K Number
K121901
Device Name
TI-MAX Z45
Manufacturer
Date Cleared
2013-02-28

(244 days)

Product Code
Regulation Number
872.4200
Panel
Dental
Reference & Predicate Devices
Predicate For
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

TI-MAX Z45 is powered by either an air-motor or electronic micromotor for use in general dentistry. The device is intended for cutting and grinding teeth, cavity preparations, tooth and crown preparations, finishing and trimming teeth and filling materials, and removal of crowns and filling materials.

Device Description

The Ti-MAX Z45 is a contra-angle dental handpiece which is powered by either an air-motor or electronic-micromotor for use in general dentistry. The TI-MAX Z45 is intended for cutting and grinding teeth, cavity preparations, tooth and crown preparations, finishing and trimming teeth and filling materials, and removal of crowns and filling materials. The Tr-MAX Z45 transmits rotational force from the motor to the gears through a clutch, and then the rotation force reaches the chuck and the dental bur receives the rotation force. The dental bur is able to cut and grind teeth and dentures using the rotation force.

AI/ML Overview

The provided text describes a 510(k) summary for a dental handpiece, the TI-MAX Z45. This document focuses on demonstrating substantial equivalence to predicate devices through various comparisons and bench testing. It does not contain information about clinical studies with human readers or AI algorithms for diagnostic purposes. Therefore, many of the requested categories related to clinical studies and AI performance cannot be addressed.

Here's the information that can be extracted from the provided text, primarily focusing on the acceptance criteria and the study performed:

1. Table of Acceptance Criteria and Reported Device Performance

The acceptance criteria for the TI-MAX Z45 are based on compliance with the international standard ISO 7785-2, which is also used for the predicate devices.

Acceptance CriterionReported Device Performance
Compliance with ISO 7785-2All TI-MAX Z45 samples were compliant with ISO 7785-2

The text also provides specific performance characteristics, although these are not explicitly labelled as "acceptance criteria" but rather as "performance" metrics within the comparison table:

Performance MetricTI-MAX Z45 Reported Value
Eccentricity0.016 mm
Force for bur extraction25.3N
Flow Rate (Coolant Water)More than 50 ml/min

2. Sample Size Used for the Test Set and Data Provenance

The document states that "All TI-MAX Z45 samples were compliant with ISO 7785-2". However, the exact sample size for the bench testing is not specified in the provided text.
The data provenance is from bench testing performed by the manufacturer, NAKANISHI, INC., a company located in Japan. The study is not a clinical study involving patient data and therefore the terms "retrospective or prospective" do not apply in the usual sense.

3. Number of Experts Used to Establish the Ground Truth for the Test Set and Qualifications of Those Experts

Not applicable. The "ground truth" for this device's acceptance was established through compliance with an engineering standard (ISO 7785-2) via bench testing, not through expert clinical interpretation of data.

4. Adjudication Method for the Test Set

Not applicable. This was bench testing against a standard, not a clinical study requiring adjudication of expert opinions.

5. If a Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study Was Done

No, a Multi-Reader Multi-Case (MRMC) comparative effectiveness study was not done. This document describes the regulatory submission for a physical dental handpiece, not an AI software or a diagnostic tool that would typically involve human readers and comparative effectiveness studies.

6. If a Standalone (i.e., algorithm only without human-in-the-loop performance) Was Done

No. This is a hardware device (dental handpiece), not an algorithm or software. Therefore, standalone algorithm performance is not applicable.

7. The Type of Ground Truth Used

The "ground truth" for the device's performance regarding safety and effectiveness was established by compliance with the international standard ISO 7785-2. This is an engineering/performance standard for dental handpieces.

8. The Sample Size for the Training Set

Not applicable. This is a hardware device, not an AI or machine learning model that requires a training set.

9. How the Ground Truth for the Training Set Was Established

Not applicable. As above, this is a hardware device and does not involve a training set as understood in the context of AI development.

{0}------------------------------------------------

Image /page/0/Picture/0 description: The image shows the NSK logo in the upper portion of the image. The logo is white text on a black background. The lower portion of the image contains the text "510(k) Summary" in a large font. The text is black on a white background.

Image /page/0/Picture/1 description: The image contains a sequence of alphanumeric characters. The characters appear to be handwritten and include the letters 'KI' followed by the numbers '21901'. The characters are written in black ink on a white background. The writing style is somewhat cursive, with some characters connected.

FEB 2 8 2013

  • Owner/Company name, address a. NAKANISHI, INC. 700 Shimohinata, Kanuma-shi, Tochigi, 322-8666, Japan

b. Contact

Toshihiko Shinozaki Assistant Manager, R&D Department, Pharmaceutical Affairs Group NAKANISHI, INC. 700 Shimohinata, Kanuma-shi, Tochigi, 322-8666, Japan

Phone:011-81-289-64-3380
Fax:011-81-289-62-6665
Email:t-shinozaki@nsk-nakanishi.co.jp

Application Correspondent C.

Fumiaki Kanai, Ph.D. President and CEO MIC International 4-1-17 Hongo, Bunkyo-ku Tokyo, 113-0033, Japan

Phone: 011-81-3-3818-8577 Fax: 011-81-3-3818-8573 Email: kanaif@mici.co.jp

d. Date prepared

June 28, 2012

e. Name of device

Trade Name: Classification Name: Regulation Name: Regulatory Class: Product Code:

TI-MAX Z45 Handpiece, Contra-and Right-angle Attachment, Dental Dental handpiece and accessories Class I EGS

510(k) Summary: Page 1 of 6

Image /page/0/Picture/17 description: The image shows a black and white drawing of a bird in flight. The bird has a long beak and a forked tail. Below the bird, the words "Powerful Partners" are written in a small font. The image is simple and appears to be a logo or emblem.

{1}------------------------------------------------

NSK

Predicate devices ﮨﺖ

The Ti-MAX Z45 is substantially equivalent to the following legally marketed devices:

510(k):K070663
Trade name:A-DEC/W&H SYNEA AIR-DRIVEN HIGHSPEED HANDPIECE,
MODELS TA-98, TA-97
A-DEC/W&H SYNEA HANDPIECE ATTACHMENT, MODELS WA-99LT,
WA-86LT, WA-66LT, WA-56LT, HA-43LT
Product code:EFB
Classification Name:Handpiece, Air-powered, Dental
510(k):K011061
Trade name:SURGICAL CONTRA-ANGLE HANDPIECES TYPES WS-56E,
WS-75-E/KM, WS-92E/3
Product code:EGS

Classification Name: Handpiece, Contra-and Right-angle Attachment, Dental

Hereinafter, the predicate devices are called "the SYNEA HANDPIECE (K070663)" and "the SURGICAL CONTRA-ANGLE HANDPIECES (K011061)", respectively, for convenience of discussion in this application. Regarding the SYNEA HANDPIECE (K070663), A-DEC/W&H SYNEA HANDPIECE ATTACHMENT is the exact predicate device for the TI-MAX Z45. Since the HA-43LT type of the A-DEC/W&H SYNEA HANDPIECE ATTACHMENT is a straight handpiece, the type is eliminated as the predicate device for the T1-MAX Z45 hereinafter in this submission. The SYNEA HANDPIECE (K070663) indicates A-DEC/W&H SYNEA HANDPIECE ATTACHMENT MODELS WA-99LT, WA-86LT, WA-66LT, WA-56LT in this application.

g. Description of the device

The Ti-MAX Z45 is a contra-angle dental handpiece which is powered by either an air-motor or electronic-micromotor for use in general dentistry. The TI-MAX Z45 is intended for cutting and grinding teeth, cavity preparations, tooth and crown preparations, finishing and trimming teeth and filling materials, and removal of crowns and filling materials. The Tr-MAX Z45 transmits rotational force from the motor to the gears through a clutch, and then the rotation force reaches the chuck and the dental bur receives the rotation force. The dental bur is able to cut and grind teeth and dentures using the rotation force.

h. Statement of Intended Use

TI-MAX Z45 is powered by either an air-motor or electronic micromotor for use in general dentistry.

The device is intended for cutting and grinding teeth, cavity preparations, tooth and crown

{2}------------------------------------------------

NET

preparations, finishing and trimming teeth and filling materials, and removal of crowns and filling materials.

i. Summary of Technological Characteristics

Summary or receded in rotation of the TI-MAX Z45 is 168,000 min1. The rotation speed is increased by 4.2-fold at the chuck using the gears. Since the TI-MAX Z45 uses rotational force for the treatment, temperature increase may occur on the drilling point. Therefore, the TI-MAX Z45 has 4-port water spray outlet on the head in order to cool down the treatment area. It is possible to switch the type of coolant water flow, water jet or water spray. The TI-MAX Z45 has opticfiber for lighting.

The friction grip bur (not exceed 25 mm) which conforms ISO 1797-1 is intended to use for the TI-MAX Z45. The TI-MAX Z45 uses the push-button chuck mechanism.

The TI-MAX Z45 can be connected only E-type motors which conforms ISO 3964.

Statement of substantial equivalence i.

The Indications for Use of the TI-MAX Z45 is similar to the SYNEA HANDPIECE (K070663). The principle of operation of the TI-MAX Z45 is identical to the predicates. That is, the TI-MAX Z45 and the predicates transmit rotational force from the motor to the dental bur using the gears. The dental bur is able to cut and grind teeth and dentures using the rotation force. In addition, design features (Contra-Angle, Push-Button Chuck, Motor coupling, Thermal safety system) of the Ti-MAX Z45 are identical to those of the predicates.

Following table is comparison between the TI-MAX Z45 and the predicates.

TI-MAX Z45SYNEA HANDPIECE(K070663)SURGICALCONTRA-ANGLEHANDPIECES(K011061)
Indications for UseTI-MAX Z45 is poweredby either an air-motor orelectronic micromotorfor use in generaldentistry.The device is intendedfor cutting and grindingteeth, cavitypreparations, tooth andcrown preparations,finishing and trimmingThe A-dec/W&H SyneaAir-Driven HighspeedHandpiece is anair-powered dentalhandpiece for use ingeneral dentistry. Thisdevice is designed forremoving cariousmaterial and excessfilling material, cavityand crown preparation,root canal preparations,Indications are verywidespread in the fieldof implantology andsurgery. Thementioned handpieceshave been developedespecially for thefollowing applications:WS-56 E:for e,g.osteotomla on theupper and lower jaw.germectomls,
teeth and fillingmaterials, and removalof crowns and fillingmaterials.finishing toothpreparations,restorations andpolishing teeth.sequestrotomlaWS-75 E/KM: for e.g.implantology(preparation of thebone cavity, placingthe implants), surgicaltreatment ofdysgnathia,osteosynthesis,segmentosteotomlaand especially mildosteotomla.WS-92 E/3 : for e.g.hemisection, wisdomtooth extraction.
Product CodeEGSEFBEGS
ClassificationNameHandpiece, Contra-andRight-angle Attachment,DentalHandpiece, Air-powered,DentalHandpiece, Contra-andRight-angleAttachment, Dental
Design featuresContra-Angle,Push-Button Chuck,Motor coupling,Thermal safety systemContra-Angle,Push-Button Chuck,Motor coupling,Thermal safety systemContra-Angle,Push-Button Chuck,Motor coupling,Thermal safety system
Gear ratio1:4.21:5, 1:1, 2:1, 10:11:1, 20:1. 1:2,7
Maximummotor/drive speed40,000 rpm40,000 rpm50,000 rpm
MaterialsStainless Steel,TitaniumUnknownStainless steel
Motor couplingCompliant with ISO3964Compliant with ISO3964Compliant with ISO3964
Source of powerAir-motor,Electronic-micromotorAir-motor,Electronic-micromotorAir-motor,Electronic-micromotor
LightGlass Rod (Fiberoptic)With light type/Withoutlight typeWith lighttype/Without light type
DimensionHead Diameter: 9.6mmHead Height: 14.5mmLength: 96.2mmHead Height: 12.3 mmor 13.7mmUnknown
Weight66.5 gUnknownUnknown
PerformanceCompliant with ISO7785-2Compliant with ISO7785-2Compliant with ISO7785-2
-Eccentricity0.016 mmUnknownUnknown
-Force for burextraction25.3NUnknownUnknown
SterilizationSterilized by user(Autoclave)Sterilized by user(Autoclave)Sterilized by user(Autoclave)
Thermal safetyAir/Water spray,compliant withISO7785-2Air/Water spray,compliant withISO7785-2Air/Water spray,compliant withISO7785-2
-Air/Water Sprayport4-portSingle or 5-portSingle or 3-port
-CoolantWaterTypeWater spray/Water jetWater sprayWater spray
-Flow RateMore than 50 ml/minMore than 50 ml/minMore than 50 ml/min
-Waterpressuresetting range2 bar0.5-2 barUnknown
-Chip air pressuresetting range2 bar1.5-3barUnknown
LubricantPANA Spray (510(k)number is K052700)W&H Service oil F1W&H Service oil F1
BurFG bursFG burs, contra-anglebursFG burs, contra-angleburs
-Maximumburlength25 mm25mm (FG burs), 34mm(contra-angle burs)34mm (WS-56Econtra-angle burs), 45mm (WS-75 E/KM,contra-angle bur), 25mm (WS-92 E/3, FGbur)

Comnarison table

510(k) Summary: Page 3 of 6

Image /page/2/Picture/13 description: The image shows a black and white drawing of a bird perched on a branch. The bird is facing to the left and has a long tail. The branch is thin and has a few leaves on it. The drawing is simple and has a vintage look.

{3}------------------------------------------------

1577

510(k) Summary: Page 4 of 6

Image /page/3/Picture/4 description: The image shows the words "Powerful Partners" in a stylized font. The text is black and the background is white. There is a small graphic above the text.

{4}------------------------------------------------

NSK

Note*: The models for "the A-DEC/W&H SYNEA HANDPIECE ATTACHMENT" are used as the predicate device for the Ti-Max Z45 in the submission.

As shown in the comparison table, the indications for use of the TI-MAX Z45 is similar to the SYNEA HANDPIECE (K070663). As described above, the principle of operation and design features of the TI-MAX Z45 are identical to those of the predicates. However, the dimensions and materials of the TI-MAX Z45 are different from the predicates. The gear ratio of the TI-MAX Z45 is also different from that of the predicates. Therefore, the maximum rotation speed at the chuck is different between the Ti-MAX Z45 and the predicates. In addition, the number of the air/water spray port is different between the TI-MAX Z45 and the predicates. In order to evaluate that those differences do not affect safety and effectiveness of the TI-MAX Z45, bench testing was performed. Bench testing demonstrated that the TI-MAX Z45 met the requirement of ISO7785-2 which was used for evaluation of the predicate devices. Based on above result, the TI-MAX Z45 is substantially equivalent to the predicates and does not raise any new safety and effectiveness concern.

510(k) Summary: Page 5 of 6

Powerts: Partrers

{5}------------------------------------------------

k. Bench Testing

The bench tests were performed in order to ensure the safety and effectiveness of the TI-MAX Z45, verify conformity to ISO 7785-2 and demonstrate substantial equivalence to the predicates.

All TI-MAX Z45 samples were compliant with ISO 7785-2 and demonstrated substantial equivalence to the predicates.

ﻨﺴﺘ Conclusion

The indications for use of the TI-MAX Z45 is similar to the SYNEA HANDPIECE (K070663). In addition, the principle of operation and design features of the TI-MAX Z45 are identical to those of the predicates. However, the dimensions and materials of the TI-MAX Z45 are different from the predicates. The gear ratio of the TI-MAX Z45 is also different from that of the predicates. Therefore, the maximum rotation speed at the chuck is different between the TI-MAX Z45 and the predicates. In addition, the number of the air/water spray port is different between the TI-MAX Z45 and the predicates. Although there are those differences in characteristics between the TI-MAX Z45 and the predicates, a number of performance testing indicated that the Ti-MAX Z45 met the requirement of the recognized consensus or voluntary standard. Based on above result, we conclude the TI-MAX Z45 is substantially equivalent to the predicates and does not raise any new safety and effectiveness concern.

Image /page/5/Picture/6 description: The image shows a black and white drawing of a bird perched on a branch. The bird has a long beak and a long tail. The text "Powerful Partners" is written below the bird. The drawing is simple and stylized.

510(k) Summary: Page 6 of 6

{6}------------------------------------------------

DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/6/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a circular seal with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES • USA" around the perimeter. Inside the circle is a stylized design resembling an eagle or bird-like figure with three curved lines representing wings or feathers.

Public Health Service

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

February 28, 2013

Nakanishi, Incorporated C/O Fumiaki Kanai, Ph.D. President and Chief Executive Officer MIC International 4-1-17 Hongo, Bunkyo-ku Tokyo, Japan 113-0033

Re: K121901

Trade/Device Name: TI-MAX Z45 Regulation Number: 21 CFR 872.4200 Regulation Name: Dental Handpiece and Accessories Regulatory Class: I Product Code: EGS Dated: February 5, 2013 Received: February 11: 2013

Dear Dr. Kanai:

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, Orug 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 contractlie ality 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.

{7}------------------------------------------------

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/ResourcesforYou/Industry/default.htm.

Sincerely vours.

Image /page/7/Picture/7 description: The image contains the words "Kwame Ulmer" in bold, black font on the left side of the image. To the right of the name is the word "HEDA" in a stylized font. The letters are outlined with multiple lines, giving them a three-dimensional appearance. The letter "O" is placed above the "D".

for

Anthony D. Watson, B.S., M.S., M.B.A. Director Division of Anesthesiology, General Hospital, Respiratory, Infection Control and Dental Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

{8}------------------------------------------------

Indications for Use

K121901 510(k) Number (If known):

Device Name: TI-MAX Z45

Indications for Use

TI-MAX Z45 is powered by either an air-motor or electronic micromotor for use in general dentistry.

The device is intended for cutting and grinding teeth, cavity preparations, tooth and crown preparations, finishing and trimming teeth and filling materials, and removal of crowns and filling materials.

Prescription Use
(Per 21 CFR 801 Subpart D)

![x mark](data:image/png;base64,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

AND/OR

Over-the Counter Use (21 CFR 801 Subpart C)

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Mary S. Runner -S 013:02.28 07:38:56

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

510(k) Number;

§ 872.4200 Dental handpiece and accessories.

(a)
Identification. A dental handpiece and accessories is an AC-powered, water-powered, air-powered, or belt-driven, hand-held device that may include a foot controller for regulation of speed and direction of rotation or a contra-angle attachment for difficult to reach areas intended to prepare dental cavities for restorations, such as fillings, and for cleaning teeth.(b)
Classification. Class I.