K Number
K111120
Device Name
CSM SUBMERGED-R IMPLANT SYSTEM
Manufacturer
Date Cleared
2011-10-14

(176 days)

Product Code
Regulation Number
872.3640
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The CSM submerged-R Implant System is especially designed for use in dental implant surgery. According to the widely accepted clinical studies successful osseointegration between fixture and the live bone depends on surgical implantation under proper conditions, shape of fixture and surface treatment technique. Implants are intended for use in support of single or multiple-unit restorations and partial or fully edentulous mandibles and maxilla. In case of Customized Hand Milling Abutment, its wall thickness is 2mm and height is 12mm. It can be reduced into Max. 7mm. The margin of the product can be modified up to Max 20°. In case of Non-Hex Cementation Abutment, it is a bridge type. Two or more products must be used. Under part of abutment is made in order to avoid restriction in connecting work.
Device Description
The CSM submerged - R implant system includes various one-stage Fixtures and two-stage Fixtures made of titanium. These implants are surgically inserted into the upper jaw and serve as a tooth root replacement providing a stable foundation for restorations. This product is a fixture and an abutment prosthetic dentistry material which are dental implant infrastructures. The connection with the abutment is inserted in bones as internal connection (the morse taper 11° and Hexagon type) method. A connection will restore mastication function of the patient who has difficulties due to damage of the natural tooth and function as a supporting the prosthetic dentistry material such as artificial tooth.
More Information

Not Found

No
The summary describes a dental implant system made of titanium, focusing on mechanical properties and surgical placement. There is no mention of AI or ML in the intended use, device description, or performance studies.

Yes
The device is described as a "fixture and an abutment prosthetic dentistry material which are dental implant infrastructures" that are "surgically inserted into the upper jaw and serve as a tooth root replacement" and will "restore mastication function of the patient who has difficulties due to damage of the natural tooth". These functions directly relate to treating a medical condition (damaged teeth) and restoring physiological function (mastication), which aligns with the definition of a therapeutic device.

No

The device is described as a dental implant system, specifically fixtures and abutments, used in dental implant surgery to replace tooth roots and support restorations. Its purpose is to restore mastication function, not to diagnose medical conditions or diseases.

No

The device description explicitly states the system includes "various one-stage Fixtures and two-stage Fixtures made of titanium" which are surgically inserted, indicating a hardware component.

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

Here's why:

  • Intended Use: The intended use is for dental implant surgery, specifically to replace tooth roots and support dental restorations. This is a surgical procedure performed directly on the patient's body.
  • Device Description: The device is described as a fixture and abutment made of titanium, surgically inserted into the jawbone. This is a physical implant.
  • Lack of IVD Characteristics: There is no mention of the device being used to examine specimens derived from the human body (like blood, urine, tissue samples, etc.) to provide information for diagnosis, monitoring, or treatment.

IVD devices are used in vitro (outside the body) to analyze biological samples. This device is used in vivo (inside the body) as a surgical implant.

N/A

Intended Use / Indications for Use

The CSM submerged-R Implant System is especially designed for use in dental implant surgery. According to the widely accepted clinical studies successful osseointegration between fixture and the live bone depends on surgical implantation under proper conditions, shape of fixture and surface treatment technique. Implants are intended for use in support of single or multiple-unit restorations and partial or fully edentulous mandibles and maxilla. In case of Customized Hand Milling Abutment, its wall thickness is 2mm and height is 12mm. It can be reduced into Max. 7mm. The margin of the product can be modified up to Max 20°. In case of Non-Hex Cementation Abutment, it is a bridge type. Two or more products must be used. Under part of abutment is made in order to avoid restriction in connecting work.

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

DZE, NHA

Device Description

The CSM submerged - R implant system includes various one-stage Fixtures and two-stage Fixtures made of titanium. These implants are surgically inserted into the upper jaw and serve as a tooth root replacement providing a stable foundation for restorations.

This product is a fixture and an abutment prosthetic dentistry material which are dental implant infrastructures. The connection with the abutment is inserted in bones as internal connection (the morse taper 11° and Hexagon type) method. A connection will restore mastication function of the patient who has difficulties due to damage of the natural tooth and function as a supporting the prosthetic dentistry material such as artificial tooth.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

upper jaw, mandibles and maxilla

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)

All of the data consistent with the recommendations in the FDA guidance document Root-form Endosseous Dental Implants and Endosseous Dental Implant Abutments, May 12, 2004, mechanical testing of the implants demonstrated that the CSM submerged-R Implant System possess mechanical strength at least equivalent to the predicate devices.

fatigue testing demonstrated that there is substantial equivalence in the performance, safety and effectiveness between the CSM submerged-R Implant System and the referenced predicate devices. Fatigue testing also demonstrated that this system meets its predefined acceptance criteria and performs in accordance with its intended use.

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.

K090825, K093321

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

KIII120

CSM Implant

510(K) Summary

Submitter

CSM Implant Cho Sung Am B205 Techno-Building, Kyoungpook National Univ. #573-13, Bokhyun-dong, Buk-Gu, Daegu, Korea Phone: 82-53-952-8261 Fax: 82-53-954-8261

Official Correspondent

Kodent Inc. April Lee 325 N. Puente St. Unit B Brea, CA 92821 Email: kodentinc@gmail.com Phone: 714-525-0114 Fax: 714-525-0116

Device Information

Trade Name: CSM submerged-R Implant System

Common Name: Endosseous Dental Implant

Classification Name: Implant, Endosseous, Root-Form

Product Code: DZE

Regulation Number: 872.3640

Device Class: Class II

Date Prepared: Aug, 2010

General Description

The CSM submerged - R implant system includes various one-stage Fixtures and two-stage Fixtures made of titanium. These implants are surgically inserted into the upper jaw and serve as a tooth root replacement providing a stable foundation for restorations.

This product is a fixture and an abutment prosthetic dentistry material which are dental implant infrastructures. The connection with the abutment is inserted in bones as internal connection (the morse taper 11° and Hexagon type) method. A connection will restore mastication function of the patient who has difficulties due to damage of the natural tooth and function as a supporting the prosthetic dentistry material such as artificial tooth.

Indication for Use

The CSM submerged-R Implant System is especially designed for use in dental implant surgery. According to the widely accepted clinical studies successful osseointegration between fixture and the live bone depends on surgical implantation under proper conditions, shape of fixture and surface treatment technique. Implants are intended for use in support of single or multiple-unit restorations and partial or fully edentulous mandibles and maxilla. In case of Customized Hand Milling Abutment, its wall thickness is 2mm and height is 12mm. It can be reduced into Max. 7mm. The margin of the product can be modified up to Max 20°. In case of Non-Hex Cementation Abutment, it is a bridge type. Two or more products must be used. Under part of abutment is made in order to avoid restriction in connecting work.

1

Predicate Devices & Comparison

The subject device is substantially equivalent to the following predicate device:

  • SQ IS System manufactured by Neobiotech Co., Ltd. (K090825) .
    Testing and other comparisons have established that the subject of CSM submerged-R Implant System is substantially equivalent in design, materials, indications and intended use, packaging, labeling, and performance to other predicate devices of the type currently marketed in the U.S.

Comparison Chart

Subject DevicePredicate Device
510(K) NumberN/AK090825
Device NameCSM submerged-R Implant
SystemSQ IS System
ManufacturerCSM ImplantNeobiotech Co., Ltd.
Indications for UseMandible and Maxilla
Endosseous Dental Implant &
AccessoriesMandible and Maxilla
Endosseous Dental Implant &
Accessories
DesignSubmerged Implant DesignSubmerged Implant Design
Implant SterileYesYes
Sterilization MethodGammaGamma
Surface TreatmentRBM
(Resorbable Blasting Media)RBM
(Resorbable Blasting Media)
Implant Diameters3.52 ~ 5.32 mm3.5 ~ 8.0 mm
Implant Lengths8 ~ 14 mm7 ~ 15 mm
Abutment diameters4.0 ~ 6.5 mm3.5 ~ 8.0mm
Abutment lengths5.5 ~ 7.5mm4.0~8.0mm
AttachmentsVarious abutments and
componentsVarious abutments and
components
Implant materialTi-6Al-4V ELI
ASTM-F136Ti-6Al-4V ELI
ASTM-F136
Cover Screw
MaterialCP. Ti. Gr. 4
ASTM-F67CP. Ti. Gr. 4
ASTM-F67
Product CodeDZE. NHADZE. NHA

2

Substantial equivalence chart summary

The CSM submerged-R Implant System has a substantially equivalent intended use as the identified predicate, SQ IS System (K093321) manufactured by Neobiotech Co., Ltd. and is made of titanium metal intended to be surgically placed in the bone of the upper or lower jaw arches. The system is similar to other commercially available products based on the intended use, the technology used, the claims, the material composition employed and performance characteristics. CSM submerged-R Implant System and predicate device are made from pure titanium and the surface treatment is done with RBM.

These predicate devices and CSM submerged-R Implant System have been designed, manufactured and tested in compliance with FDA's Class II special controls guidance document root-form endosseous dental implants and endosseous dental implant abutment. The subject and predicate devices are similar in size, surface treatment, and both are sterilized via gamma irradiation. When compared with predicate devices, no new questions of safety or effectiveness have been raised for the CSM submerged-R Implant System.

Performance Data

All of the data consistent with the recommendations in the FDA guidance document Root-form Endosseous Dental Implants and Endosseous Dental Implant Abutments, May 12, 2004, mechanical testing of the implants demonstrated that the CSM submerged-R Implant System possess mechanical strength at least equivalent to the predicate devices.

Among the information and data presented in this 510(k) submission to support the substantial equivalence of the CSM submerged-R Implant System to the specified predicate devices, fatigue testing demonstrated that there is substantial equivalence in the performance, safety and effectiveness between the CSM submerged-R Implant System and the referenced predicate devices. Fatigue testing also demonstrated that this system meets its predefined acceptance criteria and performs in accordance with its intended use.

Safety and Effectiveness

CSM submerged-R Implant System is substantially equivalent to a predicate device when the device has the same intended use and the same technological characteristics as the previously cleared predicate device, and it can be demonstrated that the device is as safe and effective as the predicate device, and that the new device does not raise different questions regarding safety and effectiveness as compared to the predicate device. The CSM submerged-R Implant System, as designed and manufactured, is as safe and effective as the predicate devices and therefore is determined to be substantially equivalent to the referenced predicate devices.

3

Conclusion

The CSM submerged-R Implant System, subject of this submission, constitutes a safe, reliable and effective medical device, meeting all the declared requirements of its intended use. Device presents no adverse health effects or safety risks to patients when used as intended. This system has the same intended use and fundamental scientific technology as its predicate devices. Therefore, CSM submerged-R Implant System and its predicate devices are believed to be substantially equivalent.

t

4

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Food and Drug Administration 10903 New Hamoshire Avenue Document Control Room -WO66-G609 Silver Spring, MD 20993-0002

CSM Implant Company, Limited C/O Ms. April Lee Consultant 325 North Puente Street, Unit B Brea, California 92821

OCT 1 4 2011

· Re: K111120

Trade/Device Name: CSM submerged-R Implant System Regulation Number: 21 CFR 872.3640 Regulation Name: Endosseous Dental Implant Regulatory Class: II Product Code: DZE, NHA Dated: September 27, 2011 Received: October 3, 2011

Dear Ms. Lec:

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 ffor 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.

5

Page 2 - Ms. Lee

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 electronic 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/Industrv/default.htm.

Sincerely yours.

hn 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

6

Indication for Use

510(K) Number (if known):K1111120
-------------------------------------

Device Name: CSM submerged-R Implant System

The CSM submerged-R Implant System is especially designed for use in dental implant surgery. According to the widely accepted clinical studies successful osseointegration between fixture and the live bone depends on surgical implantation under proper conditions, shape of fixture and surface treatment technique. Implants are intended for use in support of single or multiple-unit restorations and partial or fully edentulous mandibles and maxilla. In case of Customized Hand Milling Abutment, its wall thickness is 2mm and height is 12mm. It can be reduced into Max. 7mm. The margin of the product can be modified up to Max 20°. In case of Non-Hex Cementation Abutinent, it is a bridge type. Two or more products must be used. Under part of abutment is made in round shape in order to avoid restriction in connecting work.

Prescription Use (Part 21 CFR 801 Subpart D) AND/OR

Over-The-Counter

(Per 21 CFR 801 Subpart C)

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

ﻟﺪﻳﻨﺔ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ

Concurrence of CDRH, Office of Device Evaluation (ODE)
(Division Sign-Off)
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Division of Anesthesiology, General Hospital Infection Control, Dental Devices

510(k) Number: