K Number
K140507
Device Name
HIOSSEN PROSTHETIC SYSTEM
Date Cleared
2014-08-20

(174 days)

Product Code
Regulation Number
872.3630
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
Hiossen Prosthetic system is intended for use with a dental implant to provide support for prosthetic restorations such as crowns, bridges, or over-dentures.
Device Description
The Hiossen Prosthetic system is intended for use as an aid in prosthetic restoration. It consists of Abutments, overdenture components and Abutment Screws. The Hiossen Prosthetic 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.
More Information

No
The summary describes a system of physical components (abutments, screws) for dental prosthetics and makes no mention of software, algorithms, or AI/ML capabilities.

No
The device aids in prosthetic restoration by providing support for crowns, bridges, or over-dentures, which are restorative rather than therapeutic.

No

The device is described as a prosthetic system intended to provide support for restorations. It does not mention diagnosing conditions.

No

The device description explicitly states it consists of physical components (Abutments, overdenture components, and Abutment Screws), indicating it is a hardware-based medical device, not software-only.

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

Here's why:

  • Intended Use: The intended use clearly states that the Hiossen Prosthetic system is for providing support for prosthetic restorations in the mouth (crowns, bridges, over-dentures) in conjunction with a dental implant. This is a direct interaction with the patient's body for a structural purpose.
  • Device Description: The description lists components like abutments, overdenture components, and abutment screws. These are all physical components used in dental procedures.
  • Lack of IVD Characteristics: An IVD device is used to examine specimens derived from the human body (like blood, urine, tissue) in vitro (outside the body) to provide information for diagnosis, monitoring, or screening. This device does none of that.

The Hiossen Prosthetic system is a dental prosthetic device, not an IVD.

N/A

Intended Use / Indications for Use

Hiossen Prosthetic system is intended for use with a dental implant to provide support for prosthetic restorations such as crowns, bridges, or over-dentures. A dental implant fixture to provide support for prosthetic restorations such as crowns, bridges, or over-dentures.

Product codes

NHA

Device Description

The Hiossen Prosthetic system is intended for use as an aid in prosthetic restoration. It consists of Abutments, overdenture components and Abutment Screws.

The Hiossen Prosthetic 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.

The Hiossen Prosthetic system is substantially equivalent in design, function and intended use to the HU.HS.HG Prosthetic System (K081575), TS implant system (K121585), NP-cast abutment system (K121843), US.SS.GS System, (K073247) and Prosthetic system (K110308)

These proposed abutments are compatible with the HIOSSEN Implant fixture only. HTIII SA Fixture (K101096).

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Not Found

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)

Summary of nonclinical testing
Proposed devices in this submission are substantially equivalent to the predicate devices Therefore we didn't consider conducting additional test but biocompatibility test and retention test of O-Ring are conducted because material of O-Ring is changed

Summary of clinical testing
No clinical studies are submitted

Key Metrics (Sensitivity, Specificity, PPV, NPV, etc.)

Not Found

Predicate Device(s)

K081575, K121585, K121843, K110308, K073247, K121995

Reference Device(s)

K101096

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 872.3630 Endosseous dental implant abutment.

(a)
Identification. An endosseous dental implant abutment is a premanufactured prosthetic component directly connected to the endosseous dental implant and is intended for use as an aid in prosthetic rehabilitation.(b)
Classification. Class II (special controls). 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.)

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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 circular seal with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" arranged around the perimeter. Inside the circle is an abstract symbol resembling a stylized human figure, with three overlapping profiles facing to the right. The profiles are rendered in a dark color, contrasting with the white background of the seal.

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

Auqust 20, 2014

OSSTEM IMPLANT Company, Ltd. C/O Mr. Patrick Lim Manager 85 Ben Fairless Dr Fairless Hills, PA 19030

Re: K140507

Trade/Device Name: Hiossen Prosthetic System Regulation Number: 21 CFR 872.3630 Regulation Name: Endosseous dental implant abutment Regulatory Class: Class II Product Code: NHA Dated: July 17, 2014 Received: July 23, 2014

Dear Mr. Lim:

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. Lim

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 contact the Division of Small Manufacturers, International and Consumer Assistance at its tollfree number (800) 638-2041 or (301) 796-7100 or at its Internet address http://www.fda.gov/MedicalDevices/Resourcesfor You/Industry/default.htm. 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 yours,

Mary S. Runner -S

Erin I. Keith, M.S. Director Division of Anesthesiology, General Hospital, Respiratory, Infection Control and Dental Devices Office of Device Evaluation Center for Devices and Radiological Health

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Image /page/2/Picture/1 description: The image shows the logo and contact information for OSSTEM Implant Co., Ltd. The address is #507-8 Geoje3-Dong Yeonje-Gu Busan, 611-804 Republic of Korea. The telephone number is +82 51 850-2500, and the fax number is +82 51 850-4341. The website address is www.osstem.com.

Indications for Use Statement

Indications for Use

510(k) Number K _140507

Device Name : Hiossen Prosthetic system

Indication for use : Hiossen Prosthetic system is intended for use with a dental implant to provide support for prosthetic restorations such as crowns, bridges, or over-dentures.

Prescription Use X (Per 21CFR801 Subpart D) OR Over-The-Counter Use (Per 21CFR807 Subpart C)

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

QS-QI-505-2(Rev.0)

3

Section 010

OSSTEM Implant Co., Ltd

#507-8 Geoje3-Dong Yeonje-Gu Busan, 611-804 Republic of Korea Tel: +82 51 850-2500 Fax: +82 51 850-4341 www.osstem.com

510(k) Summary

This summary of 510(k) safety and effectiveness information is being submitted in accordance with requirements of 21 CFR Part 807.92.

Date: December 13, 2013

  1. Company and Correspondent making the submission:
  • Submitter's Name :
  • Address :
  • Contact :
  • Phone:
  • Correspondent's Name:
  • Address:
  • Contact:
  • Phone:

. 2. Device :

Trade or (Proprietary) Name : Common or usual name :

Classification Name :

OSSTEM Implant Co., Ltd. #507-8 Geoje3-Dong Yeonje-Gu Busan, 611-804, Republic of Korea Mr. Hee Kwon Son +82 51 850 2575

HIOSSEN Inc. 85 Ben Fairless Dr. Fairless Hills, PA 19030 Patrick Lim 888 678 0001

Hiossen Prosthetic system Dental Abutment Endosseous dental implant abutment 21CFR872.3630 Class II NHA

3. Predicate Device:

HU.HS.HG Prosthetic System, OSSTEM Implant Co., Ltd., K081575 TS implant system, OSSTEM Implant Co., Ltd., K121585 NP-cast abutment system, OSSTEM Implant Co., Ltd., K121843 Prosthetic system, OSSTEM Implant Co., Ltd., K110308 US.SS.GS System, OSSTEM Implant Co., Ltd., K073247 TS Fixture system, OSSTEM Implant Co., Ltd., K121995

4. Description :

The Hiossen Prosthetic system is intended for use as an aid in prosthetic restoration. It consists of Abutments, overdenture components and Abutment Screws

The Hiossen Prosthetic system is similar to other commercially available products based on

QS-QI-505-3(Rev.0)

4

OSSTEM Implant Co., Ltd.

STEM® #507-8 Geoje3-Dong Yeonje-Gu Busan, 611-804 Republic of Korea Tel: +82 51 850-2500 Fax: +82 51 850-4341 www.osstem.com

the intended use, the technology used, the claims, the material composition employed and performance characteristics.

The Hiossen Prosthetic system is substantially equivalent in design, function and intended use to the HU.HS.HG Prosthetic System (K081575), TS implant system (K121585), NP-cast abutment system (K121843), US.SS.GS System, (K073247) and Prosthetic system (K110308)

These proposed abutments are compatible with the HIOSSEN Implant fixture only. HTIII SA Fixture (K101096)

ItemContent
ET Custom Healing
AbutmentDescription
Used after successful osseointegration and removing cover screw to make a soft tissue shape before loading prosthetics.
Material
PEEK
Diameter
7.05mm/ 5.0mm (Oval in shape)
Height
7mm, 9mm, 11mm, 7.5mm, 9.5mm, 11.5mm
NP-Cast AbutmentDescription
NP-Cast Abutment is used for cases with path and aesthetic and spatial constraints
After customization, be sure to use only dental non-precious metal alloy for casting to make the prosthesis
Material
Co-Cr-Mo Alloy + POM
Diameter
4.0mm, 4.5mm
Height
10.5mm, 15.5mm, 13.71mm, 15.71mm, 13mm, 15mm
O-RingDescription
Use for making stud-type overdenture
Material
Polymer
Diameter
4.6mm
O-Ring Retainer Cap setO-Ring Retainer Cap set consist of Retainer and O-ring
Retainer Cap is cleared K81575
O-Ring Retainer setO-Ring Retainer set consist of Retainer and O-ring
Retainer is cleared K81575
Esthetic Low Gold
CylinderDescription
Use for making screw-retained prosthesis
After customization, be sure to use only dental gold alloy for casting to make the prosthesis
Material
Gold Alloy + POM
Diameter
4.8mm
Height
12mm

QS-QI-505-3(Rev.0)

5

OSSTEM Implant Co., Ltd.

OSSTEM®

#507-8 Geoje3-Dong Yeonje-Gu Busan, 611-804 Republic of Korea
Tel: +82 51 850-2500 Fax: +82 51 850-4341 www.osstem.com

- Substantial Equivalence Matrix

| | ET Custom Healing
abutment | Predicate devices | |
|--------------------------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|----------------------------------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Part Name | | Healing Abutment | Quick Temporary
Abutment |
| 510K | Proposed | K081575 | K121585 |
| Material | PEEK | Titanium | PEEK |
| Manufacturer | OSSTEM Implant Co.,
Ltd. | OSSTEM Implant Co.,
Ltd. | OSSTEM Implant Co.,
Ltd. |
| Description
(Intended for
use) | Used to make a soft
tissue shape before
setting up prosthetics and
removing cover screw
after osseointegration. | Used to make a soft
tissue shape before
setting up prosthetics and
removing cover screw
after osseointegration | It is used temporary until
final prosthesis is made
to maintain esthetic
Apperance |
| Indication for
use | Hiossen Prosthetic
system is intended for
use with a dental implant
to provide support for
prosthetic restorations
such as crowns, bridges,
or overdentures. | HU/HS/HG Prosthetic
System is intended for
use as an aid in
prosthetic
restoration. | The abutment is intended
for use with a dental
implant fixture to
provide support for
prosthetic restorations
such as crowns, bridges,
or overdenture. |
| Design | Image: ET Custom Healing abutment design | Image: Healing Abutment design | Image: Quick Temporary Abutment design |
| SE | ET Custom Healing abutment has tha same "Inatended for use" with predicate
device, Healing Abutment (K081575) but material is difference
Materier of ET Custom Healing abutment is the same with predicate device,
Quick Temporary Abutment (K121585) | | |

Package for ET Custom Healing Abutment to keep sterile is Blister & Tyvek package Package of ET Custom Healing Abutment, has the same material and contact area as package for TS Fixture System that has already been cleared by 510(K), K121995 with shelf life of 8years. Therefore, shelf life of 8years for TS Custom Healing Abutment was submitted

QS-QI-505-3(Rev.0)

6

STEM Implant Co.,

OSTEON
IMPLANT #50

07-8 Geoje3-Dong Yeonje-Gu Busan, 611-804 Republic of Korea Tel: +82 51 850-2500 Fax: +82 51 850-4341 www.osstem.com

| Part Name | O-Ring Retainer Cap Set
O-Ring Retainer Set
O-ring | Predicate devices
O-Ring Retainer Cap Set
O-Ring Retainer Set
O-ring |
|--------------|-------------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------|
| 510K | Proposed | K081575 |
| Material | Retainer: Titanium
O-Ring : Acrylonitrile & Butadiene
Polymer | Retainer: Titanium
O-Ring : Silicone |
| Manufacturer | OSSTEM Implant Co., Ltd. | OSSTEM Implant Co., Ltd. |
| Intended use | Use for marking stud-type overdenture | Use for marking stud-type overdenture |
| Design | Image: O-Ring Retainer Cap Set Design | Image: O-Ring Retainer Cap Set Design |
| SE | O-Ring Retainer Cap, O-Ring Retainer and O-Ring have a cleared with 510(K),
K81575 but material of O-ring is changed | |

5. Indication for use :

Hiossen prosthetic system is intended for use with a dental implant fixture to provide support for prosthetic restorations such as crowns, bridges, or over-dentures.

    1. Review :
      Hiossen prosthetic system has same indication for use and technological characteristics as the predicate device.

Hiossen prosthetic system has been subjected to safety, performance, and product validations prior to release. Safety tests including biocompatibility have been considered to ensure the devices comply with the applicable International and US regulations.

    1. Summary of nonclinical testing
      Proposed devices in this submission are substantially equivalent to the predicate devices Therefore we didn't consider conducting additional test but biocompatibility test and retention test of O-Ring are conducted because material of O-Ring is changed
    1. Summary of clinical testing No clinical studies are submitted
    1. Conclusions

In accordance with the Federal Food, Drug and Cosmetic Act, 21 CFR Part 807, and based on the information provided in this premarket notification Osstem Implant Co., Ltd. concludes that the Hiossen prosthetic system is substantially equivalent to the predicate devices as described herein.

QS-QI-505-3(Rev.0)