singlestage surgicalprocedures andcementedrestorations. | Intended for singlestage surgicalprocedure andcementedrestorations. | Intended for singlestage surgicalprocedures andcementrestorations. |
| Intended for surgicalimplantation inedentulous mandiblesor maxillae forattachment of completedenture prostheses, oras a terminal orintermediaryattachment for fixed orremovable bridgework,or as a freestandingsingle toothreplacement. | Intended for surgicalimplantation inedentulous mandiblesor maxillae forattachment ofcomplete dentureprostheses, or as aterminal orintermediaryattachment for fixedor removablebridgework. | Intended for surgicalimplantation inedentulous mandiblesor maxillae forattachment of completedenture prostheses, oras a terminal orintermediaryattachment for fixed orremovable bridgework,or as a freestandingsingle toothreplacement. | Intended toprovide supportfor prostheticconstructionsfor fully andpartiallyedentulousarches usingone or two stagesurgicalprocedures. | Platform Diameter | 3.7, 4.7, 5.7, and 6.5mm | 5.0mm | 4.5 and 5.7mm | 3.5, 4.0, 4.5, 5.0mm | Indication | Immediate Load | Immediate Load | Immediate Load | Immediate Load |
| Immediate LoadThreaded, root formimplant | Immediate LoadThreaded, root formimplant | Immediate LoadThreaded, root formimplant | Immediate LoadThreaded, rootform implant | Implant Surface | Roughened – HA Blasted | Roughened – HA Blasted | HA coated/Roughened or Roughened – HA Blasted | Micro- roughened surface | GeneralDesign | Threaded, root formimplant | Threaded, root formimplant | Threaded, root formimplant | Threaded, root formimplant |
| Single stage surgery | Single stage surgery | Single stage surgery | Two or singlestage surgery | Packaging | Inner sleeve to suspend the implant/fixture- mount assembly inside an outer vial sealed with a cap. Packaging also includes surgical cover screw, extender, and temporary coping | Inner sleeve to suspend the implant/carrier assembly inside an outer vial sealed with a cap. Packaging also includes, extender, and temporary coping | Implants are packaged with a carrier in a double vial system. The packaging also offers a surgical cover screw and an extender. | Implants are packaged with a carrier. | PlacementMethod | Single stage surgery | Single stagesurgery | Single stagesurgery | Single stage surgery |
| Titanium alloy | Titanium alloy | Titanium alloy | Commerciallypure titanium | Sterilization | Gamma irradiation | Gamma irradiation | Gamma irradiation | Unknown | Material | Titanium alloy | Titanium alloy | CPe titanium | Titanium alloy |
| Threaded body withsmooth collar | Threaded body withsmooth collar | Threaded body withsmooth collar | Threaded bodywith micro-threads at the | Implant BodyType | Tapered threaded bodywith an integratedabutment | Tapered threadedbody with anintegrated angledabutment | Tapered threadedbody with anintegrated abutment | Tapered threadedbody with anintegrated abutment | |||||
| Body Diameter | 3.0, 3.7, 4.7, and5.7mm | 3.7, 4.7, and 5.7mm | 3.5, 4.3, and 5.0mm | 3.0, 3.5, 4.1, and5.0mm | |||||||||
| Lengths | 10, 13, and 16mm | 13 and 16mm | 10, 13, and 16mm | 10mm - 15 mm | |||||||||
| ImplantSurface | Roughened - HABlasted | Roughened - HABlasted | HA coated androughened surface | Micro-roughenedsurface | |||||||||
| Packaging | Inner sleeve to suspendthe implant/carrierassembly inside anouter vial sealed with acap. Packaging also | Inner sleeve tosuspend theimplant/carrierassembly inside anouter vial sealed | Unknown | Unknown |
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K06 1319
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Table 4: One-Piece Implants
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| includes a temporarycoping | with a cap. | |||
|---|---|---|---|---|
| Sterilization | Gamma irradiation | Gamma irradiation | Unknown | Unknown |
Conclusion પતં
Based on the companison analysis, the ident of the market in the more institutios, similar general dosign
features, the Spectra System is substanted to be predicate devices.
A statement that the submitter believes, to the best of his or her knowledge, that all ata and information submitted
ไ
A Truthful and Accurate Statement is included in Section 3.0, signed by Dr. Gerald A. Niznick, the owner of I
Direct L.C.
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Image /page/10/Picture/1 description: The image shows the seal of the Department of Health and Human Services (HHS). The seal features the department's name in a circular arrangement around a symbol. The symbol consists of three stylized human figures, representing the department's mission to protect the health of all Americans and provide essential human services.
Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850
SEP 2 6 2006
Ms. Patty McMahon Vice President Implant Direct, LLC 27030 Malibu Hills Road Calabasas Hills, California 91301
Re: K061319
Trade/Device Name: Spectra Dental Implant System Regulation Number: 872.3640 Regulation Name: Endosseous Dental Implant Regulatory Class: II Product Code: DZE Dated: July 28, 2006 Reccived: July 31, 2006
Dear Ms. McMahon:
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. Fxisting 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.
{11}------------------------------------------------
Page 2 - Ms. McMahon
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 vou 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.
Director Division of Anesthesiology, General Hospital, Infection Control and Dental Devices Office of Device Evaluation Center for Devices and Radiological Health
Enclosure
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Indications for Use
510(k) Number (if known): K061319
Device Name: Spectra Dental Implant System
Indications for Use:
The Spectra Dental Implant System consists of one-piece implants for single-stage or twostage surgical procedures that are intended for use in partially or fully edentulous mandibles and maxillae, in support of single or multiple-unit restorations and terminal or intermediate abutment support for fixed bridgework. They may be placed in immediate function if initial implant stability can be established.
The ScrewDirect 3.0mm implant is indicated for:
-
- An artificial root structure for single tooth replacement of mandibular central and lateral incisors and maxillary lateral incisors.
-
- Multiple tooth replacements or denture stabilization.
The Screw Redirect implant is intended for support and retention of fixed single tooth and fixed partial denture restorations in the premolar, cuspid, and incisor regions of the partially edentulous maxillary jaw. It is indicated for immediate functional loading when four or more implants are splinted together in the endentulous upper or lower jaw.
The Screw Indirect implant is indicated for the support and retention of bar overdentures or as a terminal or intermediary attachment for screw-retained fixed bridgework. It is indicated for immediate functional loading when four or more implants are splinted together in the edentulous upper or lower jaw. This implant model is not indicated for use with abutments, only with a 2mm extender.
Prescription Use (Part 21 CFR 801 Subpart D)
ASOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO
AND/OR
Over-The-Counter Use (21 CFR 801 Subpart C)
(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED)
Concurrence of CDRH, Office of Device Evaluation (ODE)
Robert S. Betz DDS for H. Susan Rummer
Number: K061319
§ 872.3640 Endosseous dental implant.
(a)
Identification. An endosseous dental implant is a prescription device made of a material such as titanium or titanium alloy that is intended to be surgically placed in the bone of the upper or lower jaw arches to provide support for prosthetic devices, such as artificial teeth, in order to restore a patient's chewing function.(b)
Classification. (1) Class II (special controls). The device is classified as class II if it is a root-form endosseous dental implant. The root-form endosseous dental implant is characterized by four geometrically distinct types: Basket, screw, solid cylinder, and hollow cylinder. The guidance document entitled “Class II Special Controls Guidance Document: Root-Form Endosseous Dental Implants and Endosseous Dental Implant Abutments” will serve as the special control. (See § 872.1(e) for the availability of this guidance document.)(2)
Classification. Class II (special controls). The device is classified as class II if it is a blade-form endosseous dental implant. The special controls for this device are:(i) The design characteristics of the device must ensure that the geometry and material composition are consistent with the intended use;
(ii) Mechanical performance (fatigue) testing under simulated physiological conditions to demonstrate maximum load (endurance limit) when the device is subjected to compressive and shear loads;
(iii) Corrosion testing under simulated physiological conditions to demonstrate corrosion potential of each metal or alloy, couple potential for an assembled dissimilar metal implant system, and corrosion rate for an assembled dissimilar metal implant system;
(iv) The device must be demonstrated to be biocompatible;
(v) Sterility testing must demonstrate the sterility of the device;
(vi) Performance testing to evaluate the compatibility of the device in a magnetic resonance (MR) environment;
(vii) Labeling must include a clear description of the technological features, how the device should be used in patients, detailed surgical protocol and restoration procedures, relevant precautions and warnings based on the clinical use of the device, and qualifications and training requirements for device users including technicians and clinicians;
(viii) Patient labeling must contain a description of how the device works, how the device is placed, how the patient needs to care for the implant, possible adverse events and how to report any complications; and
(ix) Documented clinical experience must demonstrate safe and effective use and capture any adverse events observed during clinical use.