K Number
K153253
Device Name
GC Reline II
Manufacturer
Date Cleared
2016-03-03

(114 days)

Product Code
Regulation Number
872.3760
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
GC RELINE II is a resilient material for making soft relining of dentures.
Device Description
GC RELINE II is a VPS silicone for relining of dentures. The components consist of the base silicone paste and the catalyst silicone paste that are extruded from a cartridge and are automixed with a mixing tip. GC Reline II is available in the following viscosities: Soft, Extra Soft, and Extra Extra Soft. The cartridge is made of high density polyethylene and the cap is made of polypropylene. The mixing tip is made of polypropylene. GC Reline Primer for Resin is a resin adhesive that is packaged in a glass bottle. GC Reline Modifier is available in Liquid A and Liquid B and is similar to the Base and Catalyst of the subject device. Liquid A and Liquid B are dispensed in equal amounts onto the mixing pad and mixed together. It is used to modify (activate) the existing reline surface to accept additional Reline II material.
More Information

No
The device description and performance studies focus on the material properties and biocompatibility of a denture relining material, with no mention of AI or ML technologies.

Yes.
The device is a resilient material for relining dentures, which is used to provide comfort and improve the fit of dentures for patients, thus serving a therapeutic purpose.

No

Explanation: The device is described as a "resilient material for making soft relining of dentures." Its functions are related to physical properties (viscosity, hardness, adhesion) and biocompatibility, not to diagnosing a condition or disease.

No

The device description clearly states it is a VPS silicone material for relining dentures, consisting of pastes, cartridges, mixing tips, and primers, which are all physical components, not software.

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

Here's why:

  • Intended Use: The intended use is "a resilient material for making soft relining of dentures." This describes a material used on a medical device (dentures), not a test performed on a biological sample to diagnose or monitor a medical condition.
  • Device Description: The description details a silicone material, primers, and modifiers used for relining dentures. This aligns with a dental material, not an in vitro diagnostic test.
  • Lack of IVD Characteristics: There is no mention of analyzing biological samples (blood, urine, tissue, etc.), detecting analytes, or providing diagnostic information about a patient's health status.

Therefore, GC RELINE II is a dental material used for relining dentures, not an in vitro diagnostic device.

N/A

Intended Use / Indications for Use

GC RELINE II is a resilient material for making soft relining of dentures.

Product codes

EBI

Device Description

GC RELINE II is a VPS silicone for relining of dentures. The components consist of the base silicone paste and the catalyst silicone paste that are extruded from a cartridge and are automixed with a mixing tip. GC Reline II is available in the following viscosities: Soft, Extra Soft, and Extra Extra Soft.

The cartridge is made of high density polyethylene and the cap is made of polypropylene. The mixing tip is made of polypropylene.

GC Reline Primer for Resin is a resin adhesive that is packaged in a glass bottle.

GC Reline Modifier is available in Liquid A and Liquid B and is similar to the Base and Catalyst of the subject device. Liquid A and Liquid B are dispensed in equal amounts onto the mixing pad and mixed together. It is used to modify (activate) the existing reline surface to accept additional Reline II material.

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)

Benchtop testing demonstrates that the subject device GC Reline II, like its predicate device GC Reline Soft/Extra Soft, is in compliance with ISO 10139-2:2009 Dentistry-Soft lining materials for removable dentures-Part 2: Materials for long-term use, and as such, the subject device meets specific requirements for softness, adhesion, water sorption and water solubility as well as for packaging, marking and manufacturer's instructions for soft denture lining materials suitable for long-term use. The subject device GC Reline II was also tested and met the requirement for cytotoxicity, irritation and sensitivity as shown in the biocompatibility table above.

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

Not Found

Predicate Device(s)

K990376

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 872.3760 Denture relining, repairing, or rebasing resin.

(a)
Identification. A denture relining, repairing, or rebasing resin is a device composed of materials such as methylmethacrylate, intended to reline a denture surface that contacts tissue, to repair a fractured denture, or to form a new denture base. This device is not available for over-the-counter (OTC) use.(b)
Classification. Class II.

0

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 border with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" arranged around the circumference. Inside the circle is a stylized image of three human profiles facing to the right, stacked on top of each other.

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

March 3, 2016

GC America, Inc. Mr. Mark Heiss Director, Regulatory & Academic Affairs 3737 W. 127th St. Alsip. Illinois 60803

Re: K153253

Trade/Device Name: GC Reline II Regulation Number: 21 CFR 872.3760 Regulation Name: Denture Relining, Repairing, or Rebasing Resin Regulatory Class: II Product Code: EBI Dated: February 1, 2016 Received: February 3, 2016

Dear Mr. Heiss:

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. Mark Heiss

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 devicerelated adverse events) (21 CFR 803); good manufacturing practice requirements as set forth in the quality systems (OS) 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 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, Tina Kiang -S

for 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

2

Indications for Use

510(k) Number (if known) K153253

Device Name

GC Reline II

Indications for Use (Describe)

GC RELINE II is a resilient material for making soft relining of dentures.

Type of Use (Select one or both, as applicable)

Prescription Use (Part 21 CFR 801 Subpart D)
Over-The-Counter Use (21 CFR 801 Subpart C)

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GC AMERICA INC.

3737 W 127 STREET
ALSIP, ILLINOIS 60803
TEL (708) 597-0900
FAX (708) 926-9100
www.gcamerica.com

K153253 510(k) Summary

February 29, 2016 Date Prepared:

  • Submitter Information: 1.
    GC AMERICA INC. 3737 W. 127th Street Alsip, IL 60803
Contact Person:Mark Heiss, D.D.S.
Phone:(708) 926-3090
Alternate Contact:Lori Rietman
Phone:(708) 926-3092
Fax:(708) 926-9100
    1. Device Name: Proprietary Name: Classification Name: CFR Regulation: Device Classification: Product Code:
      GC RELINE II Denture relining, repairing or rebasing resin 21CFR 872.3760 Class II EBI
    1. Predicate Device:
CompanyDevice510(k)Date Cleared
GC America, Inc.GC Reline Soft/Extra SoftK990376March 5, 1999

4

    1. Description of Device:
      GC RELINE II is a VPS silicone for relining of dentures. The components consist of the base silicone paste and the catalyst silicone paste that are extruded from a cartridge and are automixed with a mixing tip. GC Reline II is available in the following viscosities: Soft, Extra Soft, and Extra Extra Soft.

The cartridge is made of high density polyethylene and the cap is made of polypropylene. The mixing tip is made of polypropylene.

GC Reline Primer for Resin is a resin adhesive that is packaged in a glass bottle.

GC Reline Modifier is available in Liquid A and Liquid B and is similar to the Base and Catalyst of the subject device. Liquid A and Liquid B are dispensed in equal amounts onto the mixing pad and mixed together. It is used to modify (activate) the existing reline surface to accept additional Reline II material.

న. Indications for Use: GC RELINE II is a resilient material for making soft relining of dentures.

    1. Technological characteristics:
      The components of GC RELINE II and the predicate device are similar. The subject device GC Reline II contains a new ingredient, Polydimethylsiloxane, which is used in each of the three viscosities. Bench testing demonstrates that the addition of the new ingredient does not impact technological characteristics when compared to the predicate K990376. The curing mechanism of the applicant and predicate devices is by polymerization of uncured vinyl polysiloxane. This reaction is caused by chemical polymerization initiator systems. Bench top testing indicates that even with different formula, applicant device and predicate devices, meet specifications listed in ISO 10139-2.

Therefore, the applicant and predicate device are substantially equivalent. There are no statistically significant differences between GC RELINE II and GC RELINE when comparing performance data.

5

Applicant devicePrimary Predicate
Product categoryCHAIRSIDE
VINYL
POLYSILOXANE
RESILIENT DENTURE LINERCHAIRSIDE
VINYL
POLYSILOXANE
RESILIENT DENTURE LINER
Trade nameGC RELINE IIGC RELINE (Soft/ Extra Soft)
510(k) NumberK153253K990736
Indications for
UseGC RELINE II is a resilient material for
making soft relining of dentures.GC RELINE Soft Extra Soft is a resilient
material for making soft relining of dentures.
Device DescriptionGC RELINE II is a VPS silicone for relining
of dentures. The device consists of the base
paste and the catalyst paste Including VPS.
The material sets by mixing the catalyst paste
with the base paste.GC RELINE is a VPS silicone for relining of
dentures. The device consists of the base paste
and the catalyst paste Including VPS. The material
sets by mixing the catalyst paste with the base
paste.
Device
ComponentsBase:
Silicon dioxide
Vinyldimethylpolysiloxane
Methylhydrogen dimethylpolysiloxane
Polydimethylsiloxane*
Colorant
Catalyst: Silicon dioxide
Vinyldimethylpolysiloxane
Polydimethylsiloxane*
Platinum CatalystBase:
Silicon dioxide
Vinyldimethylpolysiloxane
Methylhydrogen dimethylpolysiloxane
Methylphenylpolysiloxane
Colorant
Catalyst: Silicon dioxide
Vinyldimethylpolysiloxane
Platinum Catalyst
Similar Physical
Properties
(tested in
accordance with
ISO 10139-2)Shore A hardness, 24h
Shore A hardness, 28d
Bond strength (MPa)
Sorption( $[\mu$ /mm3)
Solubility ( $[\mu$ /mm3)Shore A hardness, 24h
Shore A hardness, 28d
Bond strength (MPa)
Sorption( $[\mu$ /mm3)
Solubility ( $[\mu$ /mm3)
Composition of
MaterialsCartridge - high density polyethylene
Cap - polypropylene
Mixing tip - polypropylene.
GC Reline II Primer for Resin-8g glass bottle.
GC Reline II Modifier-polypropylene bottle.
GC Reline II Remover-high density
polyethylene.Cartridge - high density polyethylene
Cap-polypropylene
Mixing tip - polypropylene.
GC Reline II Primer for Resin - 8 g glass bottle.
GC Reline II Modifier-polypropylene bottle.
Standards of
ConformityISO 10139:2009, Sections 5.1, 5.2, 5.3
ISO10993-1:2009, Sections 6.2.2.2, 6.2.2.3,
6.2.2.4
ISO 10993-2:2006
ISO 10993-5:2009 Sections 8.5
ISO 10993-10:2010, Sections 6, 7Not available
Biocompatibility10993-5 Cytotoxicity - pass
10993-10 irritation - pass
10993-10 sensitization - passNot available

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Biocompatibility Testing

| Test | Test Standard | Test Results
(pass or fail) |
|---------------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------------------------------|
| Cytotoxicity Test | Under the conditions of ISO 10993-1:2009, Biological evaluation of medical
devices, sections 6.2.2.2, 6.2.2.3, 6.2.2.4, the test articles should meet the test
requirements | Pass |
| Cytotoxicity Test
In Vitro | Under the conditions of ISO 10993-5:2009, Biological evaluation of medical
devices, section 8.5 Determination of cytotoxicity, the test articles should meet
the test requirements | Pass |
| Irritation and
Sensitization | Under the conditions of ISO 10993-10:2010, biological evaluation of medical
devices, Sections 6, 7, the test articles should meet the
test requirements | Pass |

7. Nonclinical Testing:

Benchtop testing demonstrates that the subject device GC Reline II, like its predicate device GC Reline Soft/Extra Soft, is in compliance with ISO 10139-2:2009 Dentistry-Soft lining materials for removable dentures-Part 2: Materials for long-term use, and as such, the subject device meets specific requirements for softness, adhesion, water sorption and water solubility as well as for packaging, marking and manufacturer's instructions for soft denture lining materials suitable for long-term use. The subject device GC Reline II was also tested and met the requirement for cytotoxicity, irritation and sensitivity as shown in the biocompatibility table above.

8. Substantial equivalence:

The subject device GC RELINE II and its predicate device GC RELINE (Soft/ Extra Soft) share the same function and intended use. The curing mechanism of the new and predicate device is equivalent. Bench testing demonstrates that the addition of a new ingredient in the subject device does not impact technological characteristics when compared to the predicate K990376.

The subject device and predicate devices encompass the same range of physical dimensions, including hardness, bond strength, sorption, solubility, and also share equivalent biocompatibility. Both the subject and predicate devices are provided nonsterile and have a shelf life of 2 years. Any differences in the technological characteristics do not raise new questions.

GC AMERICA INC. has demonstrated that, for the purposes of FDA's regulation of medical devices, the subject device GC Reline II is substantially equivalent to the predicate device in intended use, material composition, fundamental scientific technology, principals of operation, and basic design.