K Number
K192284
Device Name
DiaFil Flow
Date Cleared
2020-03-25

(216 days)

Product Code
Regulation Number
872.3690
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
-Restoration of Class III, Class V, smaller Class IV -Repair of resin, porcelain, and acrylic temporary materials -Undercut blockout
Device Description
The subject device is a light-curved complex resin for aesthetic restoration for both anterior and posterior parts, which is used for restoration that requires aesthetics through decay and damage in a form of paste with unpolymerized dimethacrylate monomer, inorganic filler, and photoinitiators mixed. The subject device is packaged with the following: Syringe, Disposable Tip, Protective Cap, Shade Sheet
More Information

Not Found

No
The device description and performance studies focus on the material properties and biocompatibility of a light-cured resin, with no mention of AI or ML capabilities.

Yes
The device is described as a "light-curved complex resin for aesthetic restoration for both anterior and posterior parts" used for "restoration that requires aesthetics through decay and damage," which directly addresses and treats a medical condition (dental decay/damage).

No
The device is described as a light-curved complex resin for aesthetic restoration, indicating it is used for treatment and repair rather than diagnosis.

No

The device description clearly states it is a "light-curved complex resin" in a "paste form" and is packaged with physical components like a syringe and disposable tip. This indicates it is a physical material, not software.

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

Here's why:

  • IVD Definition: In vitro diagnostics are tests performed on samples taken from the human body, such as blood, urine, or tissue, to detect diseases, conditions, or infections. They are used to provide information for diagnosis, monitoring, or screening.
  • Device Description and Intended Use: The description clearly states the device is a "light-curved complex resin for aesthetic restoration" used for "restoration that requires aesthetics through decay and damage." Its intended uses are for restoring dental cavities (Class III, V, smaller IV), repairing dental materials, and undercut blockout.
  • Lack of Biological Sample Testing: There is no mention of the device being used to test or analyze any biological samples from a patient. It is a material applied directly to the tooth.
  • Performance Studies: The performance studies listed focus on material properties, biocompatibility, and safety standards related to dental restorative materials, not diagnostic accuracy or performance on biological samples.

Therefore, this device falls under the category of a dental restorative material, not an in vitro diagnostic device.

N/A

Intended Use / Indications for Use

-Restoration of Class III, Class V, smaller Class IV

-Repair of resin, porcelain, and acrylic temporary materials

-Undercut blockout

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

EBF

Device Description

The subject device is a light-curved complex resin for aesthetic restoration for both anterior and posterior parts, which is used for restoration that requires aesthetics through decay and damage in a form of paste with unpolymerized dimethacrylate monomer, inorganic filler, and photoinitiators mixed. The subject device is packaged with the following: Syringe, Disposable Tip, Protective Cap, Shade Sheet

Model Name: There are 57 models, and they are divided 19 types. (A1, A2, A2O, A3, A3O, A3.5, A4, B1, B2, B3, B4, C1, C2, C3, C4, D1, D2, D3, D4) These 19 types have differences in the pigment type and content (%).

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)

This device has demonstrated conformance with non-clinical performance requirements through evaluation and testing in accordance with the following harmonized standards:

•ISO 4049:2009, Dentistry - Polymer-based restorative materials

•ISO 7405:2008, Dentistry – Evaluation of biocompatibility of medical devices used in dentistry

•ISO 10993-1:2009, Evaluation and testing within a risk management process

•ISO 10993-2:2006, Animal welfare requirements

•ISO 10993-3:2014, Tests for genotoxicity, carcinogenicity and reproductive toxicity

·ISO 10993-5:2009, Tests for in vitro cytotoxicity

•ISO 10993-6:2016, Tests for local effects after implantation

•ISO 10993-10:2010, Tests for irritation and skin sensitization

· ISO 10993-11:2017, Tests for systemic toxicity

·ISO 10993-12:2012, Sample preparation and reference materials

Through this additional non-clinical bench testing, the subject device is substantially equivalent to the predicate device.

No clinical data was collected or provided to support substantial equivalence between the subject and predicate devices.

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.

K060637

Reference Device(s): Identify the Reference Device(s) K/DEN number and list them here in a comma separated list exactly as they appear in the text.

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information for the subject device only (e.g. presence / absence, what scope was granted / cleared under the PCCP, any restrictions, etc).

Not Found

§ 872.3690 Tooth shade resin material.

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

0

Image /page/0/Picture/0 description: The image shows the logo of the U.S. Food and Drug Administration (FDA). On the left is the Department of Health & Human Services logo. To the right of that is the FDA logo in blue. Underneath the FDA logo is the word "ADMINISTRATION".

March 25, 2020

Diadent Group International Kab Lee Quality Assurance Manager 16, Osongsaengmyeong 4-ro, Osong-eup, Heungdeok-gu Cheongji-si, 28161 Chungcheongbuk-do KOREA

Re: K192284

Trade/Device Name: DiaFil Flow Regulation Number: 21 CFR 872.3690 Regulation Name: Tooth shade resin material Regulatory Class: Class II Product Code: EBF Dated: December 26, 2019 Received: December 26, 2019

Dear Kab Lee:

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

1

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,

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

2

Indications for Use

510(k) Number (if known) K192284

Device Name DiaFil Flow

Indications for Use (Describe)

-Restoration of Class III, Class V, smaller Class IV

-Repair of resin, porcelain, and acrylic temporary materials

-Undercut blockout

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

510(k) Summary

This 510(k) summary on the safety and effectiveness information is submitted in accordance with the requirements of 21 CFR 807.92.

1. Application Information

Date PreparedMar 25,2020
Company Name and
AddressDiaDent Group International
16, Osongsaengmyeong 4-ro, Osong-eup, Heungdeok-gu,
Cheongju-si, Chungcheongbuk-do, 28161, Republic of Korea
Contact PersonKab Sun Lee
Quality Assurance Manager
Phone: +82-43-266-2315
FAX: +82-43-235-2315
Email: diadent32@diadent.co.kr

2. Device Information

Device NameDiaFil Flow
510(k) NumberK192284
Classification NameTooth shade resin material
Review PanelDental
Regulation Number21 CFR 872.3690
Product CodeEBF
Device ClassII

3. Predicate Devices

The legally marketed devices to which substantial equivalence is being claimed are:

Primary Predicate Device
510(k) Number:K060637
Applicant:VERICOM CO., LTD.
Device Name:DENFIL FLOW
Regulation Number:21 CFR 872.3690
Product Code:EBF
Device Class:II

4. Device Description

The subject device is a light-curved complex resin for aesthetic restoration for both anterior and posterior parts, which is used for restoration that requires aesthetics through decay and damage in a form of paste with unpolymerized dimethacrylate monomer, inorganic filler, and photoinitiators mixed. The subject device is packaged with the following: Syringe, Disposable Tip, Protective Cap, Shade Sheet

Model Name: There are 57 models, and they are divided 19 types. (A1, A2, A2O, A3, A3O, A3.5, A4, B1, B2, B3, B4, C1, C2, C3, C4, D1, D2, D3, D4) These 19 types have differences in the pigment type and content (%).

4

Also, they (19 types) are packaged according to 3 forms: Economic, Refill, Intro Kit. The components of each package form are as follows.

Components
SyringeDisposable tipsShade Sheet
Economic Package2g x 4ea40ea1ea
Refill Package2g x 1ea10eaN/A
Intro Kit0.5g x 1ea2eaN/A

5. Indications for Use

-Restoration of Class III. Class V. smaller Class IV

-Repair of resin, porcelain, and acrylic temporary materials

-Undercut blockout

6. Non-Clinical Performance Data

This device has demonstrated conformance with non-clinical performance requirements through evaluation and testing in accordance with the following harmonized standards:

•ISO 4049:2009, Dentistry - Polymer-based restorative materials

•ISO 7405:2008, Dentistry – Evaluation of biocompatibility of medical devices used in dentistry

•ISO 10993-1:2009, Evaluation and testing within a risk management process

•ISO 10993-2:2006, Animal welfare requirements

•ISO 10993-3:2014, Tests for genotoxicity, carcinogenicity and reproductive toxicity

·ISO 10993-5:2009, Tests for in vitro cytotoxicity

•ISO 10993-6:2016, Tests for local effects after implantation

•ISO 10993-10:2010, Tests for irritation and skin sensitization

· ISO 10993-11:2017, Tests for systemic toxicity

·ISO 10993-12:2012, Sample preparation and reference materials

Through this additional non-clinical bench testing, the subject device is substantially equivalent to the predicate device.

7. Clinical Performance Data

No clinical data was collected or provided to support substantial equivalence between the subject and predicate devices.

8. Comparison with predicate Device

8.1 Comparison table

This device compares to the legally marketed devices as follows:

Subject DevicePrimary Predicate DeviceDiscussion
510(k)
Number-K060637
ApplicantDiaDent Group
InternationalVERICOM CO., LTD.
Device NameDiaFil FlowDENFIL FLOW
Indications
for Use•Restoration of Class
III, Class V, smaller
Class IV•Class V restorations
(Cervical caries, root
erosion, wedge
shaped defects)See the below
Repair of resin, porcelain, and acrylic temporary materials Undercut blockoutAnterior restorations (Class III, IV) Small posterior restorations Restorative therapy for mini-cavities of all types Extended fissures sealings in molars and premolars Repair of composite/ceramic veneers Blocking out of undercuts
DescriptionDiaFil Flow belongs to Group 1 of Class 2 of Type 1 according to the standard classification of ISO 4049. It is a light-curved complex resin for aesthetic restoration for both anterior and posterior parts. It is used for aesthetic restoration which is caused by decay and damage, and it is a paste form consisting of a mixture of unpolymerized dimethacrylate monomer, inorganic filler, and photoinitiators. That means that it makes a hard restoration by polymerizing through dental visible-ray polymerizer after recovering with the unpolymerized product.DenFil Flow is a light-cured radio-opaque flowable restorative resin. It is composed of Epoxyacrylate (Bis-GMA), Diurethane dimethacrylate, Triethylenglycol dimethacrylate, Barium aluminosilicate, and other materials. As Denfil flow has a lower viscosity than paste type composite resin-Flow; 0.16 mm/30sec, so it can restore narrow & deep cavity easily. DenFil Flow can be applied to fill cavities of all types exactly and efficiently by using a disposable tip. And DenFil Flow has various shades that correspond to the most common used shading system.Equivalent
Package ContentsSyringe Disposable Tip Protective CapSyringe Disposable Tip Protective CapEquivalent
ImageImage: DIAFIL FLOWImage: DenFil Flow
Composition•UDMA
•Bis-EMA
•TMPTMA
•BKY-405
•Barium-alumino-
silicate
•Silica
•Ytterbium
•Camphorquinone
•Ethyl-4-
(Dimethylamino)benzo
ate(EDB)
•BHT
•2-Hydoxy-4-
(octoxy)benzophenone•UDMA
•Bis-GMA
•TEGDMA
•Barium-alumino-
silicate
•SilicaSee the below
Light curing
time20 seconds
(If light curing unit
output is below
400mW/cm2, as
measured by a curing
radiometer, more time
may be needed.)20 seconds
(If light curing unit
output is below
400mW/cm2, as
measured by a curing
radiometer, more time
may be needed.)Equivalent
Period of UsePermanentPermanentEquivalent
Shelf life3 years3 yearsEquivalent
Bio-
compatibilityBiocompatibleBiocompatibleEquivalent
StandardsISO7405ISO7405Equivalent

5

Product Name: DiaFil Flow

6

DiaDent Group International

Product Name: DiaFil Flow

9. Differences

Indication for use

Subject DevicePrimary Predicate Device
DiaFil FlowDENFIL FLOW
Restoration of Class III, Class V,
smaller Class IVClass V restorations (cervical caries, root erosion,
wedge shaped defects)
Anterior restorations (Class III, IV)
Small posterior restorations
Repair of resin, porcelain, and
acrylic temporary materialsRestorative therapy for mini-cavities of all types
Extended fissures sealings in molars and premolars
Repair of composite/ceramic veneers
Undercut blockoutBlocking out of undercuts

7

The subject device has the same indications for use as the predicate device. The indications for use of the subject device is more simplified than the predicate device.

Material composition
Subject DevicePrimary Predicate Device
DiaFil FlowDENFIL FLOW
•UDMA•UDMA
•Bis-EMA•Bis-GMA
•TMPTMA•TEGDMA
•BKY-405•Barium-alumino-silicate
•Barium-alumino-silicate•Silica
•Silica
•Ytterbium
•Camphorquinone
•Ethyl-4-
(Dimethylamino)benzoate(EDB)
•BHT
•2-Hydoxy-4-
(octoxy)benzophenone

The main compositions are similar, but the compositions of DiaFil Flow and the predicate device are not same completely. However, DiaFil Flow and the predicate device are substantially equivalent through Biological Safety Assessment Report. (#BSA-2018-14)

The subject device has the similar technological characteristics as the predicate device: indications for use, main raw materials, mechanical properties (curing time, photopolymerization type resin).

ConClusions

Based on the above information and all data provided in this submission, the comparison of indications for use, technological characteristics, and non-clinical performance testing demonstrates that the subject device is substantially equivalent to the legally marketed devices identified in this submission.