(91 days)
Not Found
No
The summary describes a chemical cleanser and does not mention any computational or data-driven processes indicative of AI/ML.
No
The device is described as a cleanser to remove contaminants from a tooth surface, which is a preparatory step for bonding and does not directly treat a disease or condition.
No
Explanation: The device description states its purpose is to "help remove contaminants from the surface of a tooth prior to bonding." This is a therapeutic or preparatory action, not a function that diagnoses a condition or disease.
No
The device description clearly states it is an "acidic, aqueous cleanser," which is a physical substance, not software.
Based on the provided information, this device is not an IVD (In Vitro Diagnostic).
Here's why:
- IVDs are used to examine specimens derived from the human body. The intended use of "Clean and Boost" is to clean the surface of a tooth prior to bonding. This is a direct application to the tooth itself, not the analysis of a specimen taken from the body (like blood, urine, tissue, etc.).
- The description focuses on cleaning the tooth surface. The purpose is to remove contaminants from the tooth, not to diagnose a condition or provide information about a patient's health based on a biological sample.
Therefore, "Clean and Boost" falls outside the definition of an In Vitro Diagnostic device.
N/A
Intended Use / Indications for Use
Clean and Boost is an acidic, aqueous cleanser that has been designed to help remove contaminants from the surface of a tooth prior to bonding. These contaminants can be hand piece oil, tooth debris, or imaging powder (used to create digital impressions for CAD/CAM restorations).
Product codes
KLE
Device Description
Clean and Boost is an acidic, aqueous cleanser that has been designed to help remove contaminants from the surface of a tooth prior to bonding.
Mentions image processing
Not Found
Mentions AI, DNN, or ML
Not Found
Input Imaging Modality
Not Found
Anatomical Site
tooth
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)
Not Found
Key Metrics (Sensitivity, Specificity, PPV, NPV, etc.)
Not Found
Predicate Device(s)
Reference Device(s)
Not Found
Predetermined Change Control Plan (PCCP) - All Relevant Information
Not Found
§ 872.3200 Resin tooth bonding agent.
(a)
Identification. A resin tooth bonding agent is a device material, such as methylmethacrylate, intended to be painted on the interior of a prepared cavity of a tooth to improve retention of a restoration, such as a filling.(b)
Classification. Class II.
0
DEPARTMENT OF HEALTH & HUMAN SERVICES
Image /page/0/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a stylized eagle with three tail feathers. The words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" are arranged in a circle around the eagle.
Food and Drug Administration 10903 New Hampshire Avenue Document Control Room -WO66-G609 Silver Spring, MD 20993-0002
Mr. Chris Kulton Regulatory Consultant Apex Dental Materials, Inc. 330 Telser Road Lake Zurich, Illinois 60047
MAY 3 1 2012
Re: K120620
Trade/Device Name: Clean and Boost Regulation Number: 21 CFR 872.3200 Regulation Name: Resin Tooth Bonding Agent Regulatory Class: II Product Code: KLE Dated: May 21, 2012 Received: May 23, 2012
Dear Mr. Kulton:
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.
1
Page 2 - Mr. Kulton
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/Industry/default.htm.
Sincerely yours,
for
Esther
Furniture
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
2
Indications for Use:
510(K) Number (if known):
Device name:
Clean and Boost
Clean and Boost is an acidic, aqueous cleanser that has been designed to help remove contaminants from the surface of a tooth prior to bonding. These contaminants can be hand piece oil, tooth debris, or imaging powder (used to create digital impressions for CAD/CAM restorations).
(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRL, Office of Device Evaluation (ODE)
M
Prescription use X (Per 21 CFR 801.109 URSON Over- The- Counter Use
(Division Sign-Off)
Division of Anesthesiology, General Hospital(Optional Format 1-2-96)
Interaction Courted Davissa Infection Control, Dental Devices
510(k) Number: K120620
510K Submission for Clean and Boost Apex Dental Materials, 330 Telser Road Lake Zurich, IL 60047
CONFIDENTIAL
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