K Number
K192007
Device Name
TheraBase, TheraBase Ca
Manufacturer
Date Cleared
2020-03-17

(232 days)

Product Code
Regulation Number
872.3275
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
- 1. Metal crowns, bridges, inlays (includes porcelain-fused -to- metal and composite-to-metal) - 2. Porcelain, Ceramic Crowns, inlays, and onlays (includes alumina and zirconia) - 3. Resin crowns, bridges, inlays, and onlays (resin-based composite-ceramic hybrid) - 4. Metal (prefabricated or cast) and non-metal/fiber endodontic posts - 5. Implant supported restorations - 6. Orthodontic Appliances (brackets, bands) - 7. Lining and basing applications under restorations
Device Description
TheraBase and TheraBase Ca are a self-etching, self-adhesive, dual-cured resin luting cement and base/liner that is exclusively formulated for luting crowns, bridges, inlays, onlays and posts (prefabricated metal and non-metal/fiber posts, as well as cast posts) and basing/lining under restorations. TheraBase is a paste/paste, fluoride- and calcium-releasing, luting cement and base/liner which requires no etching, no priming or bonding of the prepared surfaces. TheraBase Ca is a paste/paste, calcium-releasing, luting cement and base/liner which requires no etching, no priming or bonding of the prepared surfaces. They are easy-to use, require only a short chair time, and produce a good bond to most dental materials. The cements are available in a Natural shade. They are radiopaque, allowing for easy identification on radiographs.
More Information

Not Found

No
The device description and performance studies focus on the physical and chemical properties of a dental luting cement and base/liner. There is no mention of AI, ML, or any computational analysis of data for diagnosis, treatment planning, or other clinical decision-making.

No
The device is a luting cement and base/liner used for dental restorations and appliances; it does not directly treat a disease or condition, but rather aids in the mechanical attachment and support of dental prosthetics.

No

Explanation: This device is a resin luting cement and base/liner used for bonding dental restorations. It does not identify, diagnose, or monitor diseases or health conditions.

No

The device description clearly indicates it is a physical material (resin luting cement and base/liner) used for dental restorations, not a software program.

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

Here's why:

  • Intended Use: The intended use clearly describes the device as a dental luting cement and base/liner for bonding various dental restorations and appliances within the mouth. This is a direct application within the human body for structural and restorative purposes.
  • Device Description: The description reinforces its function as a material used to bond dental components.
  • No mention of testing samples from the human body: IVDs are designed to examine specimens derived from the human body (like blood, urine, tissue) to provide information about a physiological state, disease, or condition. This device does not perform such testing.
  • Performance Studies: The performance studies focus on the physical, mechanical, and biocompatibility properties of the material itself, not on its ability to diagnose or provide information about a patient's health status based on a sample.

In summary, this device is a dental material used for bonding and lining within the oral cavity, which falls under the category of a medical device, but not an In Vitro Diagnostic device.

N/A

Intended Use / Indications for Use

    1. Metal crowns, bridges, inlays (includes porcelain-fused -to- metal and composite-to-metal)
    1. Porcelain, Ceramic Crowns, inlays, and onlays (includes alumina and zirconia)
    1. Resin crowns, bridges, inlays, and onlays (resin-based composite-ceramic hybrid)
    1. Metal (prefabricated or cast) and non-metal/fiber endodontic posts
    1. Implant supported restorations
    1. Orthodontic Appliances (brackets, bands)
    1. Lining and basing applications under restorations

Product codes

EMA

Device Description

TheraBase and TheraBase Ca are a self-etching, self-adhesive, dual-cured resin luting cement and base/liner that is exclusively formulated for luting crowns, bridges, inlays, onlays and posts (prefabricated metal and non-metal/fiber posts, as well as cast posts) and basing/lining under restorations. TheraBase is a paste/paste, fluoride- and calcium-releasing, luting cement and base/liner which requires no etching, no priming or bonding of the prepared surfaces. TheraBase Ca is a paste/paste, calcium-releasing, luting cement and base/liner which requires no etching, no priming or bonding of the prepared surfaces. They are easy-to use, require only a short chair time, and produce a good bond to most dental materials. The cements are available in a Natural shade. They are radiopaque, allowing for easy identification on radiographs.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Not Found

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Not Found

Description of the training set, sample size, data source, and annotation protocol

Not Found

Description of the test set, sample size, data source, and annotation protocol

Not Found

Summary of Performance Studies (study type, sample size, AUC, MRMC, standalone performance, key results)

The following physical/mechanical properties of TheraBase and TheraBase Ca were tested:

  • Bond Strength (Modified ISO 29022 and Gel-Cap method): TheraBase is higher than or equivalent to 6.9 MPa, and bond to all the substrates. TheraBase Ca is higher than or equivalent to 6.9 MPa, and bond to all the substrates.
  • Diametral Tensile Strength: TheraBase is greater than or equal to 32 MPa. TheraBase Ca is greater than or equal to 32 MPa.
  • Film Thickness (ISO 4049:2009): TheraBase is

§ 872.3275 Dental cement.

(a)
Zinc oxide-eugenol —(1)Identification. Zinc oxide-eugenol is a device composed of zinc oxide-eugenol intended to serve as a temporary tooth filling or as a base cement to affix a temporary tooth filling, to affix dental devices such as crowns or bridges, or to be applied to a tooth to protect the tooth pulp.(2)
Classification. Class I (general controls). The device is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to § 872.9.(b)
Dental cement other than zinc oxide-eugenol —(1)Identification. Dental cement other than zinc oxide-eugenol is a device composed of various materials other than zinc oxide-eugenol intended to serve as a temporary tooth filling or as a base cement to affix a temporary tooth filling, to affix dental devices such as crowns or bridges, or to be applied to a tooth to protect the tooth pulp.(2)
Classification. Class II.

0

Image /page/0/Picture/0 description: The image contains two logos. On the left is the Department of Health & Human Services logo. On the right is the FDA logo, which includes the letters "FDA" in a blue square, followed by the words "U.S. FOOD & DRUG ADMINISTRATION" in blue text.

Tuesday, March 17, 2020

Bisco, Inc. Diana Vu RA Registration Specialist 1100 West Irving Park Rd. Schaumburg, Illinois 60193

Re: K192007

Trade/Device Name: TheraBase / TheraBase Ca Regulation Number: 21 CFR 872.3275 Regulation Name: Dental Cement Regulatory Class: Class II Product Code: EMA Dated: December 19, 2019 Received: December 23, 2019

Dear Diana Vu:

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 801); medical device reporting of medical device-related adverse events) (21 CFR 803) for

1

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 Srivinas '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

2

Indications for Use

510(k) Number (if known) K192007

Device Name TheraBase / TheraBase Ca

Indications for Use (Describe)

    1. Metal crowns, bridges, inlays (includes porcelain-fused -to- metal and composite-to-metal)
    1. Porcelain, Ceramic Crowns, inlays, and onlays (includes alumina and zirconia)
    1. Resin crowns, bridges, inlays, and onlays (resin-based composite-ceramic hybrid)
    1. Metal (prefabricated or cast) and non-metal/fiber endodontic posts
    1. Implant supported restorations
    1. Orthodontic Appliances (brackets, bands)
    1. Lining and basing applications under restorations

Type of Use (Select one or both, as applicable)

X Prescription Use (Part 21 CFR 801 Subpart D)

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

CONTINUE ON A SEPARATE PAGE IF NEEDED.

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Image /page/3/Picture/1 description: The image shows the BISCO company logo. The logo consists of five connected hexagons, alternating between red and blue. Below the hexagons is the word "BISCO" in a bold, sans-serif font, with the letters in shades of gray and black.

510 (k) SUMMARY

Applicant:

Bisco, Inc. 1100 W. Irving Park Road Schaumburg IL, 60193

Contact Person:

Diana Vu Tel: 847-534-6091 Fax: 847-534-6091

Date Prepared: 19 December 2019

Trade Name: Common Name: Product Code: Classification/Name:

TheraBase; TheraBase Ca Self-Adhesive Calcium Releasing Resin Cement and Base/Liner EMA Dental Cement Class II per 21 CFR 872.3275

Predicate Devices:

TheraCem is substantially equivalent to:

Primary Predicate:TheraCem by Bisco, Inc. K161256
Reference Predicate:NuSmile Biocem by NuSmile, LTD / Pulpdent K123265

Indications for Use:

    1. Metal crowns, bridges, inlays and onlays (includes porcelain-fused-to-metal and composite-to-metal)
    1. Porcelain, Ceramic Crowns, inlays and onlays (includes alumina and zirconia)
  • Resin crowns, bridges, inlays and onlays (resin-based composite-ceramic hybrid) 3.
    1. Metal (prefabricated or cast) and non-metal/fiber endodontic posts
    1. Implant supported restorations
  • Orthodontic Appliances (brackets, bands) 6.
  • Lining and basing applications under restorations 7.

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Image /page/4/Picture/1 description: The image shows the logo for BISCO. The logo consists of five connected hexagons, with the first and last hexagons being red, the second and fourth being blue, and the middle one being light blue. Below the hexagons is the word "BISCO" in gray and black lettering, with the bottom half of the letters being black.

510 (k) SUMMARY (continued)

The indications for use of TheraBase and TheraBase Ca are the similar to those for TheraCem and NuSmile BioCem and are summarized in the table below:

| TheraCem
(K161256) | TheraBase | TheraBase Ca | NuSmile BioCem
(K123265) |
|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Use TheraCem to cement
the following:

  1. Metal crowns,
    bridges, inlays and
    onlays (includes
    porcelain-fused-to-
    metal and composite-
    to-metal)
  2. Porcelain, Ceramic
    Crowns, inlays and
    onlays (includes
    alumina and zirconia)
  3. Resin crowns,
    bridges, inlays and
    onlays (resin-based
    composite/composite-
    ceramic hybrid)
  4. Metal (prefabricated
    or cast) and non-
    metal/fiber endodontic
    posts
  5. Implant supported
    restorations
  6. Orthodontic
    Appliances (brackets,
    bands) | 1. Metal crowns,
    bridges, inlays, onlays
    (includes porcelain-
    fused -to- metal and
    composite-to-metal)
  7. Porcelain, Ceramic
    Crowns, inlays, and
    onlays (includes
    alumina and zirconia)
  8. Resin crowns,
    bridges, inlays, and
    onlays (resin-based
    composite/composite-
    ceramic hybrid)
  9. Metal (prefabricated
    or cast) and non-
    metal/fiber endodontic
    posts
  10. Implant supported
    restorations
  11. Orthodontic
    Appliances (brackets,
    bands)
  12. Lining and basing
    applications under
    restorations | 1. Metal crowns,
    bridges, inlays, onlays
    (includes porcelain-
    fused -to- metal and
    composite-to-metal)
  13. Porcelain, Ceramic
    Crowns, inlays, and
    onlays (includes
    alumina and zirconia)
  14. Resin crowns,
    bridges, inlays, and
    onlays (resin-based
    composite/composite-
    ceramic hybrid)
  15. Metal (prefabricated
    or cast) and non-
    metal/fiber endodontic
    posts
  16. Implant supported
    restorations
  17. Orthodontic
    Appliances (brackets,
    bands)
  18. Lining and basing
    applications under
    restorations | Pulpdent RMGI Low
    Viscosity is a resin-
    modified glass ionomer
    preparation used by dental
    professionals as a liner,
    base or luting material in
    dental restorations. |

The only change in the indication for use from TheraCem to TheraBase and TheraBase Ca is the addition of "Lining and basing applications under restorations." NuSmile BioCem is added as a reference predicate to demonstrate that it does not raise new questions of safety and effectiveness as it contains the same indication listed as "liner, base."

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Image /page/5/Picture/1 description: The image shows the BISCO company logo on the left side of the image. The logo consists of a series of red and blue hexagons, followed by the word "BISCO" in large, bold letters. To the right of the logo, the text "510 (k) SUMMARY (continued)" is visible. The background of the image is white, with a faint pattern of hexagons in the upper right corner.

Description of Applicant Device:

TheraBase and TheraBase Ca are a self-etching, self-adhesive, dual-cured resin luting cement and base/liner that is exclusively formulated for luting crowns, bridges, inlays, onlays and posts (prefabricated metal and non-metal/fiber posts, as well as cast posts) and basing/lining under restorations. TheraBase is a paste/paste, fluoride- and calcium-releasing, luting cement and base/liner which requires no etching, no priming or bonding of the prepared surfaces. TheraBase Ca is a paste/paste, calcium-releasing, luting cement and base/liner which requires no etching, no priming or bonding of the prepared surfaces. They are easy-to use, require only a short chair time, and produce a good bond to most dental materials. The cements are available in a Natural shade. They are radiopaque, allowing for easy identification on radiographs.

Technological Characteristics:

All components of TheraBase and TheraBase Ca are based upon industry standard chemistry. The chemical composition of TheraBase is the same as TheraCem. The chemical composition of TheraBase Ca is similar to TheraCem. The chemical composition of TheraBase and TheraBase Ca is similar to NuSmile BioCem. The chemical compositon of each product is summarized in the table below:

| Chemical
Composition | TheraCem
(K161256) | NuSmile BioCem
(K123265) | TheraBase | TheraBase Ca |
|--------------------------|---------------------------------------|-------------------------------------|---------------------------------------|---------------------------------------|
| Filler | Amorphous Silica &
Portland Cement | Amorphous Silica | Amorphous Silica &
Portland Cement | Amorphous Silica &
Portland Cement |
| Resin composition | Methacrylate based | Methacrylate based | Methacrylate based | Methacrylate based |
| Polymerization
Method | Dual cured | Dual cured | Dual cured | Dual cured |
| Method of
Application | Bonding agent not
required | Bonding agent not
required | Bonding agent not
required | Bonding agent not
required |
| Ions Released | Calcium and fluoride | Calcium, phosphate,
and fluoride | Calcium and
fluoride | Calcium |

| Physical Mechanical
Property | TheraCem
(K161256) | NuSmile BioCem
(K123265) | TheraBase | TheraBase Ca |
|---------------------------------|-----------------------------------|-----------------------------------|-----------------------------------|-------------------|
| Radiographic
Appearance | Radiopaque | Radiopaque | Radiopaque | Radiopaque |
| Ions Released | Fluoride and
calcium releasing | Fluoride and
calcium releasing | Fluoride and
calcium releasing | Calcium releasing |
| Delivery system | Dual-syringe | Dual-syringe | Dual-syringe | Dual-syringe |

The difference in filler is TheraCem's, TheraBase's, and TheraBase Ca's additional use of Portland cement, an industry standard chemical, to facilitate calcium release and is substantially equivalent in performance to amorphous silica.

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Image /page/6/Picture/1 description: The image shows the logo for BISCO. The logo consists of a series of connected hexagons in red and blue, above the word "BISCO" in gray and black. The hexagons appear to be 3D, with shading to give them depth.

510 (k) SUMMARY (continued)

Performance Data:

The following physical/mechanical properties of TheraBase and TheraBase Ca were tested:
Physical / Mechanical PropertyTheraBaseTheraBase Ca
Bond Strength
(Modified ISO 29022
and
Gel-Cap method)TheraBase is higher than or
equivalent to 6.9 MPa, and bond
to all the substrates.TheraBase Ca is higher than or
equivalent to 6.9 MPa, and bond
to all the substrates.
Diametral Tensile
StrengthTheraBase is greater than or
equal to 32 MPa.TheraBase Ca is greater than or
equal to 32 MPa.
Film Thickness
(ISO 4049:2009)TheraBase is