K Number
K180845
Device Name
Maxima Electric System
Date Cleared
2019-07-25

(479 days)

Product Code
Regulation Number
872.4200
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Maxima Electric System is intended to convert pneumatic output from a dental treatment center to electrical energy to drive an electric micro motor and to operate electrically- driven dental handpieces. This system is designed for use by a trained professional in the field of general dentistry.
Device Description
Maxima Electric System is a system attached to dental system to operate Electricallydriven low speed handpieces. The common gear ratio is 1:1 and 1:5, the speed range is from 100 to 40,000 rpm. Software used on control box is to control speed, forward and reverse direction of the handpieces; turn on an off the cooling water and LED light. There are 3 memories for speed of common low speed handpieces can be save into the program. The air hose is connect the air and water from 4-hole standard handpiece hose from dental system to the control unit, the existing air pedal from dental system is to turn on and off and control speed by converting pneumatic from dental system to electrical energy to operate electric handpieces. The control box is power by a power supply AC/DC voltage 36 VDC. Maxima Electric System consists of the following components: 1-Control Unit 2-Motor Cable 3-Micromotor (Model ELM-B40S) 4-Accessories including the following a-Foot switch (optional) b-AC/DC Adapter c-AC cord A control unit, Motor Cable and a Micro-motor.
More Information

Not Found

No
The description focuses on basic electrical and pneumatic control of a dental handpiece, with simple memory functions for speed settings. There is no mention of learning, adaptation, or complex data analysis characteristic of AI/ML.

No
The device is described as converting pneumatic output from a dental treatment center to electrical energy to drive an electric micromotor and operate electrically-driven dental handpieces, intended for use in general dentistry. It does not state any therapeutic function for treating diseases or conditions.

No

The device is described as converting pneumatic output to electrical energy to drive an electric micro motor and operate dental handpieces, which are tools used for treatment, not diagnosis. The "Intended Use" states it's for driving dental handpieces, and the "Device Description" details its function in controlling the speed and direction of these handpieces.

No

The device description explicitly lists multiple hardware components including a Control Unit, Motor Cable, Micromotor, AC/DC Adapter, and AC cord. While software is mentioned for control functions, the device is clearly a system with significant hardware components.

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

Here's why:

  • Intended Use: The intended use clearly states that the system is for converting pneumatic output to electrical energy to drive dental handpieces for use by a trained professional in general dentistry. This describes a device used on a patient during a dental procedure, not a device used to examine specimens in vitro (outside the body) to provide diagnostic information.
  • Device Description: The description details the components and function of a system that powers dental handpieces. It focuses on mechanical and electrical aspects of operating dental tools.
  • Lack of IVD Characteristics: There is no mention of analyzing biological samples (blood, tissue, etc.), detecting analytes, or providing diagnostic information about a patient's health condition.

Therefore, the Maxima Electric System is a dental device used for treatment, not an in vitro diagnostic device.

N/A

Intended Use / Indications for Use

The Maxima Electric System is intended to convert pneumatic output from a dental treatment center to electrical energy to drive an electric micro motor and to operate electrically- driven dental handpieces. This system is designed for use by a trained professional in the field of general dentistry.

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

EBW

Device Description

Maxima Electric System is a system attached to dental system to operate Electricallydriven low speed handpieces. The common gear ratio is 1:1 and 1:5, the speed range is from 100 to 40,000 rpm.

Software used on control box is to control speed, forward and reverse direction of the handpieces; turn on an off the cooling water and LED light. There are 3 memories for speed of common low speed handpieces can be save into the program.

The air hose is connect the air and water from 4-hole standard handpiece hose from dental system to the control unit, the existing air pedal from dental system is to turn on and off and control speed by converting pneumatic from dental system to electrical energy to operate electric handpieces.

The control box is power by a power supply AC/DC voltage 36 VDC.

Maxima Electric System consists of the following components:

1-Control Unit
2-Motor Cable
3-Micromotor (Model ELM-B40S)
4-Accessories including the following
a-Foot switch (optional)
b-AC/DC Adapter
c-AC cord

A control unit, Motor Cable and a Micro-motor.

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

trained professional in the field of general dentistry.

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)

Comparison of performance testing:
"Based on performance testing results, there are no significant differences in performance of testing handpieces after 250 cycles of testing by using Maxima Electric System and KaVo Electro Torque. The Speed Vs Torque table shows the similar trend of speed and torque from the beginning of the test to the end of 250 cycles of testing.

The performance of the Maxima Electric System on the testing handpiece is similar to the performance of the KaVo Electric torque on the testing the handpiece regarding to Speed Vs Torque."

Bench Performance Testing Conducted:

  • Risk Analysis per ISO 14971
  • Sterilization and cleaning/disinfection validation per ISO 17665-1, ISO 17665-2, and FDA Guidance Document for Reprocessing of Medical Device
  • Moderate level of software documentation and verification per the FDA Guidance Document for Software Contained in Medical Devices
  • Biocompatibility Assessment per FDA Guidance Document of Use of ISO 10993-1 and Cytotoxicity testing per ISO 10993-5
  • EMC and Electrical safety testing per IEC 60601-1 and IEC 60601-1-2
  • Evaluation of conformance to ISO 14457, IEC 60601-1-6, IEC 63266, and IEC 80601-2-60.

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.

K103027

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

§ 872.4200 Dental handpiece and accessories.

(a)
Identification. A dental handpiece and accessories is an AC-powered, water-powered, air-powered, or belt-driven, hand-held device that may include a foot controller for regulation of speed and direction of rotation or a contra-angle attachment for difficult to reach areas intended to prepare dental cavities for restorations, such as fillings, and for cleaning teeth.(b)
Classification. Class I.

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 features the letters "FDA" in a blue square, followed by the words "U.S. FOOD & DRUG ADMINISTRATION" in blue text.

July 25, 2019

Handpiece Headquarters - HPR Inc. Sonny Phung Product Engineer 620 S. Placentia Avenue Placentia, California 92870

Re: K180845

Trade/Device Name: Maxima Electric System Regulation Number: 21 CFR 872.4200 Regulation Name: Dental Handpiece and Accessories Regulatory Class: Class I Product Code: EBW Dated: April 25, 2019 Received: April 26, 2019

Dear Sonny Phung:

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. Although this letter refers to your product as a device, please be aware that some cleared products may instead be combination products. The 510(k) Premarket Notification Database located at https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm identifies combination product submissions. 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

1

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) for devices or postmarketing safety reporting (21 CFR 4, Subpart B) for combination products (see https://www.fda.gov/combination-products/guidance-regulatory-information/postmarketing-safety-reportingcombination-products); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820) for devices or current good manufacturing practices (21 CFR 4, Subpart A) for combination products; 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 https://www.fda.gov/medical-device-safety/medical-device-reportingmdr-how-report-medical-device-problems.

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/device-advice-comprehensive-regulatory-assistance) and CDRH Learn (https://www.fda.gov/training-and-continuing-education/cdrh-learn). 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 (https://www.fda.gov/medical-device-advice-comprehensive-regulatoryassistance/contact-us-division-industry-and-consumer-education-dice) for more information or contact DICE by email (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100).

Sincerely,

Srinivas Nandkumar, Ph.D. Acting Assistant Director DHT1B: Division of Dental Devices OHT1: Office of Ophthalmic, Anesthesia, Respiratory, ENT and Dental Devices Office of Product Evaluation and Quality Center for Devices and Radiological Health

Enclosure

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Indications for Use

510(k) Number (if known):

Device Name: Maxima Electric System

Indications for Use:

The Maxima Electric System is intended to convert pneumatic output from a dental treatment center to electrical energy to drive an electric micro motor and to operate electrically- driven dental handpieces. This system is designed for use by a trained professional in the field of general dentistry.

Prescription Use AND/OR (Per 21 CFR 801 Subpart D) Subpart C)

Over-The-Counter Use

(Per 21 CFR 801

(PLEASE DO NOT WRITE BELOW THIS LINE - CONTINUE ON ANOTHER PAGE IF NEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)

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Image /page/3/Picture/0 description: The image contains a logo for "Handpiece Headquarters", which is a company of Henry Schein. The words "Handpiece Headquarters" are stacked on top of each other, with the word "Handpiece" on top and "Headquarters" on the bottom. The words are in red and are in a bold font. Above the words is a jagged line that resembles a heartbeat monitor. Below the words is the text "A Henry Schein Company".

510(K) SUMMARY: K180845

Reference: 510(k) Traditional Premarket Notification for Maxima Electric System

a- Submitted by: HANDPIECE HEADQUARTERS 620 S. Placentia Ave. Placentia, CA 92870 Tel. 714-579-0175 Fax. 714-579-0186

  • b- Contact person: Sonny Phung Tel. 714-579-0175 ext.4871 Fax. 714-579-0186 Email: son.phung@henryschein.com
    c- Date summary prepared: July 23, 2019

d- Device Name:

Trade or Proprietary Name: Maxima Electric System

Common Name: Dental Handpiece and accessories

Classification Name: Dental Handpiece and accessories

Classification number: 21CFR 872.4200

Product code: EBW

Class: I

e- Substantial Equivalency is claimed against the following device:

ELECTROtorque TLC4893 with INTRAmatic KL 702 by Kaltenbach & Voight GmnbH 510(k) # K103027

f- Indications for Use

The Maxima Electric System is intended to convert pneumatic output from a dental treatment center to electrical energy to drive an electric micro motor and to operate electrically- driven dental handpieces. This system is designed for use by a trained

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professional in the field of general dentistry.

g- Description of the device:

Maxima Electric System is a system attached to dental system to operate Electricallydriven low speed handpieces. The common gear ratio is 1:1 and 1:5, the speed range is from 100 to 40,000 rpm.

Software used on control box is to control speed, forward and reverse direction of the handpieces; turn on an off the cooling water and LED light. There are 3 memories for speed of common low speed handpieces can be save into the program.

The air hose is connect the air and water from 4-hole standard handpiece hose from dental system to the control unit, the existing air pedal from dental system is to turn on and off and control speed by converting pneumatic from dental system to electrical energy to operate electric handpieces.

The control box is power by a power supply AC/DC voltage 36 VDC.

Maxima Electric System consists of the following components:

1-Control Unit 2-Motor Cable 3-Micromotor (Model ELM-B40S) 4-Accessories including the following a-Foot switch (optional) b-AC/DC Adapter c-AC cord

A control unit, Motor Cable and a Micro-motor.

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1-Front panel

No.DescriptionFunction
1Rotation direction
selection buttonUsed to select the rotational direction (CW/CCW)
of the motor and change the mode.
2Motor operation
direction indicatorDisplays the current operation direction of the
motor (it is turned when the opposite direction is
selected).
3Motor LED ON/OFF
buttonUsed to turn on and off the motor LED and
release the mode.
4Motor LED stated
indicatorDisplays the set state of the motor LED (LED On
means the LED is turned on).
5Spray buttonUsed to switch on or off the spray function.
6Spray state indicatorDisplays the operational state of the spray
function; water is sprayed when it is On.
7Speed controllerUsed to set the rotational speed and
the
maximum speed of the motor.
8Selected gear indicatorDisplays the selected gear ratio of the handpiece.
9Program selection
buttonUsed to save the currently set value in the
memory / select a saved program.
10Gear selection buttonUsed to select the gear ratio of the handpiece
connected to the motor.
11Speed indicatorDisplays the rotational speed of the handpiece.

2-Rear

No.DescriptionFunction
1Tubing ConnectorSupplies air and water. ※ ISO 9168(type 3)
2Foot Switch
ConnectorConnects the control unit with the foot switch.
3Motor ConnectorServes as a connection to run the micromotor (it
cannot be separated from the control unit).
4Power SwitchPower switch of the control unit.
5Adapter ConnectorConnector through which power gets supplied from
the adapter.
6Motor CableConnects the control unit and motor.
7Motor CapConnects the motor and motor cable.

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3-Micro Motor (ELM-B40S)

No.DescriptionFunction
1Handpiece
connectorConnects the micromotor and handpiece.
※ ISO 3964(type 3)
2BodyBody component through which electrical
energy gets converted into rotational motions.
3LEDLED installed in the motor.

4) AC/DC Adapter, AC Cord

No.DescriptionFunction
1AC/DC AdapterSwitches commonly used power input to rechargeable
voltage
2Connection JackConnection jack with the control box
3AC CordPower cord connection cable to supply operating voltage

h- Comparison of technological characteristics:

1- Comparison table:

| | Subject Device: Maxima
Electric System | Predicate: ELECTROtorque
TLC4893 with INTRAmatic KL 702 |
|----------------------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Indication of use | The Maxima Electric System is
intended to convert pneumatic
output from a dental treatment
center to electrical energy to
drive an electric micro motor
for operation of electrically-
driven dental handpieces. This
system is designed for use by
a trained professional in the
field of general dentistry. | The ELECTROtorque
TLC4893 is intended to
convert pneumatic output from
a dental treatment center to
electrically energy to drive the
INTRAmatic KL 702 motor for
operation of electrically-driven
handpieces. This devices are
designed for use by a trained
professional in the field of
general dentistry. |
| Patient contact
information | None | None |
| Device Design:
Including Components | Power Supply, Control Box,
Micro Motor, AC cord. | Power Supply, Control Box,
Micro Motor, AC cord. |
| Control Unit | | |

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Speed control buttonYesYes
Speed Range100-40,000 rpm100-40,000 rpm
Digital Speed readingyesYes
Rotation ControlClockwise & Counter ClockwiseClockwise & Counter Clockwise
Light ON/OFFyesYes
Water Spray ON/OFFyesYes
Programmable setting32
Power Supply100-240 VAC
47-63 Hz
36-38 V DC
105 W100-240 VAC
47-63 Hz
36-38 V DC
120 W
Micro Motor40,000 rpm
20mm (Diameter) x 63mm (Length)
69 gm
White LED
Yes
3.0 N-Cm
4.0 Bar Max.
2.5 Bar Max.
According to ISO-3964
According to ISO-9168 (connect to 4-hole standard handpiece hose of dental system)40,000 rpm
21mm (Diameter) x 65mm (Length)
69.6 gm
White LED
Yes
3.0 N-Cm
5.0 Bar
2.0 Bar
According to ISO-3964
According to ISO-9168

2-Comparison of performance testing:

Based on performance testing results, there are no significant differences in performance of testing handpieces after 250 cycles of testing by using Maxima Electric System and KaVo Electro Torque. The Speed Vs Torque table shows the similar trend of speed and torque from the beginning of the test to the end of 250 cycles of testing.

The performance of the Maxima Electric System on the testing handpiece is similar to the performance of the KaVo Electric torque on the testing the handpiece regarding to Speed Vs Torque.

i- Bench Performance Testing Conducted:

· Risk Analysis per ISO 14971

·Sterilization and cleaning/disinfection validation per ISO 17665-1, ISO 17665-2, and FDA Guidance Document for Reprocessing of Medical Device

8

  • · Moderate level of software documentation and verification per the FDA Guidance Document for Software Contained in Medical Devices
  • · Biocompatibility Assessment per FDA Guidance Document of Use of ISO 10993-1 and Cytotoxicity testing per ISO 10993-5
  • · EMC and Electrical safety testing per IEC 60601-1 and IEC 60601-1-2
  • · Evaluation of conformance to ISO 14457, IEC 60601-1-6, IEC 63266, and IEC 80601-2-60.

j- Conclusion:

Base on comparison table, the design and operation of this product has similar intend of use, similar principle of operation and similar technological characteristics such as components for the system, similar control box with software to control speed, similar micromotor, similar connection to dental system and similar performance testing data. Handpiece headquarters believes that this Maxima Electric System is substantially equivalent to the claimed predicated device.