K Number
K180044
Device Name
SIROLaser Blue
Manufacturer
Date Cleared
2018-03-08

(59 days)

Product Code
Regulation Number
878.4810
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The SIROLaser Blue is intended for: (970 nm and 445 nm): intra- and extra-oral surgery including incision, hemostasis, coagulation and vaporization of soft tissue including marginal and epithelial lining of free gingiva and is indicated for: frenectomy; frenotomy; biopsy; operculectomy; imglant recovery; gingivoplasty; gingival troughing; crown lengthening; hemostasis of donor site; removal of granulation tissue; laser assisted flap surgery; debridement of diseased epithelial lining; incisions and draining of abscesses; tissue retraction for impressions; papillectomy; vestibuloplasty ; excision of lesions; exposure of unerupted teeth: removal of hyperplastic tissues: treatment of aphthous ulcers; leukoplakia; laser removal of diseased, inflamed and necrosed soft tissue within the periodontal pocket; sulcular debridement (removal of diseased, inflamed and necrosed soft tissue in the periodontal pocket to improve clinical indices including gingival index, gingival bleeding index, probe depth, attachment loss and tooth inability); pulpotomy; pulpotomy as adjunct to root canal therapy; fibroma removal; gingival incision; treatment of canker sores; herpetic ulcers of the oral mucosa; laser soft tissue curettage; reduction of gingival hypertrophy. Whitening (970 nm and 445 nm): The SIROLaser Blue is indicated for light activation for bleaching materials for teeth whitening and for laser-assisted whitening/bleaching of teeth. Low Level Laser Therapy (660 nm and 970 nm): The SIROLaser Blue is intended to emit energy in the red and infrared spectrum to provide topical heating for the purpose of elevating tissue temperature for the for minor muscle and joint pain and stiffness, minor arthritis pain, and for the temporary increase in local blood circulation and/or temporary relaxation of muscles.
Device Description
The SIROLaser Blue is a solid state laser device in which laser energy is generated by internal diodes. The laser output energy of the device is in the infrared, red, and blue spectra at wavelengths of 970 nm, 660nm, and 445 nm respectively. The output settings of the SIROLaser Blue can be adjusted by the user. SIROLaser Blue primarily consists of a laser control unit with graphical touch screen user interface, a laser handpiece, single-use, disposable, "EasyTip" laser fiber guides (for surgical applications), and reusable "MultiTip" light guides (for non-contact, low-power, "soft laser" applications). The laser control unit contains the 970 nm, 660 mm, and 445 nm laser diodes, electronic hardware, touchscreen graphical user interface, and software to control the laser functionality. The SIROLaser Blue handpiece assembly consists of an internal handpiece body with laser activation finger switch. The handpiece includes a removable stainless steel outer sleeve which can be cleaned and sterilized between patient procedures. The SIROLaser Blue is also offered with an optional wireless footswitch.
More Information

Not Found

No
The document describes a laser device with adjustable settings and a user interface, but there is no mention of AI or ML capabilities for analysis, decision-making, or automated adjustments based on data.

Yes

The device's intended uses clearly include therapeutic applications such as "incision, hemostasis, coagulation and vaporization of soft tissue," "treatment of aphthous ulcers," "Low Level Laser Therapy... for minor muscle and joint pain and stiffness, minor arthritis pain," and "temporary increase in local blood circulation and/or temporary relaxation of muscles." Furthermore, the performance studies section explicitly mentions testing for "therapeutic... laser equipment."

No

Explanation: The provided text describes the SIROLaser Blue's intended uses as surgical procedures (incision, hemostasis, coagulation, vaporization), teeth whitening, and low-level laser therapy for pain relief and increased blood circulation. None of these applications involve diagnosing a condition or disease.

No

The device description explicitly states it is a "solid state laser device" and details hardware components like laser diodes, a handpiece, and fiber guides, in addition to software.

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

Here's why:

  • Intended Use: The intended use clearly describes surgical procedures, teeth whitening, and low-level laser therapy performed directly on or within the patient's body. IVD devices are used to examine specimens (like blood, urine, or tissue) outside of the body to provide information about a person's health.
  • Device Description: The description details a laser device with handpieces and fiber guides for delivering laser energy to tissue. This aligns with a therapeutic or surgical device, not a device for analyzing samples.
  • Lack of IVD Characteristics: There is no mention of analyzing biological samples, reagents, or any of the typical components or processes associated with in vitro diagnostics.

Therefore, the SIROLaser Blue is a medical device, but it falls under categories like surgical lasers or therapeutic lasers, not in vitro diagnostics.

N/A

Intended Use / Indications for Use

The SIROLaser Blue is intended for:

(970 nm and 445 nm): intra- and extra-oral surgery including incision, hemostasis, coagulation and vaporization of soft tissue including marginal and epithelial lining of free gingiva and is indicated for: frenectomy; frenotomy; biopsy; operculectomy; imglant recovery; gingivoplasty; gingival troughing; crown lengthening; hemostasis of donor site; removal of granulation tissue; laser assisted flap surgery; debridement of diseased epithelial lining; incisions and draining of abscesses; tissue retraction for impressions; papillectomy; vestibuloplasty ; excision of lesions; exposure of unerupted teeth: removal of hyperplastic tissues: treatment of aphthous ulcers; leukoplakia; laser removal of diseased, inflamed and necrosed soft tissue within the periodontal pocket; sulcular debridement (removal of diseased, inflamed and necrosed soft tissue in the periodontal pocket to improve clinical indices including gingival index, gingival bleeding index, probe depth, attachment loss and tooth inability); pulpotomy; pulpotomy as adjunct to root canal therapy; fibroma removal; gingival incision; treatment of canker sores; herpetic ulcers of the oral mucosa; laser soft tissue curettage; reduction of gingival hypertrophy.

Whitening (970 nm and 445 nm): The SIROLaser Blue is indicated for light activation for bleaching materials for teeth whitening and for laser-assisted whitening/bleaching of teeth.

Low Level Laser Therapy (660 nm and 970 nm): The SIROLaser Blue is intended to emit energy in the red and infrared spectrum to provide topical heating for the purpose of elevating tissue temperature for the for minor muscle and joint pain and stiffness, minor arthritis pain, and for the temporary increase in local blood circulation and/or temporary relaxation of muscles.

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

GEX, ILY

Device Description

The SIROLaser Blue is a solid state laser device in which laser energy is generated by internal diodes. The laser output energy of the device is in the infrared, red, and blue spectra at wavelengths of 970 nm, 660nm, and 445 nm respectively. The output settings of the SIROLaser Blue can be adjusted by the user.

SIROLaser Blue primarily consists of a laser control unit with graphical touch screen user interface, a laser handpiece, single-use, disposable, "EasyTip" laser fiber guides (for surgical applications), and reusable "MultiTip" light guides (for non-contact, low-power, "soft laser" applications). The laser control unit contains the 970 nm, 660 mm, and 445 nm laser diodes, electronic hardware, touchscreen graphical user interface, and software to control the laser functionality.

The SIROLaser Blue handpiece assembly consists of an internal handpiece body with laser activation finger switch. The handpiece includes a removable stainless steel outer sleeve which can be cleaned and sterilized between patient procedures. The SIROLaser Blue is also offered with an optional wireless footswitch.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Intra- and extra-oral, soft tissue (gingiva), periodontal pocket, teeth, muscle and joint.

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 Performance Data:

  • Testing to verify the conformity of the proposed SIROLaser Blue with the requirements of IEC 60601-1: (Medical electrical equipment Part 1: General requirements for basic safety and essential performance).
  • Testing to verify the conformity of the proposed SIROLaser Blue with the requirements of IEC 60601-1-2: (Medical electrical equipment Part 1-2: General requirements for basic safety and essential performance. Collateral Standard: Electromagnetic compatibility).
  • Testing to verify the conformity of the proposed SIROLaser Blue to IEC 60825-1 (Safety of laser products – Part 1: Equipment classification and requirements).
  • Testing to verify the performance of the proposed SIROLaser Blue according to IEC 60601-2-22: (Medical electrical equipment Part 2: Particular Requirements for basic safety and essential performance of surgical, cosmetic, therapeutic, and diagnostic laser equipment).
  • Usability study conducted in conformity with IEC 62366 (Medical devices – Application of usability engineering to medical devices).
  • Statement confirming that the patient-contacting accessories of the subject SIROLaser Blue are identical to the accessories cleared for use with the predicate device and therefore no new biocompatibility testing was performed to support substantial equivalence.
  • Validation of the device's software in conformity with IEC 62304 (Medical device software – Software lifecycle processes).
  • Published bench test data is included which summarize studies conducted utilizing the SIROLaser Blue device comparing the cutting efficiency of the 445 nm laser wavelength (through histological examination of cutting depth and tissue denaturation) with the 970 nm laser wavelength of the secondary predicate device (K103753).

Clinical Performance Data:
No human clinical data was included to support substantial equivalence.

Key results: The results of the performance testing support 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.

K170500, K103753

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

§ 878.4810 Laser surgical instrument for use in general and plastic surgery and in dermatology.

(a)
Identification. (1) A carbon dioxide laser for use in general surgery and in dermatology is a laser device intended to cut, destroy, or remove tissue by light energy emitted by carbon dioxide.(2) An argon laser for use in dermatology is a laser device intended to destroy or coagulate tissue by light energy emitted by argon.
(b)
Classification. (1) Class II.(2) Class I for special laser gas mixtures used as a lasing medium for this class of lasers. The devices subject to this paragraph (b)(2) are exempt from the premarket notification procedures in subpart E of part 807 of this chapter, subject to the limitations in § 878.9.

0

Image /page/0/Picture/0 description: The image contains 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 features the letters 'FDA' in a blue square, followed by the words 'U.S. FOOD & DRUG ADMINISTRATION' in blue text.

March 8, 2018

Dentsply Sirona Karl Nittinger Senior Manager, Corporate Regulatory Affairs 221 West Philadelphia Street Suite 60W York, Pennsylvania 17401

Re: K180044

Trade/Device Name: SIROLaser Blue Regulation Number: 21 CFR 878.4810 Regulation Name: Laser Surgical Instrument For Use In General And Plastic Surgery And In Dermatology Regulatory Class: Class II Product Code: GEX Dated: March 8, 2018 Received: March 8, 2018

Dear Karl Nittinger:

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, 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

1

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.

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 medical devices and radiation-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,

Jennifer R. Stevenson -S3

For Binita S. Ashar, M.D., M.B.A., F.A.C.S. Director Division of Surgical Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

2

Indications for Use

510(k) Number (if known) K180044

Device Name SIROLaser Blue

Indications for Use (Describe)

The SIROLaser Blue is intended for:

(970 nm and 445 nm): intra- and extra-oral surgery including incision, hemostasis, coagulation and vaporization of soft tissue including marginal and epithelial lining of free gingiva and is indicated for: frenectomy; frenotomy; biopsy; operculectomy; imglant recovery; gingivoplasty; gingival troughing; crown lengthening; hemostasis of donor site; removal of granulation tissue; laser assisted flap surgery; debridement of diseased epithelial lining; incisions and draining of abscesses; tissue retraction for impressions; papillectomy; vestibuloplasty ; excision of lesions; exposure of unerupted teeth: removal of hyperplastic tissues: treatment of aphthous ulcers; leukoplakia; laser removal of diseased, inflamed and necrosed soft tissue within the periodontal pocket; sulcular debridement (removal of diseased, inflamed and necrosed soft tissue in the periodontal pocket to improve clinical indices including gingival index, gingival bleeding index, probe depth, attachment loss and tooth inability); pulpotomy; pulpotomy as adjunct to root canal therapy; fibroma removal; gingival incision; treatment of canker sores; herpetic ulcers of the oral mucosa; laser soft tissue curettage; reduction of gingival hypertrophy.

Whitening (970 nm and 445 nm): The SIROLaser Blue is indicated for light activation for bleaching materials for teeth whitening and for laser-assisted whitening/bleaching of teeth.

Low Level Laser Therapy (660 nm and 970 nm): The SIROLaser Blue is intended to emit energy in the red and infrared spectrum to provide topical heating for the purpose of elevating tissue temperature for the for minor muscle and joint pain and stiffness, minor arthritis pain, and for the temporary increase in local blood circulation and/or temporary relaxation of muscles.

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

SECTION 5. 510(k) SUMMARY for

SIROLaser Blue

1. Submitter Information:

Dentsply Sirona 221 West Philadelphia Street Suite 60 York, PA 17404

Contact Person:Karl Nittinger
Telephone Number:717-849-4424
Fax Number:717-849-4343

March 8, 2018 Date Prepared:

2. Device Name:

  • Proprietary Name: SIROLaser Blue ● Laser surgical instrument for use in general and Classification Name: . plastic surgery and in dermatology. 21 CFR 878.4810 CFR Number: .
• Device Class:Class II
• Product Code:GEX (Powered Laser Surgical Instrument)
ILY (Lamp, Infrared, Therapeutic Heating)

3. Predicate Device:

The predicate and reference devices identified relating to the substantial equivalence of the SIROLaser Blue are:

Primary Predicate Device Name510(k)Company Name
SIROLaser Advance+K170500Dentsply Sirona
Secondary Predicate Device Name510(k)Company Name
SIROLaser AdvanceK103753Sirona Dental Systems GmbH

4

4. Description of Device:

The SIROLaser Blue is a solid state laser device in which laser energy is generated by internal diodes. The laser output energy of the device is in the infrared, red, and blue spectra at wavelengths of 970 nm, 660nm, and 445 nm respectively. The output settings of the SIROLaser Blue can be adjusted by the user.

SIROLaser Blue primarily consists of a laser control unit with graphical touch screen user interface, a laser handpiece, single-use, disposable, "EasyTip" laser fiber guides (for surgical applications), and reusable "MultiTip" light guides (for non-contact, low-power, "soft laser" applications). The laser control unit contains the 970 nm, 660 mm, and 445 nm laser diodes, electronic hardware, touchscreen graphical user interface, and software to control the laser functionality.

The SIROLaser Blue handpiece assembly consists of an internal handpiece body with laser activation finger switch. The handpiece includes a removable stainless steel outer sleeve which can be cleaned and sterilized between patient procedures. The SIROLaser Blue is also offered with an optional wireless footswitch.

5. Indications for Use:

The SIROLaser Blue is intended for:

(970nm and 445nm): intra- and extra-oral surgery including incision, excision, hemostasis, coagulation and vaporization of soft tissue including marginal and inter-dental and epithelial lining of free gingiva and is indicated for: frenectomy; frenotomy; biopsy; operculectomy; implant recovery; gingivectomy; gingivoplasty; gingival troughing; crown lengthening; hemostasis of donor site; removal of granulation tissue; laser assisted flap surgery; debridement of diseased epithelial lining; incisions and draining of abscesses; tissue retraction for impressions; papillectomy; vestibuloplasty ; excision of lesions; exposure of unerupted/partially erupted teeth; removal of hyperplastic tissues; treatment of aphthous ulcers; leukoplakia; laser removal of diseased, inflamed and necrosed soft tissue within the periodontal pocket; sulcular debridement (removal of diseased, inflamed and necrosed soft tissue in the periodontal pocket to improve clinical indices including gingival index, gingival bleeding index, probe depth, attachment loss and tooth inability); pulpotomy; pulpotomy as adjunct to root canal therapy; fibroma removal; gingival incision and excision; treatment of canker sores; herpetic ulcers of the oral mucosa; laser soft tissue curettage; reduction of gingival hypertrophy.

Whitening (970nm and 445nm): The SIROLaser Blue is indicated for light activation for bleaching materials for teeth whitening and for laser-assisted whitening/bleaching of teeth.

Low Level Laser Therapy (660nm and 970nm): The SIROLaser Blue is intended to emit energy in the red and infrared spectrum to provide topical heating for the purpose of elevating tissue temperature for the temporary relief of minor muscle and joint pain and stiffness, minor arthritis pain, or muscle spasm, and for the temporary increase in local blood circulation and/or temporary relaxation of muscles.

Denstply Sirona SIROLaser Blue

5

6. Substantial Equivalence:

The subject SIROLaser Blue has the same intended use as the predicate device. Both the SIROLaser Blue and the primary predicate device are intended as powered laser surgical instruments as well as to provide topical heating to soft tissues for therapeutic purposes under 21 CFR 878.4810 and 21 CFR 890.5500, respectively.

The subject SIROLaser Blue and the primary predicate device (K170500) both generate laser energy via solid state LED technology. As does the primary predicate device (K170500), the subject SIROLaser Blue emits laser light energy in both the infrared and red spectra.

In addition to laser energy in the infrared and red spectra, the subject SIROLaser Blue also emits laser energy in the blue (445 nm) spectrum. The secondary predicate SIROLaser Advance (K103753) is included in the technological comparison because published performance bench testing which verified the equivalency of the cutting efficiency of the 445 mm laser wavelength compared to that of the 970 nm laser wavelength is included in this premarket notification to support substantial equivalence. The bench test performance verification was conducted utilizing the subject SIROLaser Blue (445 nm) and the secondary predicate SIROLaser Advance (K103753) device (970 nm) and compared soft tissue cutting performance.

The SIROLaser Blue and the predicate device are intended for surgical applications using handpieces to which single-use laser fiber tips are attached. For low-level laser therapy applications, both the SIROLaser Blue and the predicate device offer non-contact handpieces.

Detailed comparison of the intended use, indications for use, and design of the SIROLaser Blue and the predicate device is presented in Tables 6.1 and 6.2.

| Proposed Device
SIROLaser Blue | Primary Predicate Device
SIROLaser Advance+
(K170500) | Secondary Predicate Device
SIROLaser Advance
(K103753) |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Surgical Indications for Use | | |
| Intended for intra- and extra-oral surgery
including incision, excision, hemostasis,
coagulation and vaporization of soft tissue
including marginal and inter-dental and
epithelial lining of free gingiva and is
indicated for: | Intended for intra- and extra-oral
surgery including incision, excision,
hemostasis, coagulation and
vaporization of soft tissue including
marginal and inter-dental and epithelial
lining of free gingiva and is indicated
for: | Intended for intra- and extra-oral
surgery including incision,
excision, hemostasis, coagulation
and vaporization of soft tissue
including marginal and inter-
dental and epithelial lining of free
gingiva and is indicated for: |
| frenectomy; frenotomy; | frenectomy; frenotomy; | frenectomy; frenotomy; |
| biopsy; operculectomy; | biopsy; operculectomy; | biopsy; operculectomy; |
| implant recovery; | implant recovery; | implant recovery; |
| gingivectomy; gingivoplasty; | gingivectomy; gingivoplasty; | gingivectomy; gingivoplasty; |
| gingival troughing; | gingival troughing; | gingival troughing; |
| crown lengthening; | crown lengthening; | crown lengthening; |
| hemostasis of donor site; | hemostasis of donor site; | hemostasis of donor site; |
| Proposed Device
SIROLaser Blue | Primary Predicate Device
SIROLaser Advance+
(K170500) | Secondary Predicate Device
SIROLaser Advance
(K103753) |
| Surgical Indications for Use (continued) | | |
| removal of granulation tissue; | removal of granulation tissue; | removal of granulation tissue; |
| laser assisted flap surgery; | laser assisted flap surgery; | laser assisted flap surgery; |
| debridement of diseased epithelial lining; | debridement of diseased epithelial lining; | debridement of diseased epithelial
lining; |
| incisions and draining of abscesses; | incisions and draining of abscesses; | incisions and draining of
abscesses; |
| tissue retraction for impressions; | tissue retraction for impressions; | tissue retraction for impressions; |
| papillectomy; vestibuloplasty; | papillectomy; vestibuloplasty; | papillectomy; vestibuloplasty; |
| excision of lesions; | excision of lesions; | excision of lesions; |
| exposure of unerupted/partially erupted
teeth; | exposure of unerupted/partially erupted
teeth; | exposure of unerupted/partially
erupted teeth; |
| removal of hyperplastic tissues; | removal of hyperplastic tissues; | removal of hyperplastic tissues; |
| treatment of aphthous ulcers; | treatment of aphthous ulcers; | treatment of aphthous ulcers; |
| leukoplakia; | leukoplakia; | leukoplakia; |
| pulpotomy; pulpotomy as adjunct to root
canal therapy; | pulpotomy; pulpotomy as adjunct to root
canal therapy; | pulpotomy; pulpotomy as adjunct
to root canal therapy; |
| fibroma removal; gingival incision and
excision; | fibroma removal; gingival incision and
excision; | fibroma removal; gingival
incision and excision; |
| treatment of canker sores; herpetic ulcers
of the oral mucosa; | treatment of canker sores; herpetic ulcers
of the oral mucosa; | treatment of canker sores; herpetic
ulcers of the oral mucosa; |
| laser soft tissue curettage; | laser soft tissue curettage; | laser soft tissue curettage; |
| reduction of gingival hypertrophy. | reduction of gingival hypertrophy. | reduction of gingival hypertrophy. |
| Laser Periodontic Indications for Use | | |
| laser removal of diseased, infected,
inflamed and necrosed soft tissue; within
the periodontal pocket; | laser removal of diseased, infected,
inflamed and necrosed soft tissue; within
the periodontal pocket; | laser removal of diseased,
infected, inflamed and necrosed
soft tissue; within the periodontal
pocket; |
| sulcular debridement (removal of diseased,
infected, inflamed and necrosed soft tissue
in the periodontal pocket to improve
clinical indices including gingival index,
gingival bleeding index, probe depth,
attachment loss and tooth inability); | sulcular debridement (removal of
diseased, infected, inflamed and necrosed
soft tissue in the periodontal pocket to
improve clinical indices including
gingival index, gingival bleeding index,
probe depth, attachment loss and tooth
inability); | sulcular debridement (removal of
diseased, infected, inflamed and
necrosed soft tissue in the
periodontal pocket to improve
clinical indices including gingival
index, gingival bleeding index,
probe depth, attachment loss and
tooth inability); |
| Tooth Whitening Indications for Use | | |
| Light activation for bleaching materials for
teeth whitening; | Light activation for bleaching materials
for teeth whitening; | N/A |
| Laser-assisted whitening/bleaching of
teeth | Laser-assisted whitening/bleaching of
teeth | N/A |

Table 6.1: Indications for Use

6

Table 6.1 (continued): Indications for Use

7

Table 6.1 (continued): Indications for Use

| Proposed Device
SIROLaser Blue | Primary Predicate Device
SIROLaser Advance+
(K170500) | Secondary Predicate Device
SIROLaser Advance
(K103753) |
|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------------------------------------------------------------|
| Low Level Laser Therapy Indications for Use | | |
| Intended to emit energy in the red and
infrared spectrum to provide topical
heating for the purpose of elevating tissue
temperature for the temporary relief of
minor muscle and joint pain and stiffness,
minor arthritis pain, or muscle spasm, and
for the temporary increase in local blood
circulation and/or temporary relaxation of
muscles. | Intended to emit energy in the infrared
spectrum to provide topical heating for the
purpose of elevating tissue temperature
for the temporary relief of minor muscle
and joint pain and stiffness, minor arthritis
pain, or muscle spasm, the temporary
increase in local blood circulation and/or
temporary relaxation of muscles. | N/A |

Table 6.2: Design

| Proposed Device
SIROLaser Blue | Primary Predicate Device
SIROLaser Advance+
(K170500) | Secondary Predicate Device
SIROLaser Advance
(K103753) |
|------------------------------------------------------|-----------------------------------------------------------------------------------|--------------------------------------------------------------------------------|
| Laser Classification | | |
| 970 nm and 445 nm Laser: Class IV | 970 nm Laser: Class IV | 970 nm: Class IV |
| 660 nm Laser: Class II | 660 nm Laser: Class II | |
| Laser Type | | |
| Solid state diode laser | Solid state diode laser | Solid state diode laser |
| Laser Wavelength | | |
| 970 nm | 970 nm | 970 nm |
| 660 nm | 660 nm | |
| 445 nm | | |
| Optical Power | | |
| 970 nm:
0.2 W - 2.0 W (Continuous Wave) | 970 nm:
0.2 W - 7.0 W (Continuous Wave)
14 W (peak optical power) | 970 nm:
7.0 W max. (Continuous Wave)
14 W (peak optical power) |
| 660 nm:
25 mW, 50 mW, 100 mW (Continuous
Wave) | 660 nm:
25 mW, 50 mW, 100 mW (Continuous
Wave) | |
| 445 nm:
0.2 W - 3.0 W (Continuous Wave) | | |
| · Continuous Wave
· Chopped (1 Hz - 10 kHz) | · Continuous Wave
· Chopped (1 Hz - 10 kHz)
· Peak Pulse (1.5 kHz – 20 kHz) | · Continuous Wavre
· Chopped (1 Hz - 10 kHz)
· Peak Pulse (up to 20 kHz) |
| Chopped Mode: | Chopped Mode: 10 usec. to 0.99 sec. | Chopped Mode: 10 usec. to 0.99 sec. |
| 10 µsec. to 0.99 sec. | Peak Pulse: 23 µsec. | Peak Pulse: 23 µsec. |

8

Table 6.2 (continued): Design

| Proposed Device
SIROLaser Blue | Primary Predicate Device
SIROLaser Advance+
(K170500) | Secondary Predicate Device
SIROLaser Advance
(K103753) |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Aiming Beam | | |
| 660 nm
1 mW (max.) | 660 nm
1 mW (max.) | 635 nm – 650 nm
1 mW (max) |
| Optical Fiber Surgical Tips | | |
| Fiber Diameter:
200 μm, 320 μm | Fiber Diameter:
200 μm, 320 μm | Fiber Diameter:
200 μm, 320 μm |
| • Single-use tips.
• Integral laser fiber.
• Plastic proximal connection hub.
• Bendable stainless steel cannula.
• Provided sterile
(sterilized by ethylene oxide). | • Single-use tips.
• Integral laser fiber.
• Plastic proximal connection hub.
• Bendable stainless steel cannula.
• Provided sterile
(sterilized by ethylene oxide). | • Single-use tips.
• Laser fiber assembled with tip by
user.
• Plastic proximal connection hub.
• Bendable stainless steel cannula.
• Provided non-sterile. |
| Laser Handpiece | | |
| • Handpiece connected by flexible
optical fiber to control unit.
• Finger switch laser activation.
• Removable, sterilizable stainless steel
outer sleeve. | • Handpiece connected by flexible optical
fiber to control unit.
• Finger switch laser activation.
• Removable, sterilizable stainless steel
outer sleeve. | • Handpiece connected by flexible
optical fiber to control unit.
• Finger switch laser activation.
• Removable, sterilizable outer
sleeve. |
| Laser Therapy Light Guides | | |
| Curved light guides:
4 mm, 8mm diameter. | Curved light guides:
4 mm, 8mm diameter. | N/A |
| Activation Method | | |
| • Handpiece finger switch.
• Optional wireless foot switch. | • Handpiece finger switch.
• Optional wireless foot switch. | • Handpiece finger switch.
• Optional wireless foot switch. |
| Laser Control Unit Dimensions | | |
| 182 mm x 197 mm x 189 mm | 182 mm x 197 mm x 189 mm | 182 mm x 197 mm x 189 mm |
| Laser Control Unit User Interface | | |
| Color touch screen graphical user
interface. | Color touch screen graphical user interface. | Color touch screen graphical user
interface. |

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7. Non-Clinical Performance Data

The Testing to verify the performance requirements of the SIROLaser Blue was conducted and included in this premarket notification. The results of the performance testing support substantial equivalence.

Tests included in this premarket notification:

  • · Testing to verify the conformity of the proposed SIROLaser Blue with the requirements of IEC 60601-1: (Medical electrical equipment Part 1: General requirements for basic safety and essential performance).
  • . Testing to verify the conformity of the proposed SIROLaser Blue with the requirements of IEC 60601-1-2: (Medical electrical equipment Part 1-2: General requirements for basic safety and essential performance. Collateral Standard: Electromagnetic compatibility).
  • . Testing to verify the conformity of the proposed SIROLaser Blue to IEC 60825-1 (Safety of laser products – Part 1: Equipment classification and requirements).
  • . Testing to verify the performance of the proposed SIROLaser Blue according to IEC 60601-2-22: (Medical electrical equipment Part 2: Particular Requirements for basic safety and essential performance of surgical, cosmetic, therapeutic, and diagnostic laser equipment).
  • . Usability study conducted in conformity with IEC 62366 (Medical devices – Application of usability engineering to medical devices).
  • Statement confirming that the patient-contacting accessories of the subject SIROLaser Blue are identical to the accessories cleared for use with the predicate device and therefore no new biocompatibility testing was performed to support substantial equivalence.
  • . Validation of the device's software in conformity with IEC 62304 (Medical device software – Software lifecycle processes).
  • Published bench test data is included which summarize studies conducted utilizing the . SIROLaser Blue device comparing the cutting efficiency of the 445 nm laser wavelength (through histological examination of cutting depth and tissue denaturation) with the 970 nm laser wavelength of the secondary predicate device (K103753).

Clinical Performance Data 8.

No human clinical data was included to support substantial equivalence.

10

Conclusion Regarding Substantial Equivalence 9.

The information included in this premarket notification supports the substantial equivalence of the subject SIROLaser Blue. The subject device has the identical intended use as the legally marketed predicate device. The subject device also has the same indications for use and incorporates the same fundamental technology as the predicate devices.

Performance and biocompatibility data are included in this premarket notification to demonstrate the performance of the subject SIROLaser Blue against its design, functional, and safety requirements. The results of the testing included in this premarket notification support a determination of substantial equivalence.