K Number
K172839
Device Name
ENDOSOLV
Manufacturer
Date Cleared
2018-02-13

(147 days)

Product Code
Regulation Number
872.3820
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
Root canal sealers solvent when canal retreatment is required.
Device Description
ENDOSOLV (new device, K172839/S001) is a solvent used for eugenate-type or phenolic resin-based endodontic cements in the context of endodontic retreatment. This solvent is able to soften conventional zinc oxide eugenol cements and phenolic resin type sealers in the context of endodontic retreatment. It is indicated for use as a root canal sealer solvent when canal retreatment is required. ENDOSOLV (new device, K172839/S001) composition consists of ethyl acetate, amyl acetate and thymol. Ethyl acetate and amyl acetate are the two main components of the formulation that are effective in dissolving zinc oxide-eugenol-based and resin based filling material.
More Information

No
The device description and performance studies focus on the chemical composition and dissolving properties of a solvent, with no mention of AI or ML.

No
The device is a solvent used to dissolve root canal sealers during retreatment, not to treat a disease or condition itself.

No

The device is a solvent used to soften root canal sealers during retreatment, which is a therapeutic function, not a diagnostic one.

No

The device description clearly states the device is a solvent composed of chemical substances (ethyl acetate, amyl acetate, and thymol), indicating it is a chemical product, 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 "Root canal sealers solvent when canal retreatment is required." This describes a product used within the body (in the root canal) to dissolve materials.
  • Device Description: The description confirms it's a solvent used for endodontic cements in the context of endodontic retreatment. It acts directly on materials within the tooth.
  • Lack of IVD Characteristics: An IVD is a medical device used to perform tests on samples taken from the human body (like blood, urine, tissue) to provide information about a person's health. This device does not perform any such tests on biological samples.

Therefore, ENDOSOLV is a therapeutic device used in a dental procedure, not an in vitro diagnostic device.

N/A

Intended Use / Indications for Use

Root canal sealers solvent when canal retreatment is required.

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

KIF

Device Description

ENDOSOLV (new device, K172839/S001) is a solvent used for eugenate-type or phenolic resin-based endodontic cements in the context of endodontic retreatment. This solvent is able to soften conventional zinc oxide eugenol cements and phenolic resin type sealers in the context of endodontic retreatment. It is indicated for use as a root canal sealer solvent when canal retreatment is required.
ENDOSOLV (new device, K172839/S001) composition consists of ethyl acetate, amyl acetate and thymol. Ethyl acetate and amyl acetate are the two main components of the formulation that are effective in dissolving zinc oxide-eugenol-based and resin based filling 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)

Two studies were performed in accordance to ISO 6876:2012 by Septodont in order to compare the effectiveness of ENDOSOLV (new device, K172839/S001) in comparison with ENDOSOLV E (predicate device, K980633) and ENDOSOLV R, considered positive control. The literature review revealed the effectiveness of those solvents in their intended indication: soften respectively eugenate-based and phenolic resin based root canal sealer when an endodontic retreatment is necessary. Purified water is then used as negative control in both assays. Moreover, a sealer was also used as negative control: Acroseal, it is an epoxy-resin based root canal sealer and neither of the solvents is indicated to soften this material. The first assay permits to conclude that ENDOSOL V (new device, K172839/S001) is as effective as ENDOSOLV E (predicate device, K980633) to dissolve eugenate based root canal sealer. Because of the successful results obtained with the new formulation that were comparable to ENDOSOLV E (predicate device, K980633), the intended performance of dissolving eugenate based root canal filling material is confirmed.

Moreover, the second study permits to demonstrate the performance of ENDOSOLV (new device. K172839/S001) to dissolve resin based root canal filling material. This study showed ENDOSOLV (new device, K172839/S001) results comparable to those obtained with ENDOSOLV R (only approved for sale in EU; indication: soften phenolic resin based root canal sealer; voluntary withdrawal of device from EU and Canada for precautionary reasons in order to avoid any risk of exposure of formamide to pregnant patients), confirming the intended performance of ENDOSOLV (new device, K172839/S001) to dissolve resin based root canal filling material.

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

Softening Time required to dissolve root canal sealers:

  • ENDOSOLV (new device) dissolved Endomethasone SP (eugenate-based root canal sealer) in 47 sec, compared to 70 sec for ENDOSOLV E (predicate device).
  • ENDOSOLV (new device) dissolved PCS Pulp Canal Sealer (eugenate-based root canal sealer) in 41 sec, compared to 68 sec for ENDOSOLV E (predicate device).
  • ENDOSOLV (new device) dissolved Sealite regular (eugenate-based root canal sealer) in 141 sec, compared to 68 sec for ENDOSOLV E (predicate device).
  • ENDOSOLV (new device) dissolved Acroseal (resin-based root canal sealer) in 7 min 10 sec, compared to 19 min 57 sec for ENDOSOLV E (predicate device).

Softening Time Required to Dissolve Resin-Based Root Canal Sealer:

  • ENDOSOLV (new device) dissolved resin-based root canal filling material in 50 sec.
  • ENDOSOLV E (predicated device) dissolved resin-based root canal filling material in 83 sec.
  • ENDOSOLV R dissolved resin-based root canal filling material in 68 sec.
  • Water (negative control) dissolved resin-based root canal filling material in 100 sec.

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.

K980633

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.

K780003

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

Image /page/0/Picture/0 description: The image shows the logos of the Department of Health & Human Services and the Food and Drug Administration (FDA). The Department of Health & Human Services logo is on the left, and the FDA logo is on the right. The FDA logo includes the letters "FDA" in a blue square, followed by the words "U.S. FOOD & DRUG ADMINISTRATION" in blue text.

Septodont Jaimie Woodruff RA Supervisor 416 South Taylor Avenue Louisville, Colorado 80027

Re: K172839

Trade/Device Name: Endosolv Regulation Number: 21 CFR 872.3820 Regulation Name: Root Canal Filling Resin Regulatory Class: Class II Product Code: KIF Dated: September 28, 2017 Received: September 29, 2017

Dear Jaimie Woodruff:

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);

U.S. Food & Drug Administration 10903 New Hampshire Avenue Silver Spring, MD 20993 www.fda.qov

February 13, 2018

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

DEPARTMENT OF HEALTH AND HUMAN SERVICES
Food and Drug Administration

Form Approved: OMB No. 0910-0120 Expiration Date: 06/30/2020 See PRA Statement below.

Indications for Use

510(k) Number (if known) K172839

Device Name ENDOSOLV

Indications for Use (Describe)

Root canal sealers solvent when canal retreatment is required.

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)

CONTINUE ON A SEPARATE PAGE IF NEEDED.

This section applies only to requirements of the Paperwork Reduction Act of 1995.

DO NOT SEND YOUR COMPLETED FORM TO THE PRA STAFF EMAIL ADDRESS BELOW.

The burden time for this collection of information is estimated to average 79 hours per response, including the time to review instructions, search existing data sources, gather and maintain the data needed and complete and review the collection of information. Send comments regarding this burden estimate or any other aspect of this information collection, including suggestions for reducing this burden, to:

Department of Health and Human Services Food and Drug Administration Office of Chief Information Officer Paperwork Reduction Act (PRA) Staff PRAStaff@fda.hhs.gov

"An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB number."

FORM FDA 3881 (7/17)

Page 1 of 1

PSC Publishing Services (301) 443-6740 EF

004 Indications for Use Statement

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Image /page/3/Picture/0 description: The image shows the Septodont logo. The logo features the word "septodont" in black, sans-serif font, positioned to the left of a white tooth shape. The tooth and the text are set against a solid red circle. The tooth shape is stylized, with a rounded top and a curved base.

5 510(k) Summary K172839

Traditional 510(k) Summary

I. MANUFACTURER:

SEPTODONT 58, Rue Du Pont De Creteil 94107 Saint Maur Des Fosses Cedex France Phone 33(0)1.49.76.70.00 Fax 33(0)1.48.85.54.01

  • Contact Person: Jaimie Woodruff, RAC Regulatory Affairs Supervisor Septodont 416 South Taylor Avenue Louisville, CO 80027 Phone (303) 665-7535 x6270 (303) 666-4320 FAX Email: jwoodruff@septodont.com
    Date Prepared: September 8, 2017

II. DEVICE

Trade/Proprietary Name:ENDOSOLV
Common Name:Resin, Root Canal Filling
Classification Name:Root Canal Filling Resin (21 CFR 872.3820)
Regulatory Class:II
Product Code:KIF

III. PREDICATE DEVICE(S)

K980633 ENDOSOLV EProduct code: KIF (predicate device)
K780003 ENDOSOLV EProduct code: KJJ (reference device)

IV. Device Description

ENDOSOLV (new device, K172839/S001) is a solvent used for eugenate-type or phenolic resin-based endodontic cements in the context of endodontic retreatment. This solvent is able to soften conventional zinc oxide eugenol cements and phenolic resin type

4

sealers in the context of endodontic retreatment. It is indicated for use as a root canal sealer solvent when canal retreatment is required.

Despite being highly successful, some endodontic treatments do not respond to initial therapy for different reasons and, hence, retreatment, also called canalar desobturation, becomes necessary. Many techniques are available for endodontic retreatment including the use of a solvent.

ENDOSOLV (new device, K172839/S001) composition consists of ethyl acetate, amyl acetate and thymol. Ethyl acetate and amyl acetate are the two main components of the formulation that are effective in dissolving zinc oxide-eugenol-based and resin based filling material.

V. Indication for Use

ENDOSOLV (new device. K172839/S001): Root canal sealers solvent when canal retreatment is required.

ENDOSOLV E (predicate device, K980633): Root canal filling remover for zinc-oxide eugenol-based materials.

The Indication for Use statement for ENDOSOLV (new device. K172839/S001) is not identical to the predicate devices; however, the differences do not alter the intended therapeutic use nor do they affect the safety and effectiveness of the device in comparison to the predicate device.

ENDOSOLV (new device. K172839/S001) in comparison to ENDOSOLV E (predicate device. K980633) does not limit the intended use of the root canal filling remover to zincoxide eugenol based material. ENDOSOLV (new device. K172839/S001) widens the intended use scope of the product to 'root canal sealers solvent when canal retreatment is required. This new indication for use includes both the conventional zinc oxide eugenol cement and resin type sealers in context of endodontic retreatment.

VI Comparison of Technological Characteristics with the Predicate Device

Ethyl acetate and amyl acetate are the two main components of the formulation in ENDOSOLV (new device, K172839/S001) that are effective in dissolving zinc oxideeugenol-based and resin based filling materials.

The predicative devices ENDOSOLV E (reference device, K780003) and ENDOSOLV E (predicate device, K980633) the only difference between the two devices was the removal of solvent, trichloroethane replaced by tetrachloroethylene in ENDOSOLV E (predicate device, K980633). The formula was changed because trichloroethane is banned in France.

Next, the ENDOSOLV (new device, K172839/S001) in relation to ENDOSOLV E (predicate device, K980633) the major difference is the ingredient tetrachloroethylene

005_510(k) Summary Page 2 of 4

5

which has been replaced by Ethyl Acetate. The reason for the change is Tetrachloroethylene is due to concerns of toxicity. In addition, overall formulation quantities has been modified minimally between the predicate devices and new device. ENDOSOLV (new device, K172839/S001) has been adjusted to account for the substitutional change in solvent from tetrachloroethylene to Ethyl Acetate.

VII Performance Data

Biocompatibility Testing

The biocompatibility evaluation for ENDOSOLV (new device, K172839/S001; based on ISO 10993 standards) are:

Type of studyStudy numberGuidelineStudy siteMain findingsReference
Cytotoxicity1752100ISO
10993-5
(2009)EnvigoNot cytotoxic(Envigo and Markus Roth, 2016)
HypersensitivitySMKiso-
PH-16/0032ISO
10993-10
(2010)Phycher
BiodevelopmentNot sensitizer(Colas, 2016)
IrritationMJ-PH-
16/0032ISO
10993-10
(2010)Phycher
BiodevelopmentNegligible irritation(Colas and Phycher, 2016)
Pulp and dentin
testNANANANot in contact.NA

Performance Testing

Two studies were performed in accordance to ISO 6876:2012 by Septodont in order to compare the effectiveness of ENDOSOLV (new device, K172839/S001) in comparison with ENDOSOLV E (predicate device, K980633) and ENDOSOLV R, considered positive control. The literature review revealed the effectiveness of those solvents in their intended indication: soften respectively eugenate-based and phenolic resin based root canal sealer when an endodontic retreatment is necessary (Gambrel et al., 2005;Canakci et al., 2015;Ramzi et al., 2010;Saglam et al., 2013). Purified water is then used as negative control in both assays. Moreover, a sealer was also used as negative control: Acroseal, it is an epoxy-resin based root canal sealer and neither of the solvents is indicated to soften this material. The first assay permits to conclude that ENDOSOL V (new device, K172839/S001) is as effective as ENDOSOLV E (predicate device, K980633) to dissolve eugenate based root canal sealer. Because of the successful results obtained with the new formulation that were comparable to ENDOSOLV E (predicate device, K980633), the intended performance of dissolving eugenate based root canal filling material is confirmed. Please see Table 1 for Summary of Results.

Moreover, the second study permits to demonstrate the performance of ENDOSOLV (new device. K172839/S001) to dissolve resin based root canal filling material. This study showed ENDOSOLV (new device, K172839/S001) results comparable to those

005_510(k) Summary Page 3 of 4

6

obtained with ENDOSOLV R (only approved for sale in EU; indication: soften phenolic resin based root canal sealer; voluntary withdrawal of device from EU and Canada for precautionary reasons in order to avoid any risk of exposure of formamide to pregnant patients), confirming the intended performance of ENDOSOLV (new device, K172839/S001) to dissolve resin based root canal filling material. Please see Table 2 for Summary of results.

ProductCementSoftening Time
ENDOSOLV E (predicate device)Endomethasone SP (eugenate-
based root canal sealer)70sec
ENDOSOLV (new device)Endomethasone SP (eugenate-
based root canal sealer)47sec
ENDOSOLV E (predicate device)PCS Pulp Canal Sealer
(eugenate-based root canal
sealer)68sec
ENDOSOLV (new device)PCS Pulp Canal Sealer
(eugenate-based root canal
sealer)41sec
ENDOSOLV E (predicate device)Sealite regular (eugenate-based
root canal sealer)68sec
ENDOSOLV (new device)Sealite regular (eugenate-based
root canal sealer)141sec
ENDOSOLV E (predicate device)Acroseal (resin-based root canal
sealer)19min 57sec
ENDOSOLV (new device)Acroseal (resin-based root canal
sealer)7min 10sec

Table 1: Softening Time Required to Dissolve Root Canal Sealers

Table 2: Softening Time Required to Dissolve Resin- Based Root Canal Sealer

ProductCementSoftening Time (sec)
ENDOSOLV (new device)resin-based root canal filling
material50
ENDOSOLV E (predicated
device)resin-based root canal filling
material83
ENDOSOLV R (indicated for
the dissolution of phenolic based
root canal sealers)resin-based root canal filling
material68
Water (negative control)resin-based root canal filling
material100

Substantial Equivalence

ENDOSOLV (new device, K172839/S001) in relation to ENDOSOLV E (predicate device, K980633) the major difference is the ingredient tetrachloroethylene which has been replaced by Ethyl Acetate. The reason for the change is Tetrachloroethylene has concerns of toxicity. In addition, overall formulation quantities has been modified minimally between the predicate device and new device. This is due to ENDOSOL V (new device, K172839/S001) has been adjusted to account for the substitutional change in solvent from tetrachloroethylene to Ethyl Acetate.