K Number
K191836
Manufacturer
Date Cleared
2019-12-20

(164 days)

Product Code
Regulation Number
N/A
Panel
Dental
Reference & Predicate Devices
Predicate For
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

Ceramill A-Splint is indicated for the fabrication of removable bite splints.

Device Description

Ceramill A-Splint are ready to use, polymethyl methacrylate (PMMA) based computer-aided design/computer-aided manufacturing (CAD-CAM) blanks, for milling splints. Ceramill A-Splint is available as a disk (round form) or as an arch-form (or "U"-shape).

AI/ML Overview

This document, concerning the Ceramill A-Splint, primarily details a substantial equivalence determination by the FDA for a medical device and does not describe the acceptance criteria and a study proving a device meets them in the context of an AI/algorithmic device. There is no mention of AI, machine learning, or software performance in this document.

Therefore, I cannot provide the requested information regarding acceptance criteria and a study proving device performance using AI or algorithmic methods from the provided text.

The closest information available that might relate to "acceptance criteria" for this device, which is a physical material for dental applications, are the bench performance testing results compared against the ISO 20795-2:2013 standard.

Here's a breakdown of what can be extracted, interpreting "acceptance criteria" as the performance requirements from the referenced international standard for the physical materials:

1. Table of Acceptance Criteria and Reported Device Performance

Performance AttributeAcceptance Criteria (from ISO 20795-2:2013)Ceramill A-Splint PerformancePredicate Device (M-PM-Disc) PerformanceComparison to Predicate / Acceptance
Residual Monomer< 1% (implied by predicate)< 1%< 1%Same; meets ISO 20795-2:2013 (<5)
3-Point Bending Strength≥ 50 MPa> 100 MPa91.5 MPa - 96.6 MPaSimilar; meets ISO 20795-2:2013 (≥50)
Water Solubility≤ 5 µg/mm³< 0.7 µg/mm³0.2 µg/mm³Similar; meets ISO 20795-2:2013 (≤5)
Water Absorption≤ 32 µg/mm³< 25 µg/mm³26.5 µg/mm³Similar; meets ISO 20795-2:2013 (≤32)
Flexural Modulus≥ 1500 MPa≥ 2000 MPaUnknownMeets ISO 20795-2:2013 (≥1500)
Fracture Toughness (Kmax)≥ 1.1 MPa m½≥ 1.1 MPa m½UnknownMeets ISO 20795-2:2013 (≥1.1)
Fracture Toughness (Wf)≥ 250 J/m²≥ 250 J/m²UnknownMeets ISO 20795-2:2013 (≥250)
PolishabilityMeets standard requirementsPassed testingNot explicitly statedPassed
PorosityMeets standard requirementsPassed testingNot explicitly statedPassed
Biocompatibility (Cytotoxicity)No cytotoxic effects expectedNo cytotoxic effects observedNot explicitly statedPassed (based on ISO 10993-1)

Regarding the other requested information (which are typically relevant for AI/algorithmic device studies):

  1. Sample size used for the test set and the data provenance: Not applicable. This is not an AI/algorithmic device, but a physical material. The "test set" here refers to samples of the material itself for physical and chemical property testing. No specific sample sizes for these bench tests are provided in the summary.
  2. Number of experts used to establish the ground truth for the test set and the qualifications of those experts: Not applicable. Ground truth for material properties is established through standardized laboratory testing methods, not expert consensus in the way clinical AI ground truth is established.
  3. Adjudication method for the test set: Not applicable.
  4. If a multi reader multi case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance: Not applicable. This is not an AI device.
  5. If a standalone (i.e. algorithm only without human-in-the loop performance) was done: Not applicable. This is not an algorithmic device.
  6. The type of ground truth used: For the physical material properties, the "ground truth" is derived from established, standardized laboratory measurement techniques (e.g., ISO 20795-2:2013 for dental polymers, ISO 10993-1 for biocompatibility).
  7. The sample size for the training set: Not applicable. This is not an AI/algorithmic device, so there is no "training set."
  8. How the ground truth for the training set was established: Not applicable.

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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 acronym along with the full name of the agency on the right. The FDA acronym is in a blue box, and the full name is in a sans-serif font.

December 20, 2019

Amann Girrbach AG % Rachel Paul Senior Consultant QA & RA Emergo Europe Consulting Prinsessegracht 20 The Hague, 2514AP N1

Re: K191836

Trade/Device Name: Ceramill A-Splint Regulatory Class: Unclassified Product Code: MQC Dated: October 28, 2019 Received: October 31, 2019

Dear Rachel Paul:

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 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

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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 mediation-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,

for Srinivas "Nandu" Nandkumar, Ph.D. 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) K191836

Device Name

Ceramill A-Splint

Indications for Use (Describe)

Ceramill A-Splint is indicated for the fabrication of removable bite splints.

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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510(k) K191836 Summary

Ceramill A-Splint

1. Submission Sponsor

Amann Girrbach AG

Herrschaftswiesen 1

6842 Koblach

AUSTRIA

Contact: Debora Engel

Title: Regulatory Affairs Manager

Email: Debora.engel@amanngirrbach.com

Office number: + 49 (7231) 957-260

2. Submission Correspondent

Emergo Europe Consulting

Prinsessegracht 20

The Hague, 2514 AP

THE NETHERLANDS

Office Phone: +31 (0) 70 345 8570 / Direct: +31 (0) 70 850 8249

Contact: Rachel Paul

Title: Senior Consultant, QA & RA

Email: LST.AUS.ProjectManagement@ul.com

Cell Phone : 00 6 89 83 16 09

  1. Date Prepared

28 October 2019

    1. Device Identification

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Trade/Proprietary Name: Ceramill A-Splint Common/Usual Name: Occlusal splints Classification Name: Mouthguard, Prescription N/A - Unclassified Regulation Number: Product Code: MQC Device Class: N/A - Unclassified Classification Panel: Dental

5. Legally Marketed Predicate Device

K134015, M-PM-Disc (Clear), Merz Dental GmbH

6. Indication for Use Statement

Ceramill A-Splint is indicated for the fabrication of removable bite splints.

7. Device Description

Ceramill A-Splint are ready to use, polymethyl methacrylate (PMMA) based computer-aided design/computer-aided manufacturing (CAD-CAM) blanks, for milling splints. Ceramill A-Splint is available as a disk (round form) or as an arch-form (or "U"-shape).

8. Comparison of Technology

The following table compares the Ceramill A-Splint to the predicate device with respect to indications for use, principles of operation, technological characteristics, and performance testing. The comparison of the devices provides more detailed information regarding the basis for the determination of substantial equivalence. There are no differences in technology.

AttributeCeramill A-SplintM-PM-DiscComparison
ManufacturerAmann Girrbach AGMerz Dental GmbHN/A
510(k) NumberTo be determined (TBD)K134015N/A
Product CodeMQCMQCSame
RegulationReferenceUnclassifiedUnclassifiedSame
Indications for UseCeramill A-Splint isindicated for theThe Merz Dental GmbHM-PM-Disc (Clear) isindicated for theSimilar; both devices areindicated for theproduction of removable
AttributeCeramill A-SplintM-PM-DiscComparison
fabrication of removablebite splints.fabrication of removablebite splints such asmouthguards andnightguards.bite splints. Theindications for use ofCeramill A-Splint fallwithin the intended use ofunclassified mouthguarddevices. Both devices arefor prescription only.
MaterialSolidPolymethylmethacrylate(PMMA)No pigmentsSolidPolymethylmethacrylate(PMMA)No pigmentsSame
Residual monomerLess than 1% residualmonomerLess than 1% residualmonomerSame; both devices meetrequirements from ISO20795-2:2013 (<5).
Shape, sizesAvailable in round andarch shapes respectivelyof 98 and 71 mm withthree (3) different height(14, 16, 20 mm).Available only in roundshape from 90 x 15 to114.8 x 25 mm.Similar; the arch shapedoes not introduce anyadditional safety orefficacy concerns.Dimensions are in thesame range.
3-point bendingstrength>100 MPa91.5 MPa - 96.6 MPaSimilar; the specificationsare in the same range.This minor variance doesnot introduce additionalsafety or efficacyconcerns. Both devicesmeet requirements fromISO 20795-2:20131 (≥50).
Water solubility<0.7 µg/mm30.2 µg/mm³Similar; the specificationsare in the same range.This minor variance doesnot introduce additionalsafety or efficacyconcerns.
AttributeCeramill A-SplintM-PM-DiscComparison
Both devices meetrequirements from ISO20795-2:2013 (≤5).
Water absorption<25 µg/mm326.5 µg/mm³Similar; the specificationsare in the same range.This minor variance doesnot introduce additionalsafety or efficacyconcerns.Both devices meetrequirements from ISO20795-2:2013 (≤32).
Flexural modulus≥ 2000 MPaUnknownThe submission devicemeet requirements fromISO 20795-2:2013 (≥1500).
Fracture toughness(maximum stressintensity (Kmax) andtotal fracture work(Wf))Kmax≥ 1.1 MPa m1/2Wf ≥ 250 J/m²UnknownThe submission devicemeet requirements fromISO 20795-2:2013 (Kmax ≥1.1 and Wf≥ 250).
SterileDelivered and use non-sterileDelivered and use non-sterileSame
Single-UseYesYesSame
Complies with ISO10993-1YesYesSame

Table 5A - Comparison of Technology

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¹ ISO 20795-2 :2013 Dentistry – Base polymers : Part 2 : Orthodontic base polymers (FDA Recognition Number: 4-233).

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9. Non-Clinical Performance Data

To demonstrate safety and effectiveness of Ceramill A-Splint and to show substantial equivalence to the predicate device, Amann Girrbach AG completed the following non-clinical tests.

The Ceramill A-Splint passed the testing in accordance with internal requirements, national standards, and international standards shown below:

  • . Biocompatibility assessment was conducted according to ISO 10993-1. Considering the chemically defined composition, the existing dental history with PMMA polymers and the inert material properties substantiated by highly sensitive chemical analysis, it was determined that no other

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biocompatibility testing than cytotoxicity testing was required. No cytotoxic effects were observed in presence of the test material extracts.

  • . Bench performance testing conducted in conformity with ISO 20795-2:2013 met all of the requirements set forth in the standard for residual monomer testing, 3-point bending strength, water solubility, water absorption, flexural modulus, fracture toughness, polishability, and porosity.
  • Wearing testing based on an adapted Ivoclar method in a chewing simulator – the wearing period has been determined to be of a maximum of three years.
  • . Shelf Life Testing – it was demonstrated that key characteristics do not degrade after four years of storage.

10. Conclusion

Based on similarities in intended use, indications for use statements, technology, and non-clinical performance testing, Amann Girrbach believes that Ceramill A-Splint is substantially equivalent to the predicate device (K134015).

N/A