K Number
K193064
Date Cleared
2020-03-03

(120 days)

Product Code
Regulation Number
872.3630
Panel
Dental
Predicate For
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

Atlantis® suprastructures are indicated for attachment to dental implants or abutments in the treatment of partially or totally edentulous jaws for the purpose of restoring chewing function.

Atlantis® suprastructures are intended for attachment to a minimum of two (2) implants. Atlantis® suprastructures are compatible with following implants and abutments: (list of compatible implants and abutments follows in the document)

Device Description

Atlantis suprastructures are indicated for attachment to dental implants or abutments in the treatment of partially or totally edentulous jaws for the purpose of restoring chewing function. The subject Atlantis suprastructures include new compatible interfaces of the currently marketed Atlantis suprastructures made by milling (K163350) or additive manufacturing techniques (K163398) for the following abutments and implants: (list of compatible implants and abutments follows in the document). The design of the subject device is derived from patient dental models and completed by Dentsply Sirona technicians using computer-assisted design (CAD) according to the clinician's prescription. The final CAD design of the Atlantis suprastructures are fabricated using additive manufacturing (AM) to produce a customized, patient-specific device. The Atlantis suprastructures subject of this bundled premarket notification are fabricated by milling or by additive manufacturing techniques.

The milled Atlantis suprastructures are composed of commercially pure titanium (CPTi) or cobalt chrome alloy and are available in following design types: Bar, Bridge, Hybrid and 2 in 1. Additional design limitations regarding minimum required segment cross-section, maximum span between implants and maximum cantilever extension, have been introduced for Atlantis suprastructures made by milling.

Atlantis suprastructures made by additive manufacturing are provided as Bridge and Hybrid types with optional mechanical retention (pin or cell retention) on the surface. The manufacturing of the Bridges and Hybrids of the Atlantis suprastructures by an additive manufacturing technique start from a titanium alloy and a cobalt-chrome alloy in powder form.

Milled variants of the subject Atlantis® suprastructures are offered in versions composed of unalloyed titanium conforming to ASTM F67 (Standard Specification for Unalloyed Titanium for Surgical Implant Applications) and cobalt chromium alloy (CoCr) conforming to ISO 22674 (Dentistry – Metallic materials for fixed and removable restorations and appliances). Variants of the subject Atlantis® suprastructures which are fabricated utilizing additive manufacturing are manufactured using titanium alloy powder or cobalt chromium alloy powder conforming to ISO 22674 (Dentistrv – Metallic materials for fixed and removable restorations and appliances).

Fixation screws for use with the subject Atlantis® suprastructures are composed of titanium alloy confirming to ASTM F136 (Standard Specification for Wrought Titanium-6 Aluminum-4 Vanadium ELI (Extra Low Interstitial) Alloy for Surgical Implant Applications).

Screws are available for all compatible implants and abutments to screw the Atlantis suprastructures into the implant or onto the abutment.

Labeling is modified by providing a separate compatibility chart which lists all implants and abutments compatible with the Atlantis suprastructures.

AI/ML Overview

This FDA 510(k) summary for the Dentsply Sirona Atlantis® suprastructures does not describe a clinical study for acceptance criteria. Instead, it argues for substantial equivalence to existing predicate devices based on non-clinical performance data and a comparison of indications for use, design, manufacturing techniques, and materials.

Here's an analysis of the provided information, addressing your points where possible:

1. Table of Acceptance Criteria and Reported Device Performance:

The document primarily relies on the equivalency to previously cleared devices. Therefore, explicit "acceptance criteria" in the sense of predefined thresholds for a new study are not presented. Instead, the performance is demonstrated through comparisons to the predicate devices and by referencing a previous fatigue test.

Feature/TestAcceptance Criteria (Implicit)Reported Device Performance
Indications for UseIdentical clinical indications to predicate devices (K1633350, K163398)Met by comparison: The clinical indications for use are identical to the predicate devices, differing only in the expanded list of compatible implants and abutments. (Text on page 9 "The indications for use of the subject and predicate Atlantis suprastructures (K163350, K163398) are identical with respect to the clinical indications.")
Compatible Interfaces (New)Maintain structural integrity and performance when attached to new compatible implants/abutments.Met by non-clinical testing and comparison: Cross-sectional material analysis of interfaces, geometric measurement data, and statistical compatibility analysis of OEM components support compatibility. Reference to results of fatigue testing (K160207) conducted according to ISO 14801. (Text on page 10 "Cross-sectional material analysis of the subject Atlantis suprastructure interfaces with the compatible implants and abutments, comparison to existing worst case interface geometry and reference to results of fatigue testing (K160207) conducted according to test methods of ISO 14801...")
Manufacturing Process (Additive Manufacturing)Additive manufacturing process must be validated and ensure comparable device characteristics.Met by reference to previous validation: Reference to process validation testing (K163398) for Atlantis suprastructures made by additive manufacturing. (Text on page 10)
Sterilization ParametersSterilization process must be validated according to relevant international standards.Met by reference to previous validation: Reference by equivalence to validation of moist heat sterilization parameters conducted according to ISO 17665-1 and ISO 17665-2. (Text on page 10)
BiocompatibilityDevice materials must be biocompatible.Met by reference to previous data: Reference by equivalence to biocompatibility data of predicate devices (K163350, K163398). (Text on page 10)
Design Parameters (Milled)Adherence to established design limitations for segment cross-section, span, and cantilever.Met by comparison: Additional design limitations for some types of milled Atlantis suprastructures are within the design parameters cleared for the predicate device (K163350). (Text on page 10)
Design Parameters (Additive Manufacturing)Adherence to established design parameters.Met by comparison: The design parameters cleared for the predicate Atlantis suprastructures made by additive manufacturing (K163398) remain unchanged. (Text on page 10)
MaterialsConformity to specified ASTM and ISO standards for unalloyed titanium, titanium alloy, and cobalt-chrome alloy.Met by specification: Milled variants composed of CPTi (ASTM F67) or CoCr (ISO 22674). Additive manufactured variants use titanium alloy powder or CoCr alloy powder (ISO 22674). Fixation screws are titanium alloy (ASTM F136). (Text on page 7)

2. Sample Size Used for the Test Set and Data Provenance:

The document mentions "cross-sectional material analysis" and "geometric measurement data and statistical compatibility analysis." However, it does not provide specific sample sizes for these analyses. The data provenance is implied to be internal testing conducted by Dentsply Sirona or its subsidiaries, and it's non-clinical. There is no mention of country of origin for this testing data.

3. Number of Experts Used to Establish Ground Truth for the Test Set and Qualifications:

Not applicable. This device's clearance is based on non-clinical engineering and material testing, and substantial equivalence to existing devices, not a clinical study requiring expert ground truth for interpretation of outcomes.

4. Adjudication Method for the Test Set:

Not applicable, as no clinical test set requiring adjudication by experts is described.

5. If a Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study was done:

No. This is a dental implant suprastructure, not an imaging AI device where MRMC studies are typically performed.

6. If a Standalone (i.e., algorithm only without human-in-the-loop performance) was done:

No, this is a physical medical device. The "algorithm" aspect refers to the CAD design process, but the testing focuses on the resulting physical product's performance and compatibility, not an AI algorithm's diagnostic performance.

7. The Type of Ground Truth Used:

For the evaluation of the new compatible interfaces and materials, the "ground truth" is defined by:

  • Engineering specifications and dimensional accuracy.
  • Material property standards (ASTM F67, F136, ISO 22674).
  • Performance standards, particularly ISO 14801 for fatigue testing.
  • Comparison to the established performance of the predicate devices.

8. The Sample Size for the Training Set:

Not applicable. There is no mention of a training set for an AI algorithm. The CAD design uses pre-programmed libraries and patient-specific scans, but "training set" in the context of machine learning is not relevant here.

9. How the Ground Truth for the Training Set Was Established:

Not applicable, as there is no "training set" in the machine learning sense described for this device. The design process is CAD-based, utilizing established engineering principles and material science.

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March 3, 2020

Dentsply Sirona Inc. Karl Nittinger Vice President Corporate Regulatory Affairs 221 West Philadelphia Street, Suite 60W York, Pennsylvania 17401

Re: K193064

Trade/Device Name: Atlantis® suprastructures Regulation Number: 21 CFR 872.3630 Regulation Name: Endosseous Dental Implant Abutment Regulatory Class: Class II Product Code: NHA Dated: December 3, 2019 Received: December 4, 2019

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. 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.

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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 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 (OS) 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 Nandkumar, Ph.D. Director DHT1B: Division of Dental Devices OHT1: Office of Ophthalmic, Anesthesia, Respiratory, ENT and Dental Devices Office of Product Evaluation and Ouality Center for Devices and Radiological Health

Enclosure

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Indications for Use

510(k) Number (if known) K193064

Device Name

Atlantis® suprastructures

Indications for Use (Describe)

Atlantis® suprastructures are indicated for attachment to dental implants or abutments in the treatment of partially or totally edentulous jaws for the purpose of restoring chewing function.

Atlantis® suprastructures are intended for attachment to a minimum of two (2) implants. Atlantis® suprastructures are compatible with following implants and abutments:

Manufacturer/Implant system
BioHorizonsImplant LevelInternal/ Tapered 3.5, 4.5, 5.7Abutment LevelMulti-unit abutment
Biomet 3iImplant LevelCertain™ 3.25, 4.0, 4/3, 5.0, 5/4, 6.0Certain™ Prevail™ 3/4/3 (3.4), 4/5/4, 5/6/5, 4/3, 5/4, 6/5Certain™ XP 4/5, 5/6Abutment LevelLow Profile Abutment
CamlogImplant LevelScrew-line Implant 3.3Screw-line/Root-line Implant 3.8, 4.3Screw-line/Root-line Implant 5.0, 6.0
DentsplySironaImplant LevelAstra Tech Implant System®Astra Tech Implant EV 3.0 – GreenAstra Tech Implant EV 3.6 – PurpleAstra Tech Implant EV 4.2 – YellowAstra Tech Implant EV 4.8 – BlueAstra Tech Implant EV 5.4 – BrownAstra Tech Implant EV Profile 4.2Astra Tech Implant EV Profile 4.8OsseoSpeed® TX 3.0 – YellowOsseoSpeed® TX 3.5, 4.0 – AquaOsseoSpeed® TX 4.5, 5.0 – LilacOsseoSpeed® TX Profile 4.5/5.0Xive®Xive® S 3.0Xive® S 3.4, 3.8, 4.5, 5.5Abutment LevelAstra Tech Implant System®UniAbutment EVAngled Abutment EVMultibase Abutment EV20° UniAbutment45° Uni AbutmentAngled Abutment 20°Ankylos®Ankylos® Balance Base Narrow D4.2Ankylos® Balance Base D5.5
Xive®
Xive® TG 3.4, 3.8, 4.5
Xive® MP 3.4, 3.8, 4.5
Xive® MP 5.5
KeystoneImplant Level
PrimaConnex SD 3.3, 3.5
PrimaConnex RD 4.0, 4.1
PrimaConnex WD 5.0
Genesis 3.8, 4.5, 5.5, 6.5
MISImplant Level
Internal Hex Narrow SEVEN – M4
Internal Hex Standard SEVEN – M4
Internal Hex Wide SEVEN – M4
Conical Connection Narrow C1 - V3
Conical Connection Standard C1 - V3
Conical Connection Wide C1
Abutment Level
Multi-Unit Abutment
Nobel BiocareImplant Level
NobelActive NP 3.5
NobelActive RP 4.3, 5.0
NobelActive WP 5.5
NobelReplace NP 3.5
NobelReplace RP 4.3
NobelReplace WP 5.0
NobelReplace 6.0
Branemark System NP 3.3
Branemark System RP 3.75, 4.0
Abutment Level
Multi-Unit Abutment RP
StraumannImplant Level
Bone Level 3.3 NC
Bone Level 4.1, 4.8 RC
Standard/Standard Plus 4.8 RN (Regular Neck)
Standard/Standard Plus 4.8 WN (Wide Neck)
Abutment Level
RN Abutment Level
WN Abutment Level
Bone Level Multi-Base Abutment D3.5, 4.5
Bone Level Multi-Base Angled Abutment
Screw-Retained Abutment 3.5
Screw-Retained Abutment 4.6
Zimmer DentalImplant Level
Tapered Screw-Vent™ 3.5, 4.5, 5.7
Screw Vent™ 3.3, 3.7, 4.5
Abutment Level
Tapered Abutment

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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)

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Dentsply Sirona 221 West Philadelphia Street Suite 60W York, PA 17401

Image /page/5/Picture/1 description: The image shows the logo for Dentsply Sirona. The logo consists of a stylized, abstract shape on the left, resembling a curved leaf or a stylized letter 'S'. To the right of the shape are the words "Dentsply" on the top line and "Sirona" on the bottom line, with both words in a simple, sans-serif font. The color of the logo and text is a muted gray.

510(k) SUMMARY For K193064 Atlantis® suprastructures

1. Submitter Information:

Dentsply Sirona Inc. 221 West Philadelphia Street Suite 60W York, PA 17401

Contact Person:Karl Nittinger
Telephone Number:717-849-4424
Fax Number:717-849-4343
Email:karl.nittinger@dentsplysirona.com

Date Prepared: 03 March 2020

2. Device Name:

  • Proprietary Name: Atlantis® suprastructures .
  • Classification Name: Endosseous dental implant abutment .
    • CFR Number: 21 CFR 872.3630
  • . Device Class: ●
    • Class II Product Code: NHA

3. Predicate Device:

.

Predicate Device for subject Atlantis suprastructures made by milling:

Predicate Device Name510(k)Company Name
Multibase Abutments EV and ATLANTIS™SuprastructuresK163350Dentsply Sirona

Predicate Device for subject Atlantis suprastructures made by additive manufacturing:

Predicate Device Name510(k)Company Name
ATLANTIS™ SuprastructuresK163398Dentsply Sirona

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Reference Devices:

Reference Device Name510(k)Company Name
ATLANTIS™ ISUS Implant SuprastructuresK160207Dentsply Sirona
BioHorizons Tapered Internal Implant SystemK071638BioHorizons Implant Systems Inc.
BioHorizons Simple Solutions with Laser-Lok®K100985BioHorizons Implant Systems, Inc.
MIS Internal Hex Dental Implant SystemK180282MIS Implants Technologies Ltd.(Dentsply Sirona)
MIS C1 Narrow Platform Conical ConnectionImplant System, MIS C1 Wide Platform ConicalConnection AbutmentsK172505MIS Implants Technologies Ltd.(Dentsply Sirona)
MIS V3 Conical Connection Dental ImplantSystemK163349MIS Implants Technologies Ltd.(Dentsply Sirona)
Conical Connection ImplantsK112162MIS Implants Technologies Ltd.(Dentsply Sirona)
NobelActive Wide Platform (WP)K133731Nobel Biocare AB
Various Branemark System Dental ImplantProductsK022562Nobel Biocare AB

4. Description of Device:

Atlantis suprastructures are indicated for attachment to dental implants or abutments in the treatment of partially or totally edentulous jaws for the purpose of restoring chewing function. The subject Atlantis suprastructures include new compatible interfaces of the currently marketed Atlantis suprastructures made by milling (K163350) or additive manufacturing techniques (K163398) for the following abutments and implants:

  • BioHorizons Multi-unit abutment MIS Internal Hex Narrow SEVEN - M4 MIS Internal Hex Standard SEVEN - M4 MIS Internal Hex Wide SEVEN - M4 MIS Conical Connection Narrow C1 - V3 MIS Conical Connection Standard C1 - V3 MIS Conical Connection Wide C1 MIS Multi-Unit Abutment Nobel Biocare NobelActive WP 5.5 Nobel Biocare Branemark System NP 3.3 Nobel Biocare Branemark System RP 3.75, 4.0
    The design of the subject device is derived from patient dental models and completed by Dentsply Sirona technicians using computer-assisted design (CAD) according to the clinician's prescription. The final CAD design of the Atlantis suprastructures are fabricated using additive manufacturing (AM) to produce a customized, patient-specific device. The Atlantis suprastructures subject of this bundled premarket notification are fabricated by milling or by additive manufacturing techniques.

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The milled Atlantis suprastructures are composed of commercially pure titanium (CPTi) or cobalt chrome alloy and are available in following design types: Bar, Bridge, Hybrid and 2 in 1. Additional design limitations regarding minimum required segment cross-section, maximum span between implants and maximum cantilever extension, have been introduced for Atlantis suprastructures made by milling.

Atlantis suprastructures made by additive manufacturing are provided as Bridge and Hybrid types with optional mechanical retention (pin or cell retention) on the surface. The manufacturing of the Bridges and Hybrids of the Atlantis suprastructures by an additive manufacturing technique start from a titanium alloy and a cobalt-chrome alloy in powder form.

Milled variants of the subject Atlantis® suprastructures are offered in versions composed of unalloyed titanium conforming to ASTM F67 (Standard Specification for Unalloyed Titanium for Surgical Implant Applications) and cobalt chromium alloy (CoCr) conforming to ISO 22674 (Dentistry – Metallic materials for fixed and removable restorations and appliances). Variants of the subject Atlantis® suprastructures which are fabricated utilizing additive manufacturing are manufactured using titanium alloy powder or cobalt chromium alloy powder conforming to ISO 22674 (Dentistrv – Metallic materials for fixed and removable restorations and appliances).

Fixation screws for use with the subject Atlantis® suprastructures are composed of titanium alloy confirming to ASTM F136 (Standard Specification for Wrought Titanium-6 Aluminum-4 Vanadium ELI (Extra Low Interstitial) Alloy for Surgical Implant Applications).

Screws are available for all compatible implants and abutments to screw the Atlantis suprastructures into the implant or onto the abutment.

Labeling is modified by providing a separate compatibility chart which lists all implants and abutments compatible with the Atlantis suprastructures.

న. Indications for Use:

Atlantis® suprastructures are indicated for attachment to dental implants or abutments in the treatment of partially or totally edentulous jaws for the purpose of restoring function.

Atlantis® suprastructures are intended for attachment to a minimum of two (2) implants. Atlantis® suprastructures are compatible with the implants and abutments listed in the Atlantis® Suprastructures Compatibility Chart:

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Manufacturer/Implant system
BioHorizonsImplant Level
Internal/ Tapered 3.5, 4.5, 5.7
Abutment Level
Multi-unit abutment
Biomet 3iImplant Level
Certain™ 3.25, 4.0, 4/3, 5.0, 5/4, 6.0
Certain™ Prevail™ 3/4/3 (3.4), 4/5/4, 5/6/5, 4/3, 5/4, 6/5
Certain™ XP 4/5, 5/6
Abutment Level
Low Profile Abutment
CamlogImplant Level
Screw-line Implant 3.3
Screw-line/Root-line Implant 3.8, 4.3
Screw-line/Root-line Implant 5.0, 6.0
DentsplySironaImplant Level
Astra Tech Implant System®
Astra Tech Implant EV 3.0 - Green
Astra Tech Implant EV 3.6 - Purple
Astra Tech Implant EV 4.2 -
Yellow Astra Tech Implant EV 4.8
- Blue Astra Tech Implant EV 5.4 –
Brown Astra Tech Implant EV
Profile 4.2 Astra Tech Implant EV
Profile 4.8 OsseoSpeed® TX 3.0 –
Yellow OsseoSpeed® TX 3.5, 4.0 –Aqua
OsseoSpeed® TX 4.5, 5.0 – Lilac
OsseoSpeed® TX Profile 4.5/5.0
Xive®
Xive® S 3.0
Abutment Level
Astra Tech Implant System®
UniAbutment EV
Angled Abutment EV
Multibase Abutment EV
20° UniAbutment
45° UniAbutment
Angled Abutment 20°
Ankylos®
Ankylos® Balance Base Narrow D4.2
Ankylos® Balance Base D5.5
Xive®
Xive® TG 3.4, 3.8, 4.5
Xive® MP 3.4, 3.8, 4.5
Xive® MP 5.5
KeystoneImplant Level
PrimaConnex SD 3.3, 3.5
PrimaConnex RD 4.0, 4.1
PrimaConnex WD 5.0
Genesis 3.8, 4.5, 5.5, 6.5
MISImplant Level
Internal Hex Narrow SEVEN – M4
Internal Hex Standard SEVEN - M4
Internal Hex Wide SEVEN – M4
Conical Connection Narrow C1 - V3
Conical Connection Standard C1 - V3
Conical Connection Wide C1
Abutment Level
Multi-Unit Abutment
Nobel BiocareImplant Level
NobelActive NP 3.5
NobelActive RP 4.3, 5.0
NobelActive WP 5.5
NobelReplace NP 3.5
NobelReplace RP 4.3
NobelReplace WP 5.0
NobelReplace 6.0
Branemark System NP 3.3
Branemark System RP 3.75, 4.0
Abutment Level
Multi-Unit Abutment RP
StraumannImplant Level
Bone Level 3.3 NC
Bone Level 4.1, 4.8 RC
Standard/Standard Plus 4.8 RN (Regular Neck)
Standard/Standard Plus 4.8 WN (Wide Neck)
Abutment Level
RN Abutment Level
WN Abutment Level
Bone Level Multi-Base Abutment D3.5, 4.5
Bone Level Multi-Base Angled Abutment
Screw-Retained Abutment 3.5
Screw-Retained Abutment 4.6
Zimmer DentalImplant Level
Tapered Screw-Vent™ 3.5, 4.5, 5.7
Screw Vent™ 3.3, 3.7, 4.5
Abutment Level
Tapered Abutment

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Substantial Equivalence: 6.

An overview of the similarities and differences between the subject and predicate devices is given in Table 5.1 and 5.2 below.

The indications for use of the subject and predicate Atlantis suprastructures (K163350, K163398) are identical with respect to the clinical indications. The indications for use of the subject and predicate devices only differ regarding the compatible implants and abutments which are added by this 510(k) premarket notification. Design types, material, manufacturing techniques (milling, additive manufacturing), screw types (standard screw, Angulated Screw Access (ASA) as well as mechanical retention methods on the suprastructure surface (cell, pin) of the subject Atlantis suprastructures are the same as cleared for the predicate Atlantis suprastructures made by milling

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(K163350) or additive manufacturing (K163398). The additional design limitations for some design types of milled Atlantis suprastructures (Non-Standard bar, 2 in1 primary structure, Hybrid, Bridge) are within the design parameters cleared for the predicate device (K163350). The design parameters cleared for the predicate Atlantis suprastructures made by additive manufacturing (K163398) remain unchanged for the subject device.

7. Non-Clinical Performance Data:

Following non-clinical test data and analyses are included to support substantial equivalence:

· Cross-sectional material analysis of the subject Atlantis suprastructure interfaces with the compatible implants and abutments, comparison to existing worst case interface geometry and reference to results of fatigue testing (K160207) conducted according to test methods of ISO 14801: Dental-implants Dynamic Fatigue Test for Endosseous Dental Implants. ISO 14801.

· Geometric measurement data and statistical compatibility analysis of OEM implant bodies, OEM abutments, and OEM fixation screws, to support the compatibility of the subject Atlantis suprastructure interfaces with the compatible implants (K071638, K100985, K133731, K022562).

· Reference to process validation testing (K163398) for Atlantis suprastructures made by additive manufacturing.

· Reference by equivalence to validation of moist heat sterilization parameters conducted according to ISO 17665-1 Sterilization of health care products -- Moist heat -- Part 1: Requirements for the development, validation, and routine control of a sterilization process for medical devices and ISO17665-2 Sterilization of health care products - Moist heat - Part 2: Guidance on the application of ISO 17665-1.

· Reference by equivalence to biocompatibility data of predicate devices (K163350, K163398).

8. Clinical Performance Data:

No human clinical data was included in this premarket notification to support the substantial equivalence of the subject Atlantis suprastructures.

9. Conclusion Regarding Substantial Equivalence:

The information included in this bundled 510(k) submission supports the substantial equivalence of the subject Atlantis suprastructures. The subject Atlantis suprastructures have the same intended use as the legally marketed predicate devices cleared under premarket notifications K163350 and K163398. The subject device also has similar indications for use and incorporates the same fundamental technology as the predicate devices (K163398). Results of technical analyses and compatibility studies to verify the performance of the subject Atlantis suprastructures support a determination of substantial equivalence.

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SubjectDeviceIndications for Use
DentsplySironaAtlantis®suprastructuresAtlantis® suprastructures are indicated for attachment to dental implants or abutments in thetreatment of partially or totally edentulous jaws for the purpose of restoring chewing function.Atlantis® suprastructures are intended for attachment to a minimum of two (2) implants.The Atlantis® suprastructures are compatible with the implants and abutments listed in theAtlantis® Suprastructures Compatibility Chart:
Manufacturer/CompanyImplant system
BioHorizonsImplant LevelInternal/ Tapered 3.5, 4.5, 5.7Abutment LevelMulti-unit abutment
Biomet 3iImplant LevelCertain™ 3.25, 4.0, 4/3, 5.0, 5/4, 6.0Certain™ Prevail™ 3/4/3 (3.4), 4/5/4, 5/6/5, 4/3, 5/4, 6/5Certain™ XP 4/5, 5/6Abutment LevelLow Profile Abutment
CamlogImplant LevelScrew-line Implant 3.3Screw-line/Root-line Implant 3.8, 4.3Screw-line/Root-line Implant 5.0, 6.0
Dentsply SironaImplant LevelAstra Tech Implant System®Astra Tech Implant EV 3.0 - GreenAstra Tech Implant EV 3.6 - PurpleAstra Tech Implant EV 4.2 – YellowAstra Tech Implant EV 4.8 – BlueAstra Tech Implant EV 5.4 - BrownAstra Tech Implant EV Profile 4.2Astra Tech Implant EV Profile 4.8OsseoSpeed® TX 3.0 – YellowOsseoSpeed® TX 3.5, 4.0 - AquaOsseoSpeed® TX 4.5, 5.0 - LilacOsseoSpeed® TX Profile 4.5/5.0Xive®Xive® S 3.0Xive® S 3.4, 3.8, 4.5, 5.5Abutment LevelAstra Tech Implant System®UniAbutment EVAngled Abutment EVMultibase Abutment EV20° UniAbutment45° UniAbutmentAngled Abutment 20°Ankylos®Ankylos® Balance Base Narrow D4.2Ankylos® Balance Base D5.5Xive®Xive® TG 3.4, 3.8, 4.5Xive® MP 3.4, 3.8, 4.5Xive® MP 5.5
SubjectDeviceIndications for Use
Keystone DentalImplant LevelPrimaConnex SD 3.3, 3.5PrimaConnex RD 4.0, 4.1PrimaConnex WD 5.0Genesis 3.8, 4.5, 5.5, 6.5
MISImplant LevelInternal Hex Narrow SEVEN – M4Internal Hex Standard SEVEN – M4Internal Hex Wide SEVEN – M4Conical Connection Narrow C1 - V3Conical Connection Standard C1 - V3Conical Connection Wide C1Abutment LevelMulti-Unit Abutment
Nobel BiocareImplant LevelNobelActive NP 3.5NobelActive RP 4.3, 5.0NobelActive WP 5.5NobelReplace NP 3.5NobelReplace RP 4.3NobelReplace WP 5.0NobelReplace 6.0Branemark System NP 3.3Branemark System RP 3.75, 4.0Abutment LevelMulti-Unit Abutment RP
StraumannImplant LevelBone Level 3.3 NCBone Level 4.1, 4.8 RCStandard/Standard Plus 4.8 RN (Regular Neck)Standard/Standard Plus 4.8 WN (Wide Neck)Abutment LevelRN Abutment LevelWN Abutment LevelBone Level Multi-Base Abutment D3.5, 4.5Bone Level Multi-Base Angled AbutmentScrew-Retained Abutment 3.5Screw-Retained Abutment 4.6
Zimmer DentalImplant LevelTapered Screw-Vent™ 3.5, 4.5, 5.7Screw Vent™ 3.3, 3.7, 4.5Abutment LevelTapered Abutment
PredicateDevicesIndications for Use
DentsplySironaMultibaseAbutments EVandATLANTISTMSuprastructuresK163350ATLANTIST™ Suprastructures are indicated for attachment to dental implants or abutments in thetreatment of partially or totally edentulous jaws for the purpose of restoring chewing function.ATLANTIST™ Suprastructures are intended for attachment to a minimum of two (2) implants and areindicated for compatibility with the following implant and abutment systems:
Implants:
ManufacturerName of ImplantSize
Biomet 3iCertain3.25, 4/3 - Prevail ¾/3, 4/3
Certain4.0, 5/4 - Prevail 4/5/4. 5/4
Certain5.0, XP 4/5 - Prevail 5/6/5, 6/5
Certain6.0, XP 5/6
BioHorizonsInternal/Tapered3.5, 4.5, 5.7
CamlogScrew-line Implant3.3
Screw-line / Root-line Implant3.8, 4.3, 5.0, 6.0
XiVES 3.0, S 3.4, S 3.8, S 4.5, S 5.5
DENTSPLYImplantsOsseoSpeed™ TX3.0, 3.5/4.0, 4.5/5.0
Osseospeed™ Profile TX4.5/5.0
Osseospeed™ EV3.0, 3.6, 4.2, 4.8, 5.4
Osseospeed™ Profile EV4.2, 4.8
KeystoneDentalPrimaConnexSD 3.3/3.5
PrimaConnexRD 4.0/4.1
PrimaConnexWD 5.0
Genesis3.8, 4.5, 5.5/6.5
Nobel BiocareNobelActiveNP 3.5 - RP 4.3, 5.0
NobelReplaceNP-3.5 - RP 4.3 - WP 5.0 - 6.0
StraumannBone Level3.3 NC - 4.1, 4.8 NC
Standard Plus3.5 NN
Standard / Standard Plus4.8 RN - 4.8 WN
ZimmerDentalTapered Screw Vent / Screw Vent*Tapered S-V 3.5/S-V 3.3, 3.7 / Tapered S-V 4.5/ S-V 4.5
Tapered Screw Vent5.7
Abutments:
ManufacturerName of Abutment
Biomet 3iLow Profile Abutment
DENTSPLYATIS Uni Abutment EV
ATIS UniAbutment 20°, ATIS Un
ATIS Angled Abutment EV
ATIS Angled Abutment 20°
ANKYLOS Balance Base Narrow D4.2, Balance Base D5.5
ATIS Multibase Abutment EV
XiVE MP 3.4, MP 3.8, MP 4.5, MP 5.5
XiVE TG 3.4, TG 3.8, TG 4.5
Nobel BiocareMulti-Unit Abutment RP
StraumannBone Level Multi-Base Angled AbutmentBone Level Multi-Base Abutment D3.5, D4.5
RN Abutment Level, WN Abutment LevelScrew-Retained Abutment 3.5, 4.6
ZimmerDentalTapered Abutment

Table 5.1: Indications for Use for the subject and the predicate devices

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Table 5.1: Indications for Use for the subject and the predicate devices (cont.)

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Table 5.1: Indications for Use for the subject and the predicate devices (cont.)

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Table 5.1: Indications for Use for the subject and the predicate devices (cont.)
PredicateDevicesIndications for Use
DentsplySironaATLANTIS suprastructures are indicated for attachment to dental implants or abutments in the treatment of partially or totally edentulous jaws for the purpose of restoring chewing function.
ATLANTISTMSuprastructuresK163398ATLANTIS suprastructures are intended for attachment to a minimum of two (2) implants and are indicated for compatibility with the following implant and abutment systems:Implants: Biomet 3i Certain 3.25, 4/3 - Prevail 3/4/3, 4/3 Biomet 3i Certain 4.0, 5/4 - Prevail 4/5/4, 5/4 Biomet 3i Certain 5.0,XP4/5 - Prevail 5/6/5, 6/5 Biomet 3i Certain 6.0, XP 5/6 BioHorizons Internal/Tapered 3.5, 4.5, 5.7 Camlog Screw-line Implant 3.3 Camlog Screw-line / Root-line Implant 3.8, 4.3, 5.0, 6.0 DENTSPLY Implants XiVE S 3.0, S 3.4, S 3.8, S 4.5, S 5.5 DENTSPLY Implants OsseoSpeed TX 3.0, 3.5/4.0, 4.5/5.0 DENTSPLY Implants OsseoSpeed Profile TX 4.5, 5.0 DENTSPLY Implants OsseoSpeed EV 3.0, 3.6, 4.2, 4.8, 5,4 DENTSPLY Implants OsseoSpeed Profile EV 4.2, 4.8 Keystone Dental PrimaConnex SD 3.3, 3.5 Keystone Dental PrimaConnex RD 4.0, 4.1 Keystone Dental PrimaConnex WD 5.0 Keystone Dental Genesis 3.8, 4.5, 5.5/6.5 Nobel Biocare NobelActive NP 3.5 - RP 4.3, 5.0 Nobel Biocare NobelReplace NP 3.5 - RP 4.3 - WP 5.0 - 6.0 Straumann Bone Level 3.3 NC - 4.1, 4.8 RC Straumann Standard Plus 3.5 NN Straumann Standard/Standard Plus 4.8 RN - 4.8 WN Zimmer Dental Tapered S-V 3.5/ S-V 3.3, 3.7 /Tapered S-V 4.5/ S-V 4.5 Zimmer Dental Tapered Screw-Vent 5.7 Abutments: Biomet 3i Low Profile Abutment DENTSPLY Implants ATIS Uni Abutment EV DENTSPLY Implants ATIS UniAbutment 20°, ATIS UniAbutment 45° DENTSPLY Implants ATIS Angled Abutment EV,ATIS Angled Abutment 20° DENTSPLY Implants Ankylos Balance Base Narrow D4.2,Balance Base D5.5 DENTSPLY Implants XiVE MP 3.4, MP 3.8, MP 4.5, MP 5.5 DENTSPLY Implants XiVE TG 3.4, TG 3.8, TG 4.5 Nobel Biocare Multi-Unit Abutment RP Straumann Bone Level Multi-Base Angled Abutment Straumann Bone Level Multi-Base Abutment D3.5, D4.5 Straumann RN Abutment Level, WN Abutment Level Straumann Screw-Retained Abutment 3.5 Straumann Screw-Retained Abutment 4.6 Zimmer Dental Tapered Abutment

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Subject devicePredicate Devices
Dentsply SironaAtlantis® suprastructuresDentsply SironaMultibase Abutments EV andATLANTIS™ SuprastructuresK163350Dentsply SironaATLANTIS™ SuprastructuresK163398
Design
Restorationmulti-unitmulti-unitmulti-unit
Design typeBar, Bridge, Hybrid, 2 in 1Bar, Bridge, Hybrid, 2 in 1Bridge, Hybrid
Prosthesis attachmentscrew-retained, friction fit (2in1)screw-retained, friction fit (2in1)screw-retained, friction fit (2in1)
Connection suprastructure - implant/abutmentinternal, externalinternal, externalinternal, external
Design TechnologyCAD/CAM (Milling, AdditiveManufacturing (AM))CAD/CAM (Milling)CAD/CAM (AdditiveManufacturing) (AM)
Design parameters Standard Bar Micro/ StandardBar Macro$20 mm$ / $40 mm$$6 mm$ / $8 mm$$2,5 mm2$ / $4.98 mm2$$20 mm$ / $40 mm$$6 mm$ / $8 mm$$2,5 mm2$ / $4.98 mm2$N/A
Design parameters Non-Standard bar, 2 in1primary structure, Hybrid (milled), Bridge(milled):$40 mm$$15 mm$$2.5 mm2$ / $4.98 mm2$ /$4.0 mm$ height, $3.0 mm$ width*$40 mm$$15 mm$$4.0 mm$ height, $3.0 mm$ widthN/A
Design parameters Bridge and Hybrid (AM)$40 mm$$15 mm$$4.0 mm$ height, $3.0 mm$ widthN/A$40 mm$$15 mm$$4.0 mm$ height, $3.0 mm$ width
Subject devicePredicate Devices
Dentsply SironaAtlantis® suprastructuresDentsply SironaMultibase Abutments andATLANTIS™ SuprastructuresK163350Dentsply SironaATLANTIS™ SuprastructuresK163398
Mechanical retentionno retentionCell or pin retention (optional for AM)no retentionCell or pin retention (optional)
ScrewsStandard screwsAngulated Screw Access (ASA)screwsStandard screwsAngulated Screw Access (ASA)screwsStandard screwsAngulated Screw Access (ASA)screws
Material
Abutment/ suprastructureCommercially pure titanium (block)Titanium alloy (powder)Cobalt-chrome alloy (block, powder)Commercially pure titanium (block)Titanium alloy (powder)Cobalt-chrome alloy (block, powder)Commercially pure titanium (block)Titanium alloy (powder)Cobalt-chrome alloy (block, powder)
Prosthetic screwTitanium alloy blockTitanium alloy blockTitanium alloy block

Table 5.2: Similarities and Differences between the subject and the predicate devices

*2.5 mm²: if span between implants 0 to 20 mm or cantilever 0 to 6 mm²: if span between implants >20 to 40 mm or cantilever >6 to 8 mm), 4.0 mm height, 3.0 mm width: if cantilever >8 to 15 mm

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Table 5.2: Similarities and Differences between the subject and the predicate devices (cont.)

§ 872.3630 Endosseous dental implant abutment.

(a)
Identification. An endosseous dental implant abutment is a premanufactured prosthetic component directly connected to the endosseous dental implant and is intended for use as an aid in prosthetic rehabilitation.(b)
Classification. Class II (special controls). The guidance document entitled “Class II Special Controls Guidance Document: Root-Form Endosseous Dental Implants and Endosseous Dental Implant Abutments” will serve as the special control. (See § 872.1(e) for the availability of this guidance document.)