K Number
K102822
Device Name
IMPLANT-ONE SYSTEM
Date Cleared
2011-01-10

(104 days)

Product Code
Regulation Number
872.3640
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Implant-One™ system is indicated for surgical placement in partially or completely edentulous upper or lower jaws to provide a means for prosthetic attachment to restore a patient's chewing function. The Implant-One™ system is indicated for immediate loading only when primary stability is achieved and with the appropriate occlusal loading.
Device Description
The Implant-One™ Dental Implants include endosseous dental implants, cover screws, healing caps, dental implant abutments and abutment screws in a variety of sizes to accommodate differing patient anatomy. Endosseous implants are self-tapping, root-form and threaded. They range from 3.25mm to 5.5mm in diameter with lengths ranging from 8mm to 14mm and have an internal, threaded abutment connection having a Morse style taper. Cover screws and healing caps provide protection to the threads of the abutment connection during endosseous and gingival healing. Cover screws are pre-packaged with each implant. Healing caps are provided as an alternative to the cover screw and are packaged separately. Abutment options include Standard and Restorative in various heights. These are fastened to the implant using an abutment screw.
More Information

Not Found

No
The document describes a standard dental implant system and does not mention any AI or ML components or functionalities.

Yes
The device is intended to restore a patient's chewing function, which addresses a physiological dysfunction (edentulism) and aims to improve health outcomes, classifying it as a therapeutic device.

No

The device description indicates it is a system of dental implants and associated components used for surgical placement to restore chewing function, not for diagnosing conditions.

No

The device description explicitly lists physical components such as endosseous dental implants, cover screws, healing caps, dental implant abutments, and abutment screws, indicating it is a hardware-based medical device.

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

Here's why:

  • Intended Use: The intended use is for surgical placement in the jaw to provide a means for prosthetic attachment and restore chewing function. This is a surgical and restorative procedure performed directly on the patient's body.
  • Device Description: The device consists of implants, screws, caps, and abutments, all of which are physical components designed for implantation and attachment within the body.
  • Lack of Diagnostic Function: There is no mention of the device being used to examine specimens (like blood, tissue, or urine) outside of the body to provide information for diagnosis, monitoring, or screening.
  • Performance Studies: The performance studies described are non-clinical mechanical tests (ISO 14801) and comparison to predicate devices based on mechanical performance, not diagnostic accuracy.

IVD devices are specifically designed to be used in vitro (outside the body) to analyze specimens and provide diagnostic information. The Implant-One™ system is clearly an in vivo (within the body) device used for surgical and restorative purposes.

N/A

Intended Use / Indications for Use

The Implant-One™ system is indicated for surgical placement in partially or completely edentulous upper or lower jaws to provide a means for prosthetic attachment to restore a patient's chewing function. The Implant-One™ system is indicated for immediate loading only when primary stability is achieved and with the appropriate occlusal loading.

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

DZE, NHA

Device Description

The Implant-One™ Dental Implants include endosseous dental implants, cover screws, healing caps, dental implant abutments and abutment screws in a variety of sizes to accommodate differing patient anatomy. Endosseous implants are self-tapping, root-form and threaded. They range from 3.25mm to 5.5mm in diameter with lengths ranging from 8mm to 14mm and have an internal, threaded abutment connection having a Morse style taper. Cover screws and healing caps provide protection to the threads of the abutment connection during endosseous and gingival healing. Cover screws are pre-packaged with each implant. Healing caps are provided as an alternative to the cover screw and are packaged separately. Abutment options include Standard and Restorative in various heights. These are fastened to the implant using an abutment screw.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

partially or completely edentulous upper or lower jaws

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)

Non-clinical dynamic testing of the worst case Implant-One™ system construct was performed according to ISO 14801. The mechanical test results demonstrated that the Implant-One™ system performs as well as or better than the predicate devices. No clinical data was used in support of this submission.

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.

K063341/K072642, K061410/K061847, K073075

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

§ 872.3640 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.

0

K102822

Custom Dental Implants

Norwalk, WI 54648

JAN 1 0 2011

Image /page/0/Picture/4 description: The image shows the logo for Implant-One Dental Implants. The logo features a stylized image of a tooth on the left side. The text "Implant-One" is written in a bold, sans-serif font, with the words "Dental Implants" written in a smaller font below.

510(k) Summary

Date:20 December 2010
Sponsor:Custom Dental Implants Inc.
18975 Incline Road
Norwalk, WI 54648
Phone 608.269.3940
Contact Person:Thomas Arendt, Vice President
Proposed Trade
Name:Implant-One™ Dental Implants
Device ClassificationClass II
Classification Name:Endosseous dental implant & Endosseous dental implant abutment
Regulation:872.3640 & 872.3630
Device Product
Codes:DZE & NHA
Device Description:The Implant-One™ Dental Implants include endosseous dental
implants, cover screws, healing caps, dental implant abutments and
abutment screws in a variety of sizes to accommodate differing
patient anatomy. Endosseous implants are self-tapping, root-form
and threaded. They range from 3.25mm to 5.5mm in diameter with
lengths ranging from 8mm to 14mm and have an internal, threaded
abutment connection having a Morse style taper. Cover screws and
healing caps provide protection to the threads of the abutment
connection during endosseous and gingival healing. Cover screws
are pre-packaged with each implant. Healing caps are provided as
an alternative to the cover screw and are packaged separately.
Abutment options include Standard and Restorative in various
heights. These are fastened to the implant using an abutment screw.
Intended Use:The Implant-One™ system is indicated for surgical placement in
partially or completely edentulous upper or lower jaws to provide a
means for prosthetic attachment to restore a patient's chewing
function. The Implant-One™ system is indicated for immediate
loading only when primary stability is achieved and with the
appropriate occlusal loading.
Materials:The Implant-One™ components are manufactured from titanium
alloy (Ti-6Al-4V) as described by ASTM F1472 or stainless steel
according to ASTM A582.
Predicate Devices:Biomet 3i dental implants and abutments (K063341/K072642)
Zimmer Screw Vent and Contour Abutment (K061410/K061847)
FRIADENT Implant Systems (K073075)

1

The fundamental scientific technology of the Implant-One™ system Technological is the same as previously cleared devices as shown below. Characteristics:

System:Implant-OneBiomet 3iZimmerAnkylos
Material of
manufacture:Titanium and/or titanium alloy
Design:
Endosseous implantRoot-form,
TaperedRoot-form,
Straight and
taperedRoot-form,
Straight and
taperedRoot-form,
Straight
Method of
stabilizationThreaded fixationThreaded fixationThreaded fixationThreaded fixation
Range of Diameters3.25 - 5.5mm3.25 - 6mm3.3 - 6mm3.5 - 7.0mm
Range of Lengths8 - 14mm8.5 - 15mm8 - 16mm8 - 17mm
Modified surfaceYes, AlO2
blastedYes, acid etchedYes,
microtextured or
HA coatedYes, grit blasted
and etched
Connection to
abutmentHex alignment,
6° included taper,
screw attachmentHex alignment,
screw attachmentHex alignment,
1° taper, screw
attachmentKeyed
alignment,
friction-lock
taper, thread
attachment
AbutmentsStandard, Ball,
Gold copingStandard, BallStandard, Ball,
Gold copingStandard, Ball,
Gold coping

Non-clinical dynamic testing of the worst case Implant-One™ system Performance Data: construct was performed according to ISO 14801. The mechanical test results demonstrated that the Implant-One™ system performs as well as or better than the predicate devices. No clinical data was used in support of this submission.

The Implant-One™ system is substantially equivalent to the Conclusion: predicate devices referenced above is therefore safe and effective for its intended use.

2

Food and Drug Administration 10903 New Hampshire Avenue Document Control Room -WO66-G609 Silver Spring. MID 20993-0002

Custom Dental Implants, Incorporated C/O Ms. Karen E. Warden President BackRoads Consulting, Incorporated 8202 Sherman Road Chesterland, Ohio 44026

JAN 1 0 201

Re: K102822

Trade/Device Name: Implant-One" System Regulation Number: 21 CFR 872.3640 Regulation Name: Endosseous Dental Implant & Endosseous Dental Implant Abutment Regulatory Class: II Product Code: DZE & NHA Dated: December 21, 2010 Received: December 23, 2010

Dear Ms. Warden:

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. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you, however, that device labeling must be truthful and not misleading.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to 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- Ms. Warden

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); medical device reporting (reporting of medical device-related adverse events) (21 CFR 803); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820); and if applicable, the clectronic product radiation control provisions (Sections 531-542 of the Act): 21 CFR 1000-1050.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please go to

http://www.fda.gov/AboutFDA/CentersOffices/CDRH/CDRHOffices/ucm115809.htm for the Center for Devices and Radiological Health's (CDRH's) Office of Compliance. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to

http://www.fda.gov/MedicalDevices/Safety/ReportaProblem/default.htm for the CDRH's Office of Surveillance and Biometrics/Division of Postmarket Surveillance.

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) 796-7100 or at its Internet address http://www.fda.gov/MedicalDevices/Resourcesfor You/Industry/default.htm.

Sincerely yours.

h for

Anthony D. Watson, B.S., M.S., M.B.A. 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 Statement

4102822 510(k) Number:

Device Name: Implant-One™ System

Indications for Use:

The Implant-One™ system is indicated for surgical placement in partially or completely edentulous upper or lower jaws to provide a means for prosthetic attachment to restore a patient's chewing function. The Implant-One™ system is indicated for immediate loading only when primary stability is achieved and with the appropriate occlusal loading.

Prescription Use _____________________________________________________________________________________________________________________________________________________________

AND/OR

Over-the-Counter Use_

(21 CFR 801 Subpart D)

(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)

Simon Rogers

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

510(k) Number: K102833