K Number
K152471
Device Name
CAPO BULK FILL
Date Cleared
2016-08-04

(339 days)

Product Code
Regulation Number
872.3690
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
- Fillings with layer thicknesses up to 4 mm in Black's class I and II cavities - Cavity lining - as a first (bottom) layer in Black's class I and II cavities
Device Description
Not Found
More Information

Not Found

Not Found

No
The provided 510(k) summary contains no mention of AI, ML, image processing, or any other technology typically associated with AI/ML in medical devices. The intended use and device description (though not found) relate to dental fillings, which are generally passive materials.

No
The information provided describes the use of a material for dental fillings and cavity lining, which are direct treatments to modify an anatomical structure, but not necessarily a device in the context of being something that treats a disease or condition as a therapeutic device would. The description points to a material or process, not a mechanical or electronic device.

No
Explanation: The device description indicates its use for fillings and cavity lining, which are treatment procedures, not diagnostic ones. There is no mention of identifying or detecting diseases or conditions.

No

The provided 510(k) summary describes a dental filling material and its intended use in specific cavity types. It does not mention any software component or function.

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

Here's why:

  • Intended Use: The intended use describes the device as a filling material for dental cavities (Black's class I and II). This is a direct treatment or restoration of a physical condition within the body.
  • IVD Definition: In vitro diagnostics are tests performed on samples taken from the human body (like blood, urine, or tissue) to detect diseases, conditions, or infections. The device described does not involve testing samples outside the body.
  • Lack of IVD-related information: The description lacks any mention of analyzing biological samples, detecting biomarkers, or providing diagnostic information.

Therefore, this device falls under the category of a dental restorative material, not an IVD.

N/A

Intended Use / Indications for Use

  • Fillings with layer thicknesses up to 4 mm in Black's class I and II cavities
  • Cavity lining - as a first (bottom) layer in Black's class I and II cavities

Product codes

EBF

Device Description

Not Found

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

Prescription Use

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

Not Found

Key Metrics

Not Found

Predicate Device(s)

Not Found

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 872.3690 Tooth shade resin material.

(a)
Identification. Tooth shade resin material is a device composed of materials such as bisphenol-A glycidyl methacrylate (Bis-GMA) intended to restore carious lesions or structural defects in teeth.(b)
Classification. Class II.

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Image /page/0/Picture/1 description: The image is a seal for the Department of Health & Human Services - USA. The seal is circular and contains the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter. In the center of the seal is the Department of Health and Human Services logo, which consists of a stylized caduceus symbol.

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

August 4, 2016

Schuetz Dental Gmbh Anke Puent Official Correspondent Dieselstr. 5- 6 Rosbach, 61191 DE

Re: K152471

Trade/Device Name: Capo Bulk Fill Regulation Number: 21 CFR 872.3690 Regulation Name: Tooth Shade Resin Material Regulatory Class: Class II Product Code: EBF Dated: August 25, 2015 Received: August 31, 2015

Dear Anke Puent:

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 (21 CFR Part 807); labeling (21 CFR Part 801); medical device reporting of medical devicerelated 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.

1

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please contact the Division of Industry and Consumer Education 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. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 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 Industry and Consumer Education 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,

Susan Ruina DDS, MA

Tina Kiang Acting Division Director Division of Anesthesiology, General Hospital Respiratory, Infection Control and Dental Devices

Enclosure

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Indications for Use

510(k) Number (if known): K152471/S001 Device Name: Capo Bulk Fill Indications for Use:

  • Fillings with layer thicknesses up to 4 mm in Black's class I and II cavities
  • Cavity lining - as a first (bottom) layer in Black's class I and II cavities

| Prescription Use

(Part 21 CFR 801 Subpart D)
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AND/OR

| Over-The-Counter Use

(21 CFR 801 Subpart C)
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(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE OF NEEDED)Concurrence of CDRH, Office of Device Evaluation (ODE)

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