K Number
K170421
Device Name
ET Hybrid Abutment
Manufacturer
Date Cleared
2018-01-11

(332 days)

Product Code
Regulation Number
872.3630
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
ET Hybrid Abutment is a customized abutment intended for use with HIOSSEN ET dental implant in the edentulous or partially edentulous maxilla or mandible to provide support for prosthetic restorations such as crowns and bridges. All digitally designed copings for use with the ET Hybrid Abutment for CAD/CAM are intended to be sent to a HIOSSEN Inc. manufacturing facility for manufacture.
Device Description
ET Hybrid Abutment is intended to be placed onto Hiossen dental implants to provide support for customized prosthetic restorations such as crowns and bridges. The proposed devices are composed of ET Link Abutment and Coping. The ET Link Abutment is premanufactured abutment by Hiossen Inc. only and the coping would be manufactured and bonded into the ET Link Abutment by Hiossen only with design input using CAD software from both by dental laboratories and by Hiossen Inc. The final device of ET Hybrid Abutment is under controlled by Hiossen's Quality System and provided to the customer. ET Hybrid Abutment is indicated for screw-retained single tooth or cement-retained single tooth and bridge restorations. Titanium alloy is the raw material for the Link Abutment and Zirconia material is for the Coping. The ET Hybrid Abutment gives the flexibility to design customized prosthetics.
More Information

No
The summary describes a dental abutment and its manufacturing process, which involves CAD software for design input. There is no mention of AI or ML being used in the design, manufacturing, or function of the device.

No.
The device is an abutment for dental implants designed to support prosthetic restorations, not to treat a disease or condition.

No
This device is an abutment for dental implants, providing support for prosthetic restorations. It is not used to diagnose a medical condition or disease.

No

The device description clearly states the device is composed of physical components (ET Link Abutment and Coping) made of titanium alloy and zirconia, and undergoes physical testing (fatigue testing). While CAD software is used in the design process, the final device is a physical implant component.

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

Here's why:

  • IVD Definition: In Vitro Diagnostics are medical devices used to examine specimens taken from the human body (like blood, urine, or tissue) to provide information for diagnosis, monitoring, or screening.
  • Device Function: The ET Hybrid Abutment is a dental implant component designed to support prosthetic restorations (crowns and bridges) within the mouth. It is a physical device implanted into the body, not used to analyze biological samples.
  • Intended Use: The intended use clearly states its purpose is to provide support for prosthetic restorations, not to diagnose or analyze biological samples.
  • Device Description: The description details the materials and how the abutment is placed and used in the mouth, not how it interacts with biological specimens for diagnostic purposes.

Therefore, the ET Hybrid Abutment falls under the category of a dental prosthetic component, not an In Vitro Diagnostic device.

N/A

Intended Use / Indications for Use

ET Hybrid Abutment is a customized abutment intended for use with HIOSSEN ET dental implant in the edentulous or partially edentulous maxilla or mandible to provide support for prosthetic restorations such as crowns and bridges. All digitally designed copings for use with the ET Hybrid Abutment for CAD/CAM are intended to be sent to a HIOSSEN Inc. manufacturing facility for manufacture.

Product codes

NHA

Device Description

ET Hybrid Abutment is intended to be placed onto Hiossen dental implants to provide support for customized prosthetic restorations such as crowns and bridges. The proposed devices are composed of ET Link Abutment and Coping. The ET Link Abutment is premanufactured abutment by Hiossen Inc. only and the coping would be manufactured and bonded into the ET Link Abutment by Hiossen only with design input using CAD software from both by dental laboratories and by Hiossen Inc. The final device of ET Hybrid Abutment is under controlled by Hiossen's Quality System and provided to the customer. ET Hybrid Abutment is indicated for screw-retained single tooth or cement-retained single tooth and bridge restorations. Titanium alloy is the raw material for the Link Abutment and Zirconia material is for the Coping. The ET Hybrid Abutment gives the flexibility to design customized prosthetics.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

edentulous or partially edentulous maxilla or mandible

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 nonclinical testing data were provided or relied upon in support of the substantial equivalence determination.

  1. Biocompatibility
    Hiossen. Inc predicate K162390 was relied upon for biocompatibility. The subject device is manufactured using identical materials and manufacturing processes to a previously cleared predicates identified above. No additional biocompatibility testing was necessary for this device. The chemical composition, body contact and sterilization method are the same as the predicate devices. (Category: Implant Device. Contact: BONE / TISSUE. Contact Duration: C-Permanent More than 30 days )

  2. Fatigue testing
    Additional non-clinical testing data submitted to demonstrate substantial equivalence includes static and dynamic fatigue test according to ISO 14801 in saline at 2Hz on the final finished sterilized abutment.

  3. Sterilization Validation
    For the subject device, it is same in material(Titanium & Zirconia, Cement). This test had been conducted using worst case sample which is the longest height and the largest diameter. But only difference in between the proposed device and primary predicate device is angulation. Therefore, no additional testing is required. The steam sterilization validation for the predicate device was conducted according to ISO 17665-1, ISO/TS 17665-2 for gravity displacement on wrapped condition.

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

Not Found

Predicate Device(s)

ET Hybrid Abutment K162390

Reference Device(s)

K132219, K123627

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/0 description: The image shows the logo of the U.S. Food and Drug Administration (FDA). The logo consists of two parts: the Department of Health and Human Services logo on the left and the FDA logo on the right. The FDA logo is a blue square with the letters "FDA" in white, followed by the words "U.S. Food & Drug Administration" in blue.

January 11, 2018

HIOSSEN Inc. David Kim Regulatory Affair Manager 85 Ben Fairless Dr. Fairless Hills, Pennsylvania 19030

Re: K170421

Trade/Device Name: ET Hybrid Abutment Regulation Number: 21 CFR 872.3630 Regulation Name: Endosseous Dental Implant Abutment Regulatory Class: Class II Product Code: NHA Dated: December 12, 2017 Received: December 12, 2017

Dear David Kim:

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

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); 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

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Image /page/2/Picture/1 description: The image shows the logo and contact information for Hiossen Inc. The logo features the company name in a stylized font, with the letters "HI" in red and the rest of the name in gray. Below the logo is the company's address, which is 85 Ben Fairless Dr. Fairless Hills, PA 19030, along with their phone number, 1-888-678-0001, fax number, 1-267-759-7004, and website, www.hiossen.com.

Indications for Use Statement

K170421 510(k) Number

Device Name : ET Hybrid Abutment

Indication for use : ET Hybrid Abutment is a customized abutment intended for use with HIOSSEN ET dental implant in the edentulous or partially edentulous maxilla or mandible to provide support for prosthetic restorations such as crowns and bridges. All digitally designed copings for use with the ET Hybrid Abutment for CAD/CAM are intended to be sent to a HIOSSEN Inc. manufacturing facility for manufacture.

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)

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Image /page/3/Picture/2 description: The image shows the logo for Hiossen. The word "Hiossen" is written in a stylized font. The "H" and "I" are in red, and the rest of the word is in gray. There is a red swoosh above the "H" and "I".

Hiossen Inc. 85 Ben Fairless Dr. Fairless Hills, PA 19030 Tel:1-888-678-0001 / Fax: 1-267-759-7004 www.hiossen.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 : Jan. 11, 2018

1. Company and Correspondent making the submission:

- Submitter's Name :HIOSSEN IINC.
- Address :85 Ben Fairless Dr. Fairless Hills, PA 19030 USA
- Contact :Mr. David Kim
- Telephone No.888 678 0001

2. Device:

Trade or (proprietary) Name:ET Hybrid Abutment
Common or usual Name:Dental Abutment
Classification Name:Endosseous Dental Implant Abutment
Regulation Number:21 CFR 872.3630
Device Classification:Class II
Product Code:NHA

3. Predicate Device:

    1. Primary : ET Hybrid Abutment K162390 / Hiossen, Inc.
    1. Reference: Straumann Variobase Abutments (K132219, Institut Straumann AG)
    1. Reference: ET SmartFit Abutment (K123627, Hiossen Inc.)

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Image /page/4/Picture/1 description: The image shows the logo for HIOSSEN. The logo is in two colors, red and gray. The letters "HI" are in red, and the rest of the word "OSSEN" is in gray. There is a red swoosh above the "O" in "OSSEN".

85 Ben Fairless Dr. Fairless Hills, PA 19030 Tel : 1-888-678-0001 / Fax : 1-267-759-7004 www.hiossen.com

4. Description:

ET Hybrid Abutment is intended to be placed onto Hiossen dental implants to provide support for customized prosthetic restorations such as crowns and bridges. The proposed devices are composed of ET Link Abutment and Coping. The ET Link Abutment is premanufactured abutment by Hiossen Inc. only and the coping would be manufactured and bonded into the ET Link Abutment by Hiossen only with design input using CAD software from both by dental laboratories and by Hiossen Inc. The final device of ET Hybrid Abutment is under controlled by Hiossen's Quality System and provided to the customer. ET Hybrid Abutment is indicated for screw-retained single tooth or cement-retained single tooth and bridge restorations. Titanium alloy is the raw material for the Link Abutment and Zirconia material is for the Coping. The ET Hybrid Abutment gives the flexibility to design customized prosthetics.

CodeETCMAMNZSETCMAMHZSETCMARNZSETCMARHZS
(A) Angulation0~30(°)0~30(°)
(B) Gingival Diameter4.2~15 (mm)4.7~15 (mm)
(C)Total Height4.5~16(mm)4.5~16(mm)
(D)Contact DiameterØ4.2Ø4.7
(E)Wall ThicknessMinimum 0.35 (mm)Minimum 0.44 (mm)
(F)Gingival Height0.5~8.0 (mm)0.5~8.0 (mm)
(G)Post Diameter2.0~6.5 (mm)3.0~9.0(mm)
(H)Post Height4~16(mm)4~16(mm)

The design limitation for coping is defined as below.

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Image /page/5/Picture/1 description: The image shows the word "HIOSSEN" in a stylized font. The "HI" portion of the word is in red, and there is a red curved line above the "I". The rest of the word, "OSSEN", is in gray. The font is bold and sans-serif.

Hiossen Inc. 85 Ben Fairless Dr. Fairless Hills, PA 19030 Tel : 1-888-678-0001 / Fax : 1-267-759-7004 www.hiossen.com

The proposed devices are compatible with the implant systems below.

No.510(K)Proprietary nameManufacture
1K101096ET III SA Fixture SystemHIOSSEN. Inc
2K103537ETIII SA Ultra Wide SystemHIOSSEN. Inc
3K112532ET III BA Fixture SystemHIOSSEN. Inc
4K123471ETII SA FIXTURE SYSTEMHIOSSEN. Inc
5K140934HIOSSEN IMPLANT SYSTEMHIOSSEN. Inc
6K151626ET III NH SystemHIOSSEN. Inc

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Image /page/6/Picture/0 description: The image contains the word "HIOSSEN" in a stylized font. The "HI" is in red, and the "OSSEN" is in gray. There is a red swoosh above the "H" that connects to the "I".

Hiossen Inc. 85 Ben Fairless Dr. Fairless Hills, PA 19030 Tel:1-888-678-0001 / Fax: 1-267-759-7004 www.hiossen.com

Substantial Equivalence Matrix

Part NameProposed devicesPrimary predicate devicesReference Predicates
Part NameET Hybrid AbutmentET Hybrid AbutmentStraumann Variobase
AbutmentsET Smartfit Abutment
510KProposedK162390K132219K123627
MaterialTitanium Alloy Ti-6AL 4V
Zirconia OxideTitanium Alloy Ti-6AL 4V
Zirconia OxideTitanium Alloy Ti-6AL 4V
Zirconia OxideTitanium Alloy
Ti-6AL 4V
ManufacturerHIOSSEN INC.HIOSSEN INC.Institut Straumann AGHIOSSEN INC.
DescriptionET Hybrid Abutment is intended to be
placed onto Hiossen dental implants
to provide support for customized
prosthetic restorations such as crowns
and bridges. The proposed devices are
composed of ET Link Abutment and
Coping. The ET Link Abutment is
pre-manufactured abutment by
Hiossen Inc. only and the coping
would be manufactured and bonded
into the ET Link Abutment by
Hiossen only with design input using
CAD software from both by dental
laboratories and by Hiossen Inc. The
final device of ET Hybrid Abutment
is under controlled by Hiossen's
Quality System and provided to the
customer.ET Hybrid Abutment is intended to be
placed onto Hiossen dental implants
to provide support for customized
prosthetic restorations such as crowns
and bridges. The proposed devices are
composed of ET Link Abutment and
Coping. The ET Link Abutment is
pre-manufactured abutment by
Hiossen Inc. only and the coping
would be manufactured by Hiossen
only with design input using CAD
/CAM software from both by dental
laboratories and by Hiossen Inc. The
final device of ET Hybrid Abutment
is under controlled by Hiossen's
Quality System and provided to the
customer.The Straumann Variobase
Abutments are pre-manufactured
(stock) abutments, sometimes
referred to as "Ti-bases".
Straumann Variobase Abutments
are available to fit Straumann
dental implant platforms NNC
(Narrow Neck CrossFit), RN
(Regular Neck), WN (Wide Neck),
NC (Narrow CrossFit), and RC
(Regular CrossFit). A dental
laboratory technician would design
the corresponding coping and/or
crown (the second component of
the Variobase two-piece
abutment) and/or prosthetic
restoration in the dental laboratoryThe ET SmartFit Abutment is
device made of titanium alloy
intended for use as an aid in
prosthetic restoration. That is
customized abutment considering
shape of the finial prosthesis
based on the patient's mouth
model using CAD/CAM system
during the manufacturing.
The ET SmartFit Abutment is
used for cement-retained crowns
and bridges using customized
abutment considering based on
the patient's mouth using
CAD/CAM system.
Description
(Continue)ET Hybrid Abutment is indicated for
screw-retained single tooth or cement-
retained single tooth and bridge
restorations. The ET Hybrid Abutment
gives the flexibility to design
customized prosthetics.ET Hybrid Abutment is indicated for
screw-retained single tooth or cement-
retained single tooth and bridge
restorations. The ET Hybrid Abutment
gives the flexibility to design
customized prosthetics. The coping is
straight only and the ET Link abutment
is not intended to provide an angle
and/or divergence correction.using either a burnout coping or
STL model for open CAD software.
The coping and/or crown would be
manufactured via validated.Use only the basal screws provide
for the Custom Abutment. The
surgical procedure for custom
abutment is the same as the surgical
procedure for the cement- retained
abutments.
Indication
for useET Hybrid Abutment is a customized
abutment intended for use with
HIOSSEN ET dental implant in the
edentulous or partially edentulous
maxilla or mandible to provide support
for prosthetic restorations such as
crowns and bridges. All digitally
designed copings for use with the ET
Hybrid Abutment for CAD are
intended to be sent to a HIOSSEN Inc.
manufacturing facility for manufacture.ET Hybrid Abutment is a customized
abutment intended for use with
HIOSSEN ET dental implant in the
edentulous or partially edentulous
maxilla or mandible to provide support
for prosthetic restorations such as
crowns and bridges. All digitally
designed copings for use with the ET
Hybrid Abutment for CAD are
intended to be sent to a HIOSSEN Inc.
manufacturing facility for manufacture.The Straumanho Variobase' Abutment
is a titanium base placed onto
Straumann dental implants to provide
support for customized prosthetic
restorations. Straumann Variobase
Abutments are indicated for screw-
retained single tooth or cement-
retained single tooth and bridge
restorations.ET SmartFit Abutment is intended for
use with a dental implant to provide
support for prosthetic restorations
such as crowns, bridges, or
overdentures.
DesignImage: Two-piece Type [Abutment + Screw]Image: Two-piece Type [Abutment + Screw]Image: Two-piece Type [Abutment + Screw]Image: Two-piece Type [Abutment + Screw]
Diameter (mm)Ti- Base: 4.0/4.5
Two-piece: 4.2~15Ti- Base: 4.0/4.5
Two-piece : 4.2~15Ti- Base : 2.8~3.3
Two piece : N/A4~15
Height (mm)Ti- Base : 3.2
Two-piece : 4.5~16Ti- Base : 3.2
Two-piece : 4.5~16Ti-Base : 3.5
Two piece : N/A3~18
Angle (°)0 ~ 3000 ~ 300 ~ 30

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Image /page/7/Picture/0 description: The image shows the word "HIOSSEN" in a stylized font. The "HI" is in red, and the "OSSEN" is in gray. The "H" and "I" are connected, and there is a red swoosh above the "H".

Hiossen Inc.

85 Ben Fairless Dr. Fairless Hills, PA 19030 Tel:1-888-678-0001 / Fax: 1-267-759-7004 www.hiossen.com

8

Image /page/8/Picture/0 description: The image shows the Hiossen logo. The "HI" part of the logo is in red, and the "OSSEN" part is in gray. There is a red swoosh above the "HI" part of the logo.

Ben Fairless Dr. Fairless Hills. PA 19030 1-888-678-0001 / Fax :- 1-267-759-7004

www.hiossen.com

The propose device has the similar intended use for, technological characteristics as predicate devices, ET Hybrid Abutment(K162390) and ET SmartFit Abutnent(K123627) by Hossen.Inc. , Straumann Variobase Abutment(K132219) of Institut Straumann AG. Those devices are the customized abuttrent devices. Especially, the ET Hybrid Abutnent system K162390. Primary predicate) and Variobase Abutments system K132219, Reference predicate) are similar process. The Ti-base(or in pre-milled and made of titaniumnaterial and coping part is designed by the clent al laboratory and nanufacturer using the CAD software and milled and bonded into ET Link Abutment by manufacture only. The only differences with S.E the reference predicate (Variobase Abutnent,K13219) are connection shapes. The shape are only for the manufacturer's properties such as design and compatible to their own dental implant design. The primary precicate (ET Hybrid Abutment, K162390) is almost same structure and dimension but it's straight only which is no angulation compensation and gingival height range. The second reference predicate (ET SmartFit, K123627) has same manufacturing process and facility, similar dimensions but only difference is a material on the top ( Zironia vs Titanium). This proposed device is manufactured using identical material and manufacturing process to a previously cleared predicates.

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Image /page/9/Picture/1 description: The image shows the logo for Hiossen Implant. The logo is composed of the word "Hiossen" in a stylized font. The "H" and the top part of the "i" are in red, while the rest of the word is in gray. The logo is simple and modern, and the use of color helps to make it stand out.

Hiossen Inc. 85 Ben Fairless Dr. Fairless Hills, PA 19030 Tel : 1-888-678-0001 / Fax : 1-267-759-7004 www.hiossen.com

5. Indication for use :

ET Hybrid Abutment is a customized abutment intended for use with HIOSSEN ET dental implant in the edentulous or partially edentulous maxilla or mandible to provide support for prosthetic restorations such as crowns and bridges. All digitally designed copings for use with the ET Hybrid Abutment for CAD/CAM are intended to be sent to a HIOSSEN Inc. manufacturing facility for manufacture.

6. Technological Characteristics

The proposed device has similar technological characteristics as the predicate device of the ET Hybrid Abutments (K162390) of Hiossen, Inc.. ET Hybrid Abutment and predicate device are composed of ET Link Abutment and Coping. ET Link Abutment is premanufactured abutment made with Titanium allov and Coping is customized with Zirconia. The only difference is the angle of coping part.

7. Summary of nonclinical testing

The following nonclinical testing data were provided or relied upon in support of the substantial equivalence determination.

1) Biocompatibility

Hiossen. Inc predicate K162390 was relied upon for biocompatibility. The subject device is manufactured using identical materials and manufacturing processes to a previously cleared predicates identified above. No additional biocompatibility testing was necessary for this device. The chemical composition, body contact and sterilization method are the same as the predicate devices. (Category: Implant Device. Contact: BONE / TISSUE. Contact Duration: C-Permanent More than 30 days )

2) Fatigue testing

Additional non-clinical testing data submitted to demonstrate substantial equivalence includes static and dynamic fatigue test according to ISO 14801 in saline at 2Hz on the final finished sterilized abutment.

3) Sterilization Validation

For the subject device, it is same in material(Titanium & Zirconia, Cement). This test had been conducted using worst case sample which is the longest height and the largest diameter. But only difference in between the proposed device and primary predicate device is angulation. Therefore, no additional testing is required. The steam sterilization validation for the predicate device was conducted according to ISO 17665-1, ISO/TS 17665-2 for gravity displacement on wrapped condition.

8. Summary of clinical testing

No clinical studies are submitted

9. Conclusions

The documentation submitted in this premarket notification demonstrates that the ET Hybrid Abutment is substantially equivalent to the predicate devices.