(58 days)
The MTA2.1 MATERIAL is indicated for dental procedures that contact pulp and periradicular tissues, as well as obturation and sealing of root canals.
The MTA2.1 MATERIAL is designed and developed for dental clinicians to use in contact with vital pulp tissue and periradicular tissue, including sealing and obturation of root canals. This material can be used for dental procedures contacting pulpal or periradicular tissue such as: Pulp capping, Cavity lining, Base material in a cavity, Pulpotomies, Root-end filling, Apexification, Perforation repair, Root resorption, and Obturation (pulpectomy) in primary or secondary teeth. The dentist will mix the powder and water-based gel and place the mixed MTA2.1 MATERIAL into the space created by the procedure. The procedure may be part of caries treatment, root canal treatment, or periapical surgery. These procedures are performed on primary and secondary dentition and are color stable over time. MTA2.1 MATERIAL is tinted yellow, pink and gray.
The provided document describes the Avalon Biomed Inc.'s MTA2.1 MATERIAL and its substantial equivalence determination to a predicate device (MTA2 ROOT AND PULP MATERIAL, K122892). This submission is for a material, not an AI/ML powered medical device, therefore, many aspects of the requested information (e.g., sample size for test set, number of experts, adjudication methods, MRMC studies, standalone performance, training set details) are not applicable.
However, I can extract the acceptance criteria and the studies performed to demonstrate the device meets those criteria, focusing on the available non-clinical performance data.
1. Table of Acceptance Criteria and Reported Device Performance
The acceptance criteria for the MTA2.1 MATERIAL are based on established dental material standards, specifically ADA 57 and ISO 9917. The document states that the MTA2.1 MATERIAL meets these standards.
| Acceptance Criterion (Standard) | Reported Device Performance |
|---|---|
| Radiopacity (ADA 57) | Meets standard |
| Solubility (ADA 57) | Meets standard |
| Dimensional Stability (ADA 57) | Meets standard |
| Film Thickness (ADA 57) | Meets standard |
| Flow (ADA 57) | Meets standard |
| Working Time (ADA 57) | Meets standard |
| Setting Time (ADA 57) | Meets standard |
| Compressive Strength (ISO 9917) | Conforms to standard |
| Leaching of Arsenic (ISO 9917) | Conforms to standard |
| Leaching of Lead (ISO 9917) | Conforms to standard |
| Washout Stability | Confirmed stability |
| Discoloration Stability | Confirmed color stability |
| Biocompatibility (Cytotoxicity) | Evaluated, passed |
2. Sample Size Used for the Test Set and Data Provenance
- Sample Size for Test Set: Not specified. The document refers to "bench testing" and "design validation" for these non-clinical tests, implying laboratory experiments. The specific number of samples for each test (e.g., radiopacity, solubility) is not detailed.
- Data Provenance: The tests were conducted as part of the device's "design validation." This implies laboratory testing performed by or for the manufacturer (Avalon Biomed Inc.). The country of origin of the data is not explicitly stated beyond the company being in Bradenton, FL, USA, and the submission being to the US FDA. The studies are prospective in the sense that they were conducted specifically for this regulatory submission to evaluate the material's properties against predefined standards.
3. Number of Experts Used to Establish Ground Truth for the Test Set and Qualifications
Not applicable. The "ground truth" for material properties like radiopacity, solubility, or compressive strength is established through standardized laboratory measurement methods as defined by ADA 57 and ISO 9917, rather than expert consensus.
4. Adjudication Method for the Test Set
Not applicable for material property testing.
5. If a Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study was done
No, an MRMC comparative effectiveness study was not done. This type of study is typically relevant for interpretative diagnostic devices where human readers evaluate cases with and without AI assistance. This submission is for a dental material, not an AI system.
6. If a Standalone (i.e., algorithm only without human-in-the-loop performance) was done
No, this is not applicable as the device is a dental material, not an algorithm or AI system.
7. The Type of Ground Truth Used
The "ground truth" for the material's performance relies on standardized measurement methods specified by ADA 57 and ISO 9917. These standards define the procedures and expected ranges for various physical and chemical properties of dental root canal filling and pulp materials. For example:
- Radiopacity: Measured according to the method described in ADA 57.
- Solubility, Dimensional Stability, Film Thickness, Flow, Working Time, Setting Time: Measured according to the methods described in ADA 57.
- Compressive Strength, Leaching of Arsenic and Lead: Measured according to the methods described in ISO 9917.
- Biocompatibility: Evaluated through cytotoxicity tests.
8. The Sample Size for the Training Set
Not applicable. This is a dental material, not an AI/ML model that requires a training set.
9. How the Ground Truth for the Training Set was Established
Not applicable. (See #8)
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Kiuoass.
Avalon Biomed Inc.™
Carolyn Primus, President
JUN 1 1 2014
April 4, 2014
510(k) Summary
per 21CFR807.92
CONTACT:
Carolyn Primus, President Avalon Biomed Inc. 7282 55th Ave E # 227 Bradenton, FL 34203 USA www.AvalonBiomed.com Phone: (941) 753-9737 or 896-9948 Fax: (941) 753-8778 or 896-9950 E-mail: info@avalonbiomed.com Web: http://www.avalonbiomed.com/
DATE PREPARED:
May 23, 2014
MTA2.1 MATERIAL
TRADE OR PROPRIETARY NAME:
CLASSIFICATION NAME:
Root Canal Filling Resin 872.3820
PREDICATE DEVICE:
K122892, MTA2 ROOT AND PULP MATERIALS
DEVICE DESCRIPTION: The MTA2.1 MATERIAL is designed and developed for dental clinicians to use in contact with vital pulp tissue and periradicular tissue, including sealing and obturation of root canals. This material
can be used for dental procedures contacting pulpal or periradicular tissue such as: Pulp capping, Cavity lining, Base material in a cavity, Pulpotomies, Root-end filling, Apexification, Perforation repair, Root resorption, and Obturation (pulpectomy) in primary or secondary teeth.
The dentist will mix the powder and water-based gel and place the mixed MTA2.1 MATERIAL into the space created by the procedure. The procedure may be part of caries treatment, root canal treatment, or periapical surgery. These procedures are performed on primary and secondary dentition and are color stable over time. MTA2.1 MATERIAL is tinted yellow, pink and gray.
INTENDED USE: The MTA2.1 MATERIAL is intended for use for dental procedures that contact pulp and periradicular tissues, as well as obturation and sealing of root canals.
TECHNOLOGICAL CHARACTERISTICS: The MTA2.1 MATERIAL is primarily hydraulic tricalcium silicate powder that is substantially similar to the MTA2 ROOT AND PULP
Premarket Notification (Special)
- MTA2.1 MATERIAL
Avalon Biomed Inc.Page 17 of 53
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MATERIAL (K122892). The tricalcium silicate powders are known to set with water into a hard substance, containing calcium hydroxide dispersed among the hydrated particles of tricalcium silicates. Both materials are radiopaque.
COMPARISONS TO PREDICATE: We believe the MTA2.1 MATERIAL is substantially equivalent to the MTA2 ROOT AND PULP MATERIAL (K122892) when used for contact with pulp tissue and periapical tissue, and as a root canal sealer.
The only modification to the predicate MTA2 ROOT AND PULP MATERIAL (K122892) is a change in a radiopacity component and inorganic pigments. This modification does not affect indications for use or technology. It does not raise any new questions of safety or effectiveness.
Similarities: The predicate and the MTA2.1 MATERIAL are based on an inorganic powder composed of primarily tricalcium silicate, dicalcium silicate, and a radiopaque inorganic oxide. The predicates and the MTA2 ROOT AND PULP MATERIALS rely on water to hydrate the calcium silicate phases, and cause setting into a hard substance containing hydrated silicates and some calcium hydroxide.
Both the MTA2.1 MATERIAL and the predicate are used in root canals or on vital pulp tissue. Both the MTA2.1 MATERIAL and the predicate MTA2 ROOT AND PULP MATERIALS are used for sealing and obturation of root canals. The MTA2.1 MATERIAL and the predicate MTA2 ROOT AND PULP MATERIALS are similar because both kits contain the same gel.
The new and predicate materials had similar compositions, radiopacity, film thickness, flow and compressive strengths, when mixed at similar powder to liquid/gel ratios. Both MTA2.1 MATERIAL and the predicate material induce the precipitation of hydroxyapatite crystals in synthetic body fluid because of the tricalcium silicate powder component.
Differences: MTA2.1 material will be slightly different in color than the MTA2 ROOT AND PULP MATERIALS, which are white and gray in color. Different radiopaque and pigment powders are included in MTA2.1 than in the predicate. MTA2.1 material will be more stable to potential discoloration over time.
NON-CLINICAL PERFORMANCE: As part of design validation, MTA2.1 MATERIAL meet the ADA 57 standard for radiopacity, solubility, dimensional stability, film thickness, and flow, The ADA 57 tests were also performed to measure the working time and setting time of MTA2.1 compared to the predicates. Tests for compressive strength and leaching of arsenic and lead were performed to shown conformance to ISO 9917. Washout tests confirm the stability of the material. Discoloration tests confirm the color stability of the material.
The MTA2.1 MATERIAL was evaluated for biocompatibility with its gel in cytotoxicity test as part of design validation.
CLINICAL PERFORMANCE: No clinical tests were performed in the development of the MTA2.1 MATERIAL.
Premarket Notification (Special)
ੱ
K140955: MTA2.1 MATERIAL
Avalon Biomed Inc.Page 18 of 53
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SUBSTANTIAL EQUIVALENCE: Bench testing was performed as part of design validation to demonstrate continued conformance with the requirements were achieved to conform to the FDA recognized standards ADA 57 and appropriate requirements of ISO 9917.
We believe that the performance data provided herein demonstrate that MTA2.1 ROOT AND PULP MATERIALS are substantially equivalent to the predicate MTA2 (K122892) in design, principle of performance, technology, and composition. We believe the MTA2.1 MATERIAL performs as well as or better than the predicate device.
Premarket Notification (Special)
K140955: MTA2.1 MATERIAL
Avalon Biomed Inc.Page 19 of 53
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DEPARTMENT OF HEALTH & HUMAN SERVICES
Image /page/3/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a stylized depiction of an eagle or bird-like figure with three curved lines representing its wings or body. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES-USA" is arranged in a circular fashion around the bird-like figure.
Public Health Service
Food and Drug Administration 10903 New Hampshire Avenue Document Control Center - WO66-G609 Silver Spring, MD 20993-0002
June 11, 2014
Avalon Biomed Incorporated Dr. Carolyn Primus President 7282 550 Avenue East #227 Bradenton, FL 34203
Re: K140955
Trade/Device Name: MTA2.1 Material Regulation Number: 21 CFR 872.3820 Regulation Name: Resin, Root Canal Filling Regulatory Class: II Product Code: KIF Dated: May 23, 2014 Received: May 30, 2014
Dear Dr. Primus:
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.
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 (2 I 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
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Page 2 - Dr. Primus
forth in the quality systems (OS) regulation (2) 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/ResourcesforYou/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
Enclosure
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Indications for Use
510(k) Number (if known): K140955
Device Name: MTA2.1 MATERIAL
Indications For Use:
The MTA2.1 MATERIAL is indicated for dental procedures that contact pulp and periradicular tissues, as well as obturation and sealing of root canals.
Prescription Use X
(Part 21 CFR 801 Subpart D)
AND/OR
Over-The-Counter Use
(21 CFR 801 Subpart C)
(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF
NEEDED)
Concurrence of CDRH, Office of Device Evaluation (ODE)
Page 1 of 1
Sheena A. Green -S
2014.06.10 14:27:48 -04'00'
Premarket Notification (Special)
K140955: MTA2.1 MATERIAL
Avalon Biomed Inc. Page 15 of 53
§ 872.3820 Root canal filling resin.
(a)
Identification. A root canal filling resin is a device composed of material, such as methylmethacrylate, intended for use during endodontic therapy to fill the root canal of a tooth.(b)
Classification. (1) Class II if chloroform is not used as an ingredient in the device.(2) Class III if chloroform is used as an ingredient in the device.
(c)
Date PMA or notice of completion of a PDP is required. A PMA or a notice of completion of a PDP is required to be filed with the Food and Drug Administration on or before December 26, 1996 for any root canal filling resin described in paragraph (b)(2) of this section that was in commercial distribution before May 28, 1976, or that has, on or before December 26, 1996 been found to be substantially equivalent to a root canal filling resin described in paragraph (b)(2) of this section that was in commercial distribution before May 28, 1976. Any other root canal filling resin shall have an approved PMA or a declared completed PDP in effect before being placed in commercial distribution.