K Number
K062529
Device Name
BELMAX CM MODEL X168
Date Cleared
2006-10-05

(37 days)

Product Code
Regulation Number
872.1800
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The BELMAX CM dental panoramic and cephalometric X-ray system is indicated for use as a generator of radiographic images of the dento-maxilofacial region and is intended for dental examination and diagnosis of diseases of the teeth, jaw, and oral structures.
Device Description
The BELMAX CM Model X168 X-Ray System is the next generation of the Takara Belmont digital dental X-ray systems. Similar to the prior Takara Belmont ANA-BEL, ANA-BEL CM equipped with the Takara Belmont ADR Plus SSXI, the BELMAX CM Model X168 X-Ray System offers digital imaging with panoramic and cephalometric imaging programs with the same exposure levels (KV/mA). Modifications resulting in the device include a new sized CCD sensor including three rather than two of the same sensor array grids mounted in a removable cartridge rather than bolted in place.
More Information

Not Found

No
The document mentions "Digital processing is used" but does not mention AI, ML, or any related terms like deep learning or neural networks. The performance studies focus on image quality and landmark identification compared to film, not on algorithmic performance metrics typical of AI/ML.

No.
The device is indicated for generating radiographic images for dental examination and diagnosis, not for treating diseases or conditions.

Yes
The 'Intended Use / Indications for Use' section explicitly states that the device is "intended for dental examination and diagnosis of diseases of the teeth, jaw, and oral structures."

No

The device description explicitly states it is an "X-Ray System" and details hardware components like a "CCD sensor" and "removable cartridge," indicating it is a hardware device with integrated software for image processing.

No, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • IVD devices are used to examine specimens taken from the human body. The intended use of the BELMAX CM system is to generate radiographic images of the dento-maxilofacial region for dental examination and diagnosis. This involves imaging the patient directly, not analyzing samples taken from the patient.
  • The device description and performance studies focus on image quality and clarity for direct patient imaging. The studies compare the digital images produced by the BELMAX CM to traditional X-ray film images, evaluating the visualization of anatomical structures and landmark identification. This is consistent with an in-vivo imaging device, not an in-vitro diagnostic device.

The BELMAX CM is a medical imaging device used for in-vivo diagnosis (diagnosis performed on a living organism).

N/A

Intended Use / Indications for Use

The BELMAX CM Model X168 X-Ray System is an extraoral source dental panoramic and cephalometric X-ray System intended to produce X-rays for dental radiographic examination and diagnosis of disease of the teeth, jaw, and oral structures.

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

MUH

Device Description

The BELMAX CM Model X168 X-Ray System is the next generation of the Takara Belmont digital dental X-ray systems. Similar to the prior Takara Belmont ANA-BEL, ANA-BEL CM equipped with the Takara Belmont ADR Plus SSXI, the BELMAX CM Model X168 X-Ray System offers digital imaging with panoramic and cephalometric imaging programs with the same exposure levels (KV/mA). Modifications resulting in the device include a new sized CCD sensor including three rather than two of the same sensor array grids mounted in a removable cartridge rather than bolted in place.

Mentions image processing

Digital processing is used.

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

X-ray

Anatomical Site

teeth, jaw, and oral structures (dento-maxillofacial region)

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

A clinical trial was sponsored and conducted by the Department of Oral Radiology, Asahi University School of Dentistry and included 30 patients receiving a dental examination. Readings were performed by five specialists in orthodontic dentistry. Digital images were observed on a computer monitor using the contrast, brightness, and magnification adjustment function of the ANA-BEL CM software, while X-ray films were observed on a conventional view box.

Summary of Performance Studies (study type, sample size, AUC, MRMC, standalone performance, key results)

Clinical trial, 30 patients. On BELMAX CM digital images, skeletal hard tissue structures were clearly observed in 97% of the subjects, whereas this fell to 81% for film images. For the depiction of soft tissue structures, 87% of BELMAX CM digital images were rated as sufficient whereas only 43% for film images. The BELMAX CM digital images were rated better than the film images on overall image quality. For landmark identification, the average percentage of sufficient clarity on BELMAX CM digital images was 93.6% and on X-ray film images it was 81.6%. The BELMAX CM digital images were rated better than the film images for landmark identification.

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.

Takara Belmont ANA-BEL, ANA-BEL CM, K040748, Takara Belmont ADR Plus SSXI, K041834, Generic X-Ray film/screen, a pre-amendment device

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

§ 872.1800 Extraoral source x-ray system.

(a)
Identification. An extraoral source x-ray system is an AC-powered device that produces x-rays and is intended for dental radiographic examination and diagnosis of diseases of the teeth, jaw, and oral structures. The x-ray source (a tube) is located outside the mouth. This generic type of device may include patient and equipment supports and component parts.(b)
Classification. Class II.

0

K062529

510(k) Summary807.92(c)OCT - 5 2006
SponsorSubmitter
TAKARA BELMONT USA, INC.
BELMONT Equipment Division
101 Belmont Drive
Somerset, New Jersey 08873-1204
Contact Person:
Telephone:Robert Schiff
973-227-1830
Date Prepared:September 26, 2006
Manufacturing Facility:
Asahi Roentgen Ind. Co., Ltd
376-3 Tsukiyama-cho, Kuze,
Minami-ku, Kyoto, Japan
Corresponding Official:
Mr. Masahiro Kanaya
Device Name807.92(a)(2)
Proprietary Name:
Common/Usual Name:BELMAX CM Model X168
Dental Panoramic and Cephalometric X-Ray
System
Classification Name:
Regulation Number:
Classification Code:System, X-Ray, Extraoral Source, Digital
872.1800
MUH
Predicate Devices807.92(a)(3)
Predicate Device #1:Takara Belmont ANA-BEL, ANA-BEL CM,
K040748
Predicate Device #2:Takara Belmont ADR Plus SSXI, K041834
Predicate Device #3:Generic X-Ray film/screen, a pre-amendment
device

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SUBMITTED BY SCHIFF & COMPANY, WEST CALDWELL, NJ

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Device Description

The BELMAX CM Model X168 X-Ray System is the next generation of the Takara Belmont digital dental X-ray systems. Similar to the prior Takara Belmont ANA-BEL, ANA-BEL CM equipped with the Takara Belmont ADR Plus SSXI, the BELMAX CM Model X168 X-Ray System offers digital imaging with panoramic and cephalometric imaging programs with the same exposure levels (KV/mA). Modifications resulting in the device include a new sized CCD sensor including three rather than two of the same sensor array grids mounted in a removable cartridge rather than bolted in place.

Device Intended Use

The BELMAX CM Model X168 X-Ray System is an extraoral source dental panoramic and cephalometric X-ray System intended to produce X-rays for dental radiographic examination and diagnosis of disease of the teeth, jaw, and oral structures.

Device Technological Characteristics 807.92(a)(6)

BELMAX CM, Takara ANA-BEL and ANA-BEL CM with Takara ADR Plus SSXI Imaging Device all employ X-ray tube with maximum rated peak tube potential of 90 kV, and a CCD digital acquisition sensor in a replacement film cassette. Digital processing is used.

Nonclinical and Clinical Tests807.92(b)
-------------------------------------------

807.92(b)(1) Nonclinical Tests Discussion

The nonclinical tests included

  • physical characteristics unique to the BELMAX CM, such as tolerance . limits and effects of power noise on the operation of the device
  • operational function tests such as procedure for taking an exposure .
  • functional characteristics such as plotting of the latent image decay . characteristic as a function of time and temperature, recovery time for radiographic device to be able to accept the next exposure
  • exposure characteristics such as quantitative measurements of the input . dose required to generate an image equivalent to that provided by a predicate device
  • safety features such as a ready signal provided to indicate the SSXI is . prepared to accept and process an X-ray input

807.92(a)(4)

807.92(a)(5)

2

Clinical Tests Discussion

807.92(b)(2)

A clinical trial was sponsored and conducted by the Department of Oral Radiology, Asahi University School of Dentistry and included 30 patients receiving a dental examination. Readings were performed by five specialists in orthodontic dentistry. Digital images were observed on a computer monitor using the contrast, brightness, and magnification adjustment function of the ANA-BEL CM software, while X-ray films were observed on a conventional view box.

On BELMAX CM digital images, skeletal hard tissue structures were clearly observed in 97% of the subjects, whereas this fell to 81% for film images. For the depiction of soft tissue structures, 87% of BELMAX CM digital images were rated as sufficient whereas only 43% for film images. The BELMAX CM digital images were rated better than the film images on overall image quality. For landmark identification, the average percentage of sufficient clarity on BELMAX CM digital images was 93.6% and on X-ray film images it was 81.6%.

The BELMAX CM digital images were rated better than the film images for landmark identification.

Statement of Compliance with Federal X-ray Performance Standards

The BELMAX CM Model X168 X-Ray System is in compliance with the Federal X-ray performance standards.

Conclusion

807.92(b)(3)

The modified device has the same intended use and principle of operation as the prior Takara Belmont devices, as well as substantially equivalent technical specifications. The modifications were implemented to improve the ease of use. maintenance, and image quality, and do not change the intended use or fundamental scientific technology of the device. A hazard analysis, validation testing and clinical study against the generic X-ray film/screen predicate similar to those submitted for the prior Takara Belmont devices were presented to support the substantial equivalence of the modified Takara Belmont system.

The conclusions drawn from the nonclinical and clinical tests demonstrate that the BELMAX CM Model X168 X-Ray System is as safe, as effective and performs as well as or better than the Takara ANA-BEL and ANA-BEL CM Panoramic X-ray system with Takara ADR Plus SSXI Imaging Device and than the Generic X-Ray film.

3

The BELMAX CM, Takara ANA-BEL and ANA-BEL CM Panoramic X-ray system with Takara ADR Plus SSXI Imaging Device and with the Generic X-Ray film are substantially equivalent.

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Image /page/4/Picture/1 description: The image shows the logo for the U.S. Department of Health and Human Services. The logo consists of a circular seal with the words "DEPARTMENT OF HEALTH & HUMAN SERVICES USA" arranged around the perimeter. Inside the circle is an abstract symbol that resembles an eagle or bird in flight, with three stylized lines representing the wings and a wavy line representing the body.

Food and Drug Administration 9200 Corporate Blvd. Rockville MD 20850

OCT - 5 2006

Takara Belmont USA, Inc. Dr. Robert Schiff c/o Schiff & Company 1129 Bloomfield Avenue WEST CALDWELL-N1 07006

Re: K062529

Trade/Device Name: BELMAC CM, Model X168 Regulation Number: 21 CFR 872.1800 Regulation Name: Extraoral source x-ray system Regulatory Class: II Product Code: MUH Dated: August 28, 2006 Received: August 29, 2006

Dear Dr. Robert Schiff:

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 (Premarket Approval), 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.

Image /page/4/Picture/10 description: The image shows a circular logo with the text "1906-2006" at the top. The letters "FDA" are prominently displayed in the center of the logo. Below the letters, the word "Centennial" is written in a cursive font. Three stars are located at the bottom of the logo.

Protecting and Promoting Public Health

5

Page 2 -

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 equivatence 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 one of the following numbers, based on the regulation number at the top of this letter:

21 CFR 876.xxx(Gastroenterology/Renal/Urology)240-276-0115
21 CFR 884.xxx(Obstetrics/Gynecology)240-276-0115
21 CFR 894.xxx(Radiology)240-276-0120
Other240-276-0100

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 (240) 276-3150

or at its Internet address http://www.fda.gov/cdrl/industry/support/index.html.

Sincerely yours,

Nancy C. Hogdon

Nancy C. Brogdon Director, Division of Reproductive, Abdominal, and Radiological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

6

INDICATIONS FOR USE STATEMENT

510(k) Number (if known): Device Name:

KD62529
Not assigned yet

Indications for Use:

The BELMAX CM dental panoramic and cephalometric X-ray system is indicated for use as a generator of radiographic images of the dento-maxilofacial region and is intended for dental examination and diagnosis of diseases of the teeth, jaw, and oral structures.

Prescription Use X

(Per 21 CFR 801 Subpart D)

Over-The-Counter Use

(21 CFR 807 Subpart C)

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

Office of Device Evaluation (ODE)

David A. Ingram

(Division Sian-Off Division of Reproductive, Abd and Radiological Device 510(k) Number

SUBMITTED BY SCHIFF & COMPANY, WEST CALDWELL, NJ

012

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