K Number
K172821
Device Name
Ti-one 101 TS Dental Implant System
Date Cleared
2018-06-11

(266 days)

Product Code
Regulation Number
872.3640
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
This Product is to be used in mandible or maxilla-arch by dental surgery, and to support artificial teeth and maxilla to restore patient's chewing function. This may be accomplished by either a two-stage surgical procedure or a single surgical procedure. If a single surgical procedure is used, single or multiple implants may be inserted (type I, II or III bone) provided good initial stability (> 40 Ncm) is achieved. Intended for delayed loading.
Device Description
- (1) This Product is designed to be used in dental surgery in mandible or maxilla-arch, where has missing teeth, to have dental crown, fixation-bridge, over-denture installed afterwards, and to support and restore patient's chewing function. - (2) This implant (Ti-one 101 TS dental implants (Fixture)) is made of grade 4 pure titanium, featuring sandblasting + acid etching surface treatment (SLAffinity). - (3) Healing screw is one-piece abutment made of grade 4 titanium. - (4) Abutment is two-piece abutment made of grade 4 titanium. Its surface was anodized. - (5) Label attached to the surface of outer packaging indicates specification and model number. The range of diameter for implant (fixture) is provided as below: Ø Diameter: 3.5, 4.0, 4.5, 5.0 mm Length: 7.0, 8.0, 9.5, 11.0, 12.5, 14.0 mm All diameters are available in all lengths, other than the 3.5mm diameter which is not available in the 7.0mm length. The range of diameters and angulations for each screw model and abutment model are provided as below: Healing Screw: Ø 4.3 mm, G/H 1.0, 3.0, 4.0 mm, Height (H) 3.5, 5.0, 7.0 mm Angled Abutment: Ø 4.5, 5.5 mm, G/H 3.5 mm, V/H 11.0 mm, Length (L) 14.13, 14.15, 14.20 mm, Angulation range 12.5°, 20.0°, 27.5°
More Information

No
The device description and performance studies focus on the physical properties and mechanical performance of a dental implant system, with no mention of software, algorithms, or data processing that would indicate AI/ML.

Yes.
The device, a dental implant system, is intended to restore a patient's chewing function after dental surgery, which is a therapeutic purpose.

No

This device is a dental implant system designed to restore chewing function by supporting artificial teeth, not to diagnose a condition.

No

The device description explicitly details physical components made of titanium (implants, healing screws, abutments) and describes testing related to these physical components (sterilization, shelf life, biocompatibility, performance testing like torque and fatigue). This indicates it is a hardware medical device, not software-only.

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

Here's why:

  • Intended Use/Indications for Use: The intended use clearly states that the product is used in dental surgery to support artificial teeth and restore chewing function. This is a surgical and prosthetic application, not a diagnostic one.
  • Device Description: The description details the physical components of a dental implant system (fixture, healing screw, abutment) and their materials. This aligns with a medical device used for implantation, not a diagnostic test.
  • Lack of Diagnostic Elements: There is no mention of analyzing samples from the human body (blood, urine, tissue, etc.) or providing information about a patient's health status or disease.
  • Performance Studies: The performance studies focus on the physical and mechanical properties of the implant (sterilization, shelf life, biocompatibility, insertion/removal torque, fatigue), which are relevant to an implantable medical device, not an IVD.

In summary, this device is a dental implant system designed for surgical implantation and prosthetic support, not for performing in vitro diagnostic tests.

N/A

Intended Use / Indications for Use

This Product is to be used in mandible or maxilla-arch by dental surgery, and to support artificial teeth and maxilla to restore patient's chewing function.

This may be accomplished by either a two-stage surgical procedure or a single surgical procedure. If a single surgical procedure is used, single or multiple implants may be inserted (type I, II or III bone) provided good initial stability (> 40 Ncm) is achieved. Intended for delayed loading.

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

DZE, NHA

Device Description

  • (1) This Product is designed to be used in dental surgery in mandible or maxilla-arch, where has missing teeth, to have dental crown, fixation-bridge, over-denture installed afterwards, and to support and restore patient's chewing function.
  • (2) This implant (Ti-one 101 TS dental implants (Fixture)) is made of grade 4 pure titanium, featuring sandblasting + acid etching surface treatment (SLAffinity).
  • (3) Healing screw is one-piece abutment made of grade 4 titanium.
  • (4) Abutment is two-piece abutment made of grade 4 titanium. Its surface was anodized.
  • (5) Label attached to the surface of outer packaging indicates specification and model number.
    The range of diameter for implant (fixture) is provided as below:
    Implant (Fixture)
    Ø Diameter: 3.5, 4.0, 4.5, 5.0
    Length: 7.0, 8.0, 9.5, 11.0, 12.5, 14.0
    All diameters are available in all lengths, other than the 3.5mm diameter which is not available in the 7.0mm length.

The range of diameters and angulations for each screw model and abutment model are provided as below:
Healing Screw
Ø: 4.3
G/H: 1.0, 3.0, 4.0
Height (H) or Length (L): H: 3.5, 5.0, 7.0
Angled Abutment
Ø: 4.5, 5.5
G/H: 3.5
V/H: 11.0
Height (H) or Length (L): L: 14.13, 14.15, 14.20
Angulation range: 12.5°, 20.0°, 27.5°

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

mandible or maxilla-arch

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)

Non-clinical Testing:

  • Sterilization Test: Results show compliance with ISO11737-1:2006, ISO11737-2:2009 and ISO 11137-2:2013 requirements.
  • Shelf Life Test: Results show compliance with ASTM F1980:2016, ASTM F1929:2012, ISO 11607-1:2006, ASTM F-88 / F88M:2015 and ISO 11737-2:2009 requirements.
  • Biocompatibility testing:
    • Non-pyrogenic test report (LAL testing): Results show compliance with USP 40:2017 , USP 40:2017 , AAMI ST72:2011 requirements.
    • Other tests leveraged from predicate (K110425) due to same materials: Cytotoxicity test, Intracutaneous reactivity test, Skin sensitization test, Acute systemic toxicity test (Systemic injection), Pyrogenicity test, In vitro bacterial reverse mutation (AMES) test, In vitro chromosome aberration test, In vitro mammalian cell gene mutation test, 14-Day Repeated exposure systemic toxicity test, 90-Day Bone implantation test. These complied with ISO 10993-1, ISO 10993-3:2003, ISO 10993-5:2009, ISO10993-6:2007, ISO 10993-10:2010, ISO10993-11:2006, ISO 10993-12:2012, USP 31:2008 , US P31:2008 , OECD 471:1997, OECD 473:1997 and OECD476:1997 requirements.
  • Performance testing:
    • Insertion, Removal Torque and Broken Test
    • Fatigue test
    • SEM/EDS surface structure chart report
      Tests were conducted in accordance with ISO 14801:2007 and ASTM F543-13:2013 requirements.
      All test results demonstrate that Ti-one 101 TS Dental Implant System meets the requirements of its pre-defined acceptance criteria and indications for use.
      Clinical Testing: No clinical testing was necessary for a determination of substantial equivalence.

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.

K110425

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.

K120414, K051636

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

§ 872.3640 Endosseous dental implant.

(a)
Identification. An endosseous dental implant is a prescription device made of a material such as titanium or titanium alloy that is intended to be surgically placed in the bone of the upper or lower jaw arches to provide support for prosthetic devices, such as artificial teeth, in order to restore a patient's chewing function.(b)
Classification. (1) Class II (special controls). The device is classified as class II if it is a root-form endosseous dental implant. The root-form endosseous dental implant is characterized by four geometrically distinct types: Basket, screw, solid cylinder, and hollow cylinder. 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.)(2)
Classification. Class II (special controls). The device is classified as class II if it is a blade-form endosseous dental implant. The special controls for this device are:(i) The design characteristics of the device must ensure that the geometry and material composition are consistent with the intended use;
(ii) Mechanical performance (fatigue) testing under simulated physiological conditions to demonstrate maximum load (endurance limit) when the device is subjected to compressive and shear loads;
(iii) Corrosion testing under simulated physiological conditions to demonstrate corrosion potential of each metal or alloy, couple potential for an assembled dissimilar metal implant system, and corrosion rate for an assembled dissimilar metal implant system;
(iv) The device must be demonstrated to be biocompatible;
(v) Sterility testing must demonstrate the sterility of the device;
(vi) Performance testing to evaluate the compatibility of the device in a magnetic resonance (MR) environment;
(vii) Labeling must include a clear description of the technological features, how the device should be used in patients, detailed surgical protocol and restoration procedures, relevant precautions and warnings based on the clinical use of the device, and qualifications and training requirements for device users including technicians and clinicians;
(viii) Patient labeling must contain a description of how the device works, how the device is placed, how the patient needs to care for the implant, possible adverse events and how to report any complications; and
(ix) Documented clinical experience must demonstrate safe and effective use and capture any adverse events observed during clinical use.

0

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 & Human Services logo on the left and the FDA logo on the right. The FDA logo is in blue and white and includes the words "U.S. Food & Drug Administration."

Hung Chun Bio-S Company, Limited Allison Liu Quality Assurance Supervisor No.12, Luke 1st Road, Luzhu District Kaohsiung City, 821 TAIWAN (R.O.C.)

Re: K172821

Trade/Device Name: Ti-one 101 TS Dental Implant System Regulation Number: 21 CFR 872.3640 Regulation Name: Endosseous Dental Implant Regulatory Class: Class II Product Code: DZE, NHA Dated: May 4, 2018 Received: May 11, 2018

Dear Allison Liu:

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.

June 11, 2018

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 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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DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration

Indications for Use

510(k) Number (if known) K172821

Device Name

Ti-one 101 TS Dental Implant System

This Product is to be used in mandible or maxilla-arch by dental surgery, and to support artificial teeth and maxilla to restore patient's chewing function.

This may be accomplished by either a two-stage surgical procedure or a single surgical procedure. If a single surgical procedure is used, single or multiple implants may be inserted (type I, II or III bone) provided good initial stability (> 40 Ncm) is achieved. Intended for delayed loading.

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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3

Ti-one 101 TS Dental Implant System 510(k) Summary

510(k) Summary

5.1Type of Submission:Traditional
5.2Preparation Date:06/11/2018
5.3Submitter:Hung Chun Bio-S Co., Ltd.
Address:No.12, Luke 1st Rd., Luzhu Dist.,
Kaohsiung City, 821, Taiwan (R.O.C.)
Phone:+886-7-6955369
Fax:+886-7-6955379
Contact:Allison Liu (allison@hc-bios.com)

5.4 Identification of the Device:

Proprietary/Trade name:Ti-one 101 TS Dental Implant System
Classification Name:Endosseous dental implant
Device Classification:II
Panel:Dental
Regulation Number:872.3640
Primary Product Code:DZE
Subsequent Product Code:NHA

5.5 Primary Predicate Device (K110425):

Proprietary/Trade name:HC-Bios Dental Implant System
Manufacturer:Hung Chun Bio-S Co., Ltd.
Device Classification:II
Review Panel:Dental
Regulation Number:872.3640
Product Code:DZE

4

Ti-one 101 TS Dental Implant System 510(k) Summary

5.6Reference Device (K120414):
Proprietary/Trade name:OsseoSpeedTM Plus
Manufacturer:Astra Tech AB
Device Classification:II
Review Panel:Dental
Regulation Number:872.3640
Product Code:DZE, NHA
5.7Reference Device (K051636):
Proprietary/Trade name:CAMLOG Dental Implant Abutment
HealingCaps, and Accessories
Manufacturer:Altatec GmbH
Device Classification:II
Review Panel:Dental
Regulation Number:872.3630
Product Code:NHA

5.8 Indications for use of the subject device

This Product is to be used in mandible or maxilla-arch by dental surgery, and to support artificial teeth and maxilla to restore patient's chewing function.

This may be accomplished by either a two-stage surgical procedure or a single surgical procedure. If a single surgical procedure is used, single or multiple implants may be inserted (type I, II or III bone) provided good initial stability (> 40 Ncm) is achieved. Intended for delayed loading.

5.9 Device Description

  • (1) This Product is designed to be used in dental surgery in mandible or maxilla-arch, where has missing teeth, to have dental crown, fixation-bridge, over-denture installed afterwards, and to support and restore patient's chewing function.
  • (2) This implant (Ti-one 101 TS dental implants (Fixture)) is made of grade 4 pure titanium, featuring sandblasting + acid etching surface treatment (SLAffinity).
  • (3) Healing screw is one-piece abutment made of grade 4 titanium.
  • (4) Abutment is two-piece abutment made of grade 4 titanium. Its surface was

5

anodized.

  • (5) Label attached to the surface of outer packaging indicates specification and model number.
    The range of diameter for implant (fixture) is provided as below:
ComponentSpecification (mm)
Ø DiameterLength
Implant (Fixture)3.5, 4.0, 4.5, 5.07.0, 8.0, 9.5, 11.0, 12.5, 14.0

All diameters are available in all lengths, other than the 3.5mm diameter which is not available in the 7.0mm length.

The range of diameters and angulations for each screw model and abutment model are provided as below:

| Component | Specification (mm) | | | Angulation
range | |
|--------------------|--------------------|---------------|------|-----------------------------|------------------------|
| | Ø | G/H | V/H | Height (H) or
Length (L) | |
| Healing
Screw | 4.3 | 1.0, 3.0, 4.0 | - | H: 3.5, 5.0, 7.0 | - |
| Angled
Abutment | 4.5, 5.5 | 3.5 | 11.0 | L: 14.13, 14.15,
14.20 | 12.5°, 20.0°,
27.5° |

5.10 Non-clinical Testing

A series tests were performed to assess the proposed device is substantially equivalent to the predicate device. All the test results demonstrate that Ti-one 101 TS Dental Implant System meets the requirements of its pre-defined acceptance criteria and indications for use.

· Sterilization Test

Test results performed in test reports of sterilization test demonstrated that proposed device complies with ISO11737-1:2006, ISO11737-2:2009 and ISO 11137-2:2013 requirements.

· Shelf Life Test

Test results performed in test reports of shelf life test demonstrated that proposed device complies with ASTM F1980:2016, ASTM F1929:2012, ISO 11607-1:2006, ASTM F-88 / F88M:2015 and ISO 11737-2:2009 requirements.

6

Ti-one 101 TS Dental Implant System 510(k) Summary

• Biocompatibility testing

  • Non-pyrogenic test report (LAL testing)

(Following reports are leveraged from own K110425 predicate)

  • Cytotoxicity test i
  • Intracutaneous reactivity test ।
  • Skin sensitization test -
  • Acute systemic toxicity test (Systemic injection)
  • । Pyrogenicity test
  • In vitro bacterial reverse mutation (AMES) test ।
  • In vitro chromosome aberration test i
  • In vitro mammalian cell gene mutation test -
  • 14-Day Repeated exposure systemic toxicity test
  • । 90-Day Bone implantation test

Both proposed device and predicate device, "HC Bio-S" Dental implant system (K110425) are manufactured by Hung Chun Bio-S Co., Ltd. The materials of proposed device and predicate device (K110425) are exactly the same. Therefore, the information of biocompatibility testing for predicate device (K110425) is sufficient to describe the safety of the proposed device and demonstrate the substantial equivalence of the proposed device to the predicate device. Test results performed in biocompatibility test reports demonstrated that predicate device (K110425) complies with ISO 10993-1, ISO 10993-3:2003, ISO 10993-5:2009, ISO10993-6:2007, ISO 10993-10:2010, ISO10993-11:2006, ISO 10993-12:2012, USP 31:2008 , US P31:2008 , OECD 471:1997, OECD 473:1997 and OECD476:1997 requirements. Test results performed in "Non-pyrogenic test report (LAL testing)" demonstrated that proposed device complies with USP 40:2017 , USP 40:2017 , AAMI ST72:2011 requirements.

• Performance testing:

  • Insertion, Removal Torque and Broken Test
  • Fatigue test -
  • SEM/EDS surface structure chart report ।

Tests were conducted in accordance with ISO 14801:2007 and ASTM F543-13:2013 requirements.

7

5.11 Clinical Testing

No clinical testing was necessary for a determination of substantial equivalence. The results of non-clinical testing indicated the device was found to be substantially equivalent to the predicate device.

5.12 Substantial Equivalence Determination

The Ti-one 101 TS Dental Implant System submitted in this 510(k) file is substantially equivalent in main materials, implant surface treatment and similar design, angulation range, indication for use, components and performance claims to the cleared HC-Bios Dental Implant System (K110425), CAMLOG Dental Implant Abutments, HealingCaps, and Accessories (K051636) and OsseoSpeed TM Plus (K120414). Differences of proposed device and predicate device do not raise new issues of substantial equivalence.

| | Proposed Device | Primary Predicate Device
(K110425) | Substantially
equivalent |
|--------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------------------------------------------------------|
| Item | Ti-one 101 TS Dental
Implant System | HC-Bios Dental Implant
System | - |
| Manufacturer | Hung Chun Rio-S Co., Ltd. | Hung Chun Rio-S Co., Ltd. | Same |
| 510(k) Number | K172821 | K110425 | - |
| Classification | Class II | Class II | Same |
| Product code | DZE, NHA | DZE | Similar
The primary
product code is
the same. |
| Indication for Use | The product is to be used in
mandible or maxilla-arch by
dental surgery, and to support
artificial teeth and maxilla to
restore patient's chewing
function.
This may be accomplished by | The HC-Bios Dental Implant
System is intended to be
surgically placed in the bone of
the upper or lower jaw arches to
provide support for prosthetic
devices, such as artificial teeth,
and to restore the patient's | Similar1 |

8

Ti-one 101 TS Dental Implant System 510(k) Summary

| | Proposed Device | Primary Predicate Device
(K110425) | Substantially
equivalent |
|--------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------------------------------|
| Item | Ti-one 101 TS Dental
Implant System | HC-Bios Dental Implant
System | - |
| | either a two-stage surgical
procedure or a single surgical
procedure. If a single surgical
procedure is used, single or
multiple implants may be
inserted (type I, II or III bone)
provided good initial stability (>
40 Ncm) is achieved`. Intended
for delayed loading. | chewing function.
This may be accomplished by
either a two-stage surgical
procedure or a single surgical
procedure. If a single surgical
procedure is used, single or
multiple implants may be
inserted (type I, II or III bone)
provided good initial stability (>
40 Ncm) is achieved. Not
intended for immediate loading. | |
| Components | Dental implant (Fixture) | Dental implant
Cover/Healing screw
Standard abutment
Abutment impression part
Implant impression part | Only compare
the implant
(fixture) and the
proposed
implant is SE to
the implant of
predicate. |
| | Healing screw | | |
| | Angled abutment | | |
| Surgery type | It may be accomplished by
two-stage procedure | It may be accomplished by
two-stage procedure | Same |

� Similar1 :

Both proposed device and primary predicate device are used in mandible or maxilla-arch by dental surgery, and to support artificial teeth and maxilla to restore patient's chewing function. Both devices could be used for two-stage surgery procedure. Differences between the devices cited in this section do not raise any new issues of substantial equivalence.

9

Ti-one 101 TS Dental Implant System 510(k) Summary

Implant

| | Proposed Device | Primary Predicate Device
(K110425) | Substantially
equivalent |
|-----------------------------------|----------------------------------------|---------------------------------------|-----------------------------|
| Item | Ti-one 101 TS Dental Implant
System | HC-Bios Dental Implant
System | - |
| Material | Grade 4 Pure Titanium | Grade 4 Pure Titanium | Same |
| Surface treatment | SLA | SLA | Same |
| Implant to abutment
connection | Internal 11° morse taper | Internal 11° morse taper | Same |
| Design | Thread with micro thread | Thread | Similar |
| Diameters | 3.5, 4.0, 4.5, 5.0 mm | 3.5, 4.0, 4.5, 5.0, 6.0, 7.0 mm | Similar |
| Lengths | 7.0, 8.0, 9.5, 11.0,
12.5, 14.0 mm | 7.0, 8.0, 9.5, 11.0,
12.5, 14.0 mm | Similar |
| Sterile | Yes, Gamma irradiation | Yes, Gamma irradiation | Same |

The design is similar, and the diameter of the proposed device is within the scope of that of predicate. The Ø3.5mm implant is not available in the 7.0mm length for either the subject or primary predicate. The primary predicate is also not available in the Ø4.0mm/7.0mm length, which is an option for the subject device. Additionally, the primary predicate is available in all other combinations of diameter and length, except for Ø6.0mm and Ø7.0mm which are both not available in the 14mm length. Differences between the devices cited in this section do not raise any new issues of substantial equivalence.

Healing screw

| | Proposed Device | Primary Predicate
Device (K110425) | Reference Device
(K051636) | Substantially
equivalent |
|-----------|-------------------------------------------|---------------------------------------|------------------------------------------------------------------------|-----------------------------|
| Item | Ti-one 101 TS
Dental Implant
System | HC-Bios Dental
Implant System | CAMLOG Dental
Implant Abutments,
HealingCaps, and
Accessories | - |
| Diameters | 4.3 mm | 4.5, 5.5, 6.5 mm | 3.3, 3.8, 4.3,
5.0, 6.0 mm | Similar |
| G/H | 1.0, 3.0, 4.0 mm | 2.0, 3.0, 4.0 mm | 2.0, 4.0, 6.0 mm | Similar |
| Height | 3.5, 5.0, 7.0 mm | 3.5, 5.0, 7.0 mm | 4.0, 6.0 mm | Similar |

ゃ Although the proposed healing screw has a smaller diameter than the primary predicate, it is same as FDA-cleared reference device. Therefore, differences between the devices cited in this

10

Ti-one 101 TS Dental Implant System 510(k) Summary

section do not raise any new issues of substantial equivalence.

| | Proposed Device | Reference Device (K120414) | Substantially
equivalent |
|-------------------|----------------------------------------|------------------------------------------|-----------------------------|
| Item | Ti-one 101 TS Dental Implant
System | OsseoSpeedTM Plus | - |
| Material | Grade 4 Pure Titanium | Titanium | Similar |
| Surface treatment | Anodization | None | Different |
| Abutment size | Angled abutment | Angled abutment (TiDesign) | Some
Differences |
| Diameters | 4.5, 5.5 mm | 4.0, 4.5, 5.5 mm | |
| G/H (mm) | 3.5 | 1.5 | |
| V/H (mm) | 11.0 | for Ø4.0, 7; for Ø4.5 and Ø5.5, 9 | |
| Angulation range | 12.5°, 20.0°,27.5° | 15° for Ø4.0mm,
20° for Ø4.5 and Ø5.5 | |
| Sterile | Yes, Gamma irradiation | Yes | Similar |

Angled abutment

Although the proposed Angled abutment has a smaller G/H, larger anglulation, and ゃ different surface coating than the reference device, according to the testing result of fatigue report, differences between the devices cited in this section do not raise any new issues of substantial equivalence.

5.13 Similarity and differences

The difference between the implant of the proposed device and the predicate device is the design. The surface designed of proposed device and predicate device are thread with micro thread or thread only respectively. The Healing screw and Angled abutment were compared with the appropriate FDA-cleared reference devices to demonstrate substantial equivalence. The proposed device was tested, and the results complied with the pre-defined acceptance criteria. Therefore, the differences of proposed device and predicate device did not raise any problems of substantial equivalence. The proposed device is substantially equivalent to the predicate device in indications for use, design and performance claims.

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5.14 Conclusion

After analyzing bench tests, device description and indications for use, it can be concluded that Ti-one 101 TS Dental Implant System is substantially equivalent to the predicate device.