K Number
K170175
Device Name
ENDOSEAL MTA
Manufacturer
Date Cleared
2018-02-26

(403 days)

Product Code
Regulation Number
872.3820
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
- Permanent obturation of the root canal following vital pulp-extirpation - Permanent obturation of the root canal following removal of infected or necrotic pulp and placement of intracanal dressings.
Device Description
ENDOSEAL MTA is an endodontic sealer based on MTA, providing a biocompatible and effective root canal filling. It is premixed and pre-loaded in a syringe, which allows a complete filling of the entire root canal including accessory and lateral canals. The product is eugenol-free and will not impede adhesion inside the root canal.
More Information

Not Found

No
The summary describes a material-based endodontic sealer and its physical and biological properties. There is no mention of any computational or analytical functions that would suggest the use of AI or ML.

No

The device is an endodontic sealer used for obturation of the root canal, which is a filling material rather than a device that delivers a therapeutic effect from energy, substances, or other active means.

No

The device is an endodontic sealer used for permanent obturation of the root canal, which is a treatment procedure, not a diagnostic one.

No

The device description clearly states it is an "endodontic sealer based on MTA" and is "premixed and pre-loaded in a syringe," indicating it is a physical substance and delivery mechanism, not software.

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

Here's why:

  • IVD Definition: In vitro diagnostics are tests performed on samples taken from the human body, such as blood, urine, or tissue, to detect diseases, conditions, or infections. They are used to provide information for diagnosis, monitoring, or screening.
  • Device Function: The provided description clearly states that ENDOSEAL MTA is an "endodontic sealer based on MTA" used for "permanent obturation of the root canal." This means it's a material placed inside the body (specifically, the root canal of a tooth) to fill and seal it.
  • Lack of Diagnostic Testing: The device does not perform any tests on samples taken from the body to diagnose or monitor a condition. Its function is purely therapeutic/restorative.

The information provided describes a medical device used in a dental procedure, not an in vitro diagnostic test.

N/A

Intended Use / Indications for Use

  • Permanent obturation of the root canal following vital pulp-extirpation
  • Permanent obturation of the root canal following removal of infected or necrotic pulp and placement of intracanal dressings.

Product codes (comma separated list FDA assigned to the subject device)

KIF

Device Description

ENDOSEAL MTA is an endodontic sealer based on MTA, providing a biocompatible and effective root canal filling. It is premixed and pre-loaded in a syringe, which allows a complete filling of the entire root canal including accessory and lateral canals. The product is eugenol-free and will not impede adhesion inside the root canal.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Root canal

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)

The following properties were tested based on the referenced standard. All the test results met the preset test criteria.

  • ISO 6876 Visual, Capacity, Packaging, Flow, Setting time, Film Thickness, Solubility and Radiopacity
  • Shelf Life Test ISO 6876 (Visual, Packaging, Setting time, Solubility)
  • ISO 10993-5 Cytotoxicity
  • ISO 10993-10 Maximization test for delayed hypersensitivity (LLNA)
  • ISO 10993-11 Acute systemic toxicity
  • ISO 10993-6 Implantation
  • ISO 10993-3 AMES & Mammalian Erythrocyte Micronucleus

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

Not Found

Predicate Device(s): If the device was cleared using the 510(k) pathway, identify the Predicate Device(s) K/DEN number used to claim substantial equivalence and list them here in a comma separated list exactly as they appear in the text. List the primary predicate first in the list.

K133054, K113568, K080917

Reference Device(s): Identify the Reference Device(s) K/DEN number and list them here in a comma separated list exactly as they appear in the text.

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information for the subject device only (e.g. presence / absence, what scope was granted / cleared under the PCCP, any restrictions, etc).

Not Found

§ 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.

0

February 26, 2018

Maruchi Priscilla Chung Regulatory Affairs Consultant LK Consulting Group USA, Inc 800 Roosevelt STE 417 Irvine, California 92620

Re: K170175

Trade/Device Name: Endoseal MTA Regulation Number: 21 CFR 872.3820 Regulation Name: Root Canal Filling Resin Regulatory Class: Class II Product Code: KIF Dated: January 17, 2018 Received: January 26, 2018

Dear Priscilla Chung:

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 device-related adverse events) (21 CFR 803); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820);

1

and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

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.

For comprehensive regulatory information about mediation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/) and CDRH Learn (http://www.fda.gov/Training/CDRHLearn). Additionally, you may contact the Division of Industry and Consumer Education (DICE) to ask a question about a specific regulatory topic. See the DICE website (http://www.fda.gov/DICE) for more information or contact DICE by email (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100).

Sincerely,

Mary S. Runner -S

For Tina Kiang, Ph.D. Acting 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)

K170175

Device Name

ENDOSEAL MTA

Indications for Use (Describe)

· Permanent obturation of the root canal following vital pulp-extirpation

• Permanent obturation of the root canal following removal of infected or necrotic pulp and placement of intracanal dressings.

Type of Use (Select one or both, as applicable)
V D---------------------------------------------------------------------------------------------------------------------------------------------------------------------------O -- TL- O- -- L--- II-- II-- IO4 OFF OOL O I----

|| | Prescription Use (Part 21 CFR 801 Subpart D)

|__| Over-The-Counter Use (21 CFR 801 Subpart C)

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510(k) Summary

(K170175)

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

Date: 01/17/2018__

Applicant / Submitter: 1.

MARUCHI 2-208, 42-10, Taejanggongdan-gil, Wonju-si, Gangwon-do, 26311, Republic of Korea Tel: +82-33-734-0330 Fax:+82-33-746-2804

2. Submission Correspondent:

Priscilla Chung LK Consulting Group USA, Inc. 800 Roosevelt STE 417 Irvine CA 92620 Phone: 714-202-5789 Fax: 714-409-3357 Email: juhee.c@lkconsultinggroup.com

3. Device:

Proprietary Name:ENDOSEAL MTA
Common Name:Root Filling Material
Classification Name:Root Canal Filling Resin
Classification:Class II, 21 CFR 872.3820
Classification Product Code:KIF

4. Predicate Device:

ENDOSEAL (K133054) by MARUCHI MTA Fillapex (K113568) by Angelus Industria de Produtos Odontologicos IROOT SP (K080917) by Innovative BioCeramix Inc.

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5. Device Description:

ENDOSEAL MTA is an endodontic sealer based on MTA, providing a biocompatible and effective root canal filling. It is premixed and pre-loaded in a syringe, which allows a complete filling of the entire root canal including accessory and lateral canals. The product is eugenol-free and will not impede adhesion inside the root canal.

6. Indications for Use

  • Permanent obturation of the root canal following vital pulp-extirpation
  • · Permanent obturation of the root canal following removal of infected or necrotic pulp and placement of intracanal dressings.

7. Performance Data(Non-Clinical):

The following properties were tested based on the referenced standard. All the test results met the preset test criteria.

  • = ISO 6876 Visual, Capacity, Packaging, Flow, Setting time, Film Thickness, Solubility and Radiopacity
  • = Shelf Life Test ISO 6876 (Visual, Packaging, Setting time, Solubility)
  • ISO 10993-5 Cytotoxicity
  • ISO 10993-10 Maximization test for delayed hypersensitivity (LLNA)
  • ISO 10993-11 Acute systemic toxicity
  • ISO 10993-6 Implantation
  • ISO 10993-3 AMES & Mammalian Erythrocyte Micronucleus

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8. Substantial Equivalence

Proposed DevicePredicate DevicePredicate DevicePredicate DeviceDiscuss/Justify the
(K170175)(K133054)(K113568)(K080917)Differences
Trade NameENDOSEAL MTAENDOSEALMTA FillapexIROOT SP
DeviceENDOSEAL MTA isThe raw materials ofMTA Fillapex is aiRoot SP Root CanalEquivalent
Descriptionan endodontic sealerthe ENDOSEAL aremineral trioxideSealer(IRoot SP) is
based on MTA,Natural Pure Cement,aggregate(MTA) andpremixed ready-to-use
providing a root canalZirconium dioxide,resin root canal sealerinjectable white
filling. It is premixedandused duringhydraulic cement
and pre-loaded in aCitric acid anhydrous.endodontic treatmentpaste developed for
syringe, which allowsIt is prepared as ato permanently fill thepermanent root canal
a complete filling ofmixture of powdercanal systemfilling and sealing
the entire root canaland water, and it isfollowingapplications. iRoot SP
including accessoryused in a puttydebridement andis an insoluble.
and lateral canals.form which graduallydisinfection. Itradiopaque and
hardens in the oralconsists of twoaluminum-free
environment.component pastes thatmaterial based on a
are combined in a dualcalcium silicate
barrel syringe for easecomposition, which
of dispensing andrequires the presence
consistent dosage.of water to set and
harden. iRoot SP is
packaged in a pre-
loaded syringe and is
supplied with
disposable Intra Canal
Tips.
Common NameRoot Filling MaterialRoot Filling MaterialRoot Filling MaterialRoot Filling MaterialEquivalent
ClassificationRoot Canal FillingRoot Canal FillingRoot Canal FillingRoot Canal FillingEquivalent
NameResinResinResinResin
ClassClass IIClass IIClass IIClass IIEquivalent
Product CodeKIFKIFKIFKIFEquivalent
Indications▪ Permanent■ Repair of perforationMTA Fillapex is a▪ PermanentEquivalent
for Useobturation of the root▪ Root canal fillingroot canal sealerobturation of the root

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| | canal following vital
pulp-extirpation
▪ Permanent
obturation of the root
canal following
removal of infected or
necrotic pulp and
placement of
intracanal dressings. | | intended for the
permanent sealing of
root canals and may
be used in
combination with root
canal obturation
materials. | canal following vital
pulp-extirpation
▪ Permanent
obturation of the root
canal following
removal of infected or
necrotic pulp and
placement of
intracanal dressings.
iRoot SP is suitable
for use in the single
cone and lateral
condensation
technique. | |
|-------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------|---------------------------------------------------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Shelf Life | 2 years | 2 years | 2 years | | Equivalent |
| Standards | ISO 6876 | ISO 6876 | ISO 6876 | ISO 6876 | Equivalent |
| Basic Chemical
Composition | Natural pure cement
Zirconium dioxide
Bismuth trioxide
Bentonite Clay | Natural pure cement
Zirconium dioxide
Citric acid anhydrous | Dicalcium and
tricalcium silicate,
tricalcium aluminate,
calcium oxide, | Zirconium oxide
Calcium silicates
Calcium phosphate
monobasic | The main ingredients
are similar but some
other ingredients are
different. However, |
| | n-Methyl-2-
Pyrrolidone
Hypromellose | | pentaerythritol
rosinate, n-ethyl-o,
p-toluenesulfonamide
salicylate resin,
bismuth oxide, fumed
silica, titanium
dioxide | Calcium hydroxide
Filler and thickening
agents | the biocompatibility
and the performance
test results supported
that the subject device
is substantially
equivalent to the
predicate devices. |
| Liquid Formula | Premixed type | Mixing with distilled
water | Mixing through a dual
barrel syringe | Premixed type | Equivalent |
| Packaging | Pre-loaded syringe | Vial | Dual barrel syringe | Pre-loaded syringe | Equivalent |
| Sterile | Non-sterile | Non-sterile | Non-sterile | Non-sterile | Equivalent |

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ENDOSEAL MTA has the same indications for use and the principle of operations as the predicate devices. It has similar physical and biocompatible properties, and demonstrates comparable performance specifications to the predicate devices. In addition, ENDOSEAL MTA has a comparable delivery system to IROOT SP.

Endoseal MTA and all of the predicate devices are equivalent as they all release calcium silicate oxide and calcium hydroxide by undergoing setting reactions when water reacts with calcium oxide. The reaction results in near identical composition of products after setting, as all of liquid components would have expelled during the setting reaction. Hence, all of the products resulted in similar test results including the cytotoxicity test.

The material compositions might slightly different from the predicate devices, however, despite of this difference, the test results of biocompatibility and performance tests show that the subject device is substantially equivalent to the predicate devices.

The bench and biocompatibility testing performed demonstrates that any differences in their technological characteristics do not raise any new questions as to safety and effectiveness. Therefore, it is concluded that ENDOSEAL MTA is substantially equivalent to the predicate devices.

9. Conclusion:

Based on the testing results, MARUCHI concludes that the ENDOSEAL MTA is substantially equivalent to the predicate devices.