K Number
K172952
Device Name
Figaro Crowns Anterior Crown Kit, Figaro Crowns Posterior Crown Kit
Date Cleared
2018-07-03

(280 days)

Product Code
Regulation Number
872.3690
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
The Figaro Preformed Dental Crown is intended for restoration of permanent teeth with a single unit crown. The Figaro Crowns are intended for restoration of permanent adult teeth with a single unit crown.
Device Description
The Figaro Crown is a permanent preformed resin crown used on adult patients. The crown is designed for permanent (>30 days) tooth restoration to restore, size, strength, chewing ability and for to improve appearance. The preformed crowns are manufactured to specific sizes for improved fit. The crowns go through a finishing process and are not intended to the manipulated by the dentist. Sizing is exclusively determined by the dentist for each crown and patient. The crown is secured to the patient's mouth with standard adhesion techniques. Once the crown is cemented in place it should fully encase the portion of the tooth that lies above the gum line. The Figaro Preformed crown is made of layers fiberglass held together by epoxy resin. Small amounts of Titanium Dioxide and Yellow Iron oxide are added for cosmetic affect. The crowns are designed for the following designs, Canine, Upper Premolar, Upper Molar, Lower Premolar, Lower Molar. The crowns are provided in one size.
More Information

Not Found

No
The device description and performance studies focus on the material properties and physical characteristics of a preformed dental crown. There is no mention of AI, ML, image processing, or data-driven decision-making.

No.
A therapeutic device is one that treats or prevents a disease or condition. This device is a dental crown intended for restoration of permanent teeth, which is a restorative rather than a therapeutic function.

No.
The document describes a dental crown intended for "restoration of permanent teeth," which is a treatment rather than a diagnostic function. The device's description and performance studies focus on its physical properties and intended use for tooth restoration, not disease detection or diagnosis.

No

The device description clearly states it is a physical preformed resin crown made of fiberglass and epoxy resin, intended for permanent tooth restoration. It is a hardware device.

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 perform tests on samples taken from the human body (like blood, urine, tissue) to provide information about a person's health. They are used outside the body (in vitro).
  • Figaro Preformed Dental Crown Function: The Figaro Preformed Dental Crown is a physical device intended to be permanently placed inside the mouth to restore a tooth. It does not perform any tests on bodily samples to diagnose or monitor a condition.
  • Intended Use: The intended use is for the restoration of permanent teeth, which is a structural and functional repair, not a diagnostic process.
  • Device Description: The description focuses on the physical properties and materials of the crown, not on any analytical or testing capabilities.

Therefore, the Figaro Preformed Dental Crown falls under the category of a dental prosthetic or restorative device, not an In Vitro Diagnostic.

N/A

Intended Use / Indications for Use

The Figaro Preformed Dental Crown is intended for restoration of permanent teeth with a single unit crown.
The Figaro Crowns are intended for restoration of permanent adult teeth with a single unit crown.

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

EBF

Device Description

The Figaro Crown is a permanent preformed resin crown used on adult patients. The crown is designed for permanent (>30 days) tooth restoration to restore, size, strength, chewing ability and for to improve appearance. The preformed crowns are manufactured to specific sizes for improved fit. The crowns go through a finishing process and are not intended to the manipulated by the dentist. Sizing is exclusively determined by the dentist for each crown and patient. The crown is secured to the patient's mouth with standard adhesion techniques. Once the crown is cemented in place it should fully encase the portion of the tooth that lies above the gum line. The Figaro Preformed crown is made of layers fiberglass held together by epoxy resin. Small amounts of Titanium Dioxide and Yellow Iron oxide are added for cosmetic affect.
The crowns are designed for the following designs, Canine, Upper Premolar, Upper Molar, Lower Premolar, Lower Molar. The crowns are provided in one size.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Permanent teeth, permanent adult teeth. Specific designs for Canine, Upper Premolar, Upper Molar, Lower Premolar, Lower Molar.

Indicated Patient Age Range

Adult patients

Intended User / Care Setting

licensed dental professional such as DDS or DMD.

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 Performance Testing:
We have performed a number of bench tests to demonstrate the Figaro Crowns perform with in the specifications. These tests included:

  • Flexural Strength
  • Flexural Modulus
  • Tensile Strength
  • Tensile Modulus
  • Charpy Index

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.

K143694 Rhondium One-Visit-Crown (OVC)

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

§ 872.3690 Tooth shade resin material.

(a)
Identification. Tooth shade resin material is a device composed of materials such as bisphenol-A glycidyl methacrylate (Bis-GMA) intended to restore carious lesions or structural defects in teeth.(b)
Classification. Class II.

0

Figaro Crowns, Inc. Kyle Rose Quality Manager 1628 Ouail Ridge Circle Woodbury, Minnesota 55125 July 3, 2018

Re: K172952

Trade/Device Name: Figaro Crowns Anterior Crown Kit, Figaro Crowns Posterior Crown Kit Regulation Number: 21 CFR 872.3690 Regulation Name: Tooth Shade Resin Material Regulatory Class: Class II Product Code: EBF Dated: March 30, 2018 Received: April 3, 2018

Dear Kyle Rose:

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 (OS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

1

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

2

Indications for Use

510(k) Number (if known) K172952

Device Name

Figaro Crowns Anterior Crown Kit Figaro Crowns Posterior Crown Kit

Indications for Use (Describe)

The Figaro Preformed Dental Crown is intended for restoration of permanent teeth with a single unit crown.

Type of Use (Select one or both, as applicable)
Prescription Use (Part 81 CFR 201 Subpart D)
Over-The-Counter Use (81 CFR 201 Subpart C)

Prescription Use (Part 21 CFR 801 Subpart D)

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

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  1. 510(k) Summary K172952

Date of Preparation: 30-Mar-2018

Attn:

Figaro Crowns, Inc.

1628 Quail Ridge Circle

Woodbury, MN USA 55125

%Kyle Rose

Tel: 404.717.9358

Email: rookqualitysytems@gmail.com

Official Contact: Kyle Rose Quality Manager

Trade Name:

Figaro Crowns Anterior Crown Kit

Figaro Crowns Posterior Crown Kit

Common Name: Dental material, filling/restorative, polymer based

Classification Name: Tooth Shade Resin Material

Classification Regulations: 21 CFR 872.3690

Product Code EBF

Classification: Class II

Predicate Device: K143694 Rhondium One-Visit-Crown (OVC)

Device Description:

The Figaro Crown is a permanent preformed resin crown used on adult patients. The crown is designed for permanent (>30 days) tooth restoration to restore, size, strength, chewing ability and for to improve appearance. The preformed crowns are manufactured to specific sizes for improved fit. The crowns go through a finishing

4

Image /page/4/Picture/0 description: The image shows the logo for Figaro Crowns. The logo features a green mountain range with three peaks, with a blue line forming the shape of a tooth above the mountains. Below the mountain range, the word "FIGARO" is written in a serif font, and below that, the word "CROWNS" is written in a sans-serif font.

process and are not intended to the manipulated by the dentist. Sizing is exclusively determined by the dentist for each crown and patient. The crown is secured to the patient's mouth with standard adhesion techniques. Once the crown is cemented in place it should fully encase the portion of the tooth that lies above the gum line. The Figaro Preformed crown is made of layers fiberglass held together by epoxy resin. Small amounts of Titanium Dioxide and Yellow Iron oxide are added for cosmetic affect.

The crowns are designed for the following designs, Canine, Upper Premolar, Upper Molar, Lower Premolar, Lower Molar. The crowns are provided in one size.

Indications for Use:

The Figaro Crowns are intended for restoration of permanent adult teeth with a single unit crown.

Environment of Use:

The Figaro Crowns are available for prescription only and intended to be used by a licensed dental professional such as DDS or DMD. Not for use by the general public or OTC.

Contradictions: None

Substantial Equivalence Discussion of Comparison to Predicates:

The Figaro Crowns are viewed as substantially equivalent to the predicate device based on the equivalencies listed below.

Indications-

The indication for use is identical to the predicate K143694 Rhondium One-Visit-Crown (OVC).

Technology-

The technology used to create the preformed resin crown is similar to the predicate. The Figaro Crown does not require any additional uncured custom layers and therefore poses less risk that the predicate.

Materials-

5

Image /page/5/Picture/0 description: The image shows a logo for "Figaro Crowns". The logo features a green mountain range with three peaks, overlaid by a blue, stylized tooth shape. Below the mountain range, the word "FIGARO" is written in a bold, serif font. Underneath "FIGARO", the word "CROWNS" is written in a smaller, green, sans-serif font.

The materials are similar cured resins that have been found to meet ISO 10993 requirements and thus can be substantially equivalent to the safety of the predicate.

Figaro Crowns PreformedRhondium One-Visit-Crown
ComparisonDental Crown(OVC)
Preformed single tooth
crown for one visitPreformed single tooth crown
Crown Descriptionrestorationfor one visit restoration
Adult Canine, Upper
Premolar, Upper Molar,
Lower Premolar, LowerUpper and lower canines,
Teeth to be restoredMolar.premolars, and molars
N=8 designs :
N=5 designs:Upper Premolar, Upper Molar,
Canine, Upper Premolar,Lower Premolar,
Upper Molar, LowerLower Molar
Specific crown designPremolar, Lower Molar.Each in Left and Right designs
Each design provided in 1Each design provided in 6 sizes:
Crown SizessizeXS, S, M, L, XL, XXL
Heat cured polymer
composite resin reinforcedLight-cured polymer composite
Crown materialwith fiberglassresin

Non-clinical Performance Testing:

We have performed a number of bench tests to demonstrate the Figaro Crowns perform with in the specifications. These tests included:

  • Flexural Strength ●
  • Flexural Modulus .
  • Tensile Strength ●
  • Tensile Modulus ●
  • Charpy Index ●

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Substantial Equivalence Conclusion

The Figaro Crowns and the predicate device have similar indications for use and intended use and provide a similar range of designs and sizes for restoration. Both devices are provided nonsterile for single use only.