K Number
K201184
Device Name
Lascod Impression Materials
Manufacturer
Date Cleared
2020-05-05

(4 days)

Product Code
Regulation Number
872.3660
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Lascod family of silicone impression materials includes the brand names: Ghenesyl, Kromopan Sil are used by dentists to take the anatomical data of the patient's mouth and subsequently realize a plaster mold useful to diagnose problems, define required interventions, and/or check their effectiveness. The Ghenesyl Putty and Kromopan Sil Putty products are indicated for obtaining preliminary impressions for the two-step putty/wash and base for the sandwich technique. The impression can be electroplated. The Ghenesyl Body and Kromopan Sil Body products are indicated for the two-step putty/wash and for the sandwich technique. The impression can be electroplated. The Ghenesyl Mono and Kromopan Sil mono products are indicated for monophasic technique, though it can be used also with Super Light Body / Light Body / Regular Body wash silicones as support material inside individual impression tray or standard stainless-steel impression tray. Kromopan Sil Bite and Oklurest used by dentists to take impressions of occlusal surfaces in order to confirm the occlusal surfaces onto the plaster models assembled on an articulator. Kromopan Sil Bite and Oklurest and products are indicated for orthodontic occlusion registration keys for gnathological registrations, inter-maxillary registration keys for centered positions, eruptions and ectopic eruptions, registration for cephalometric analysis which also require subsequent scanning with CAD systems.
Device Description
Lascod Impression Materials are addition-curing polyvinylsiloxane silicones. They exhibit excellent accuracy, maximum thixotropy, and hydrophilicity. Additional elastomeric properties include, fast in the mouth setting time, high resistance to tear, dimensional accuracy, and resistance to permanent deformation. The Lascod impression material product line boasts multiple different variants: hard and soft putty; heavy, regular, light and superlight body – all putties and bodies, are available both as normal and fast set; mono and bite. Putties are provided in 300 or 150 ml plastic jars. The body and the bite product lines, are usually offered in the standard (1: 1) 50 ml dual barrel cartridges. The Mono product line is provided in two forms; a standard (1: 1) 50 ml dual cartridge, and a (5: 1) 380 ml, large dual cartridge.
More Information

Not Found

No
The summary describes traditional silicone impression materials and their physical properties. There is no mention of software, algorithms, or data processing that would indicate the use of AI/ML.

No
The device is used to take anatomical data of the patient's mouth to diagnose problems, define required interventions, and/or check their effectiveness, but it does not directly treat or cure any medical condition.

No
The device is an impression material used to take anatomical data of the patient's mouth, which then helps realize a plaster mold for diagnosis. The material itself is not diagnostic; it's a tool in the diagnostic process.

No

The device description clearly states that the device is a physical material (silicone impression material) provided in jars and cartridges, 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 devices intended for use in the collection, preparation, and examination of specimens taken from the human body for the purpose of providing information for the diagnosis, treatment, or prevention of disease.
  • Device Function: The Lascod impression materials are used to create a physical mold of the patient's mouth. This mold is then used by the dentist to diagnose problems, define interventions, and check their effectiveness.
  • Lack of Specimen Examination: The device itself does not perform any examination or analysis of a specimen taken from the body. It is a tool used to create a physical representation of the anatomical structure.
  • Purpose: The primary purpose is to capture anatomical data for subsequent use in diagnosis and treatment planning, not to directly diagnose through the analysis of a biological specimen.

While the resulting plaster mold is useful for diagnosis, the impression material itself is a physical material used to create that mold, not a diagnostic test performed on a biological sample.

N/A

Intended Use / Indications for Use

The Lascod family of silicone impression materials includes the brand names: Ghenesyl, Kromopan Sil are used by dentists to take the anatomical data of the patient's mouth and subsequently realize a plaster mold useful to diagnose problems, define required interventions, and/or check their effectiveness.

The Ghenesyl Putty and Kromopan Sil Putty products are indicated for obtaining preliminary impressions for the two-step putty/wash and base for the sandwich technique. The impression can be electroplated.

The Ghenesyl Body and Kromopan Sil Body products are indicated for the two-step putty/wash and for the sandwich technique. The impression can be electroplated.

The Ghenesyl Mono and Kromopan Sil mono products are indicated for monophasic technique, though it can be used also with Super Light Body / Light Body / Regular Body wash silicones as support material inside individual impression tray or standard stainless-steel impression tray.

Kromopan Sil Bite and Oklurest used by dentists to take impressions of occlusal surfaces in order to confirm the occlusal surfaces onto the plaster models assembled on an articulator.

Kromopan Sil Bite and Oklurest and products are indicated for orthodontic occlusion registration keys for gnathological registrations, inter-maxillary registration keys for centered positions, eruptions and ectopic eruptions, registration for cephalometric analysis which also require subsequent scanning with CAD systems.

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

ELW

Device Description

Lascod Impression Materials are addition-curing polyvinylsiloxane silicones. They exhibit excellent accuracy, maximum thixotropy, and hydrophilicity. Additional elastomeric properties include, fast in the mouth setting time, high resistance to tear, dimensional accuracy, and resistance to permanent deformation. The Lascod impression material product line boasts multiple different variants: hard and soft putty; heavy, regular, light and superlight body – all putties and bodies, are available both as normal and fast set; mono and bite. Putties are provided in 300 or 150 ml plastic jars. The body and the bite product lines, are usually offered in the standard (1: 1) 50 ml dual barrel cartridges. The Mono product line is provided in two forms; a standard (1: 1) 50 ml dual cartridge, and a (5: 1) 380 ml, large dual cartridge.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

patient's mouth, occlusal surfaces

Indicated Patient Age Range

Not Found

Intended User / Care Setting

dentists

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)

Performance testing: Lascod Impression Materials have been tested and are compliant with the requirements of ISO 4823:2015 "Dentistry Elastomeric Impression Materials." Shelf Life testing demonstrated that the silicones could be stored for three years. The performance requirements that Lascod Silicones comply with are provided in Table 1.
The key results for the subject device are:

  • Standard: ISO 4823:2015
  • Type: Type 0, 1, 2 and 3
  • Consistency: Pass
  • Working time: Pass
  • Mixing time: Pass
  • Detail Reproduction: Pass
  • Compatibility with Gypsum: Pass
  • Linear Dimensional Change: Pass
  • Elastic Recovery: Pass
  • Strain in Compression: Pass
  • Shore A Hardness: Pass
  • Shelf Life: 3 Years

Biocompatibility testing: The FDA guidance "Use of International Standard ISO 10993-1, "Biological evaluation of medical devices - Part 1: Evaluation and testing within a risk management process" was used to determine biocompatibility testing requirements. Cytotoxicity, Irritation, and Sensitization testing conducted demonstrate that the Lascod Impression Materials are biocompatible.
The key results for the subject device are:

  • Standard: ISO 10993
  • Cytotoxicity: Pass
  • Irritation: Pass
  • Sensitization: Pass

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.

K170736

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

§ 872.3660 Impression material.

(a)
Identification. Impression material is a device composed of materials such as alginate or polysulfide intended to be placed on a preformed impression tray and used to reproduce the structure of a patient's teeth and gums. The device is intended to provide models for study and for production of restorative prosthetic devices, such as gold inlays and dentures.(b)
Classification. Class II (Special Controls).

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May 5, 2020

Lascod Spa % Dave Yungvirt Official Correspondent Third Party Review Group, LLC 25 Independence Blvd Warren, New Jersey 07059

Re: K201184

Trade/Device Name: Lascod Impression Materials Regulation Number: 21 CFR 872.3660 Regulation Name: Impression material Regulatory Class: Class II Product Code: ELW Dated: April 28, 2020 Received: May 1, 2020

Dear Dave Yungvirt:

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.

1

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 (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 Ouality Center for Devices and Radiological Health

Enclosure

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Indications for Use

510(k) Number (if known) K201184

Device Name Lascod Impression Materials

Indications for Use (Describe)

The Lascod family of silicone impression materials includes the brand names: Ghenesyl, Kromopan Sil are used by dentists to take the anatomical data of the patient's mouth and subsequently realize a plaster mold useful to diagnose problems, define required interventions, and/or check their effectiveness.

The Ghenesyl Putty and Kromopan Sil Putty products are indicated for obtaining preliminary impressions for the two-step putty/wash and base for the sandwich technique. The impression can be electroplated.

The Ghenesyl Body and Kromopan Sil Body products are indicated for the two-step putty/wash and for the sandwich technique. The impression can be electroplated.

The Ghenesyl Mono and Kromopan Sil mono products are indicated for monophasic technique, though it can be used also with Super Light Body / Light Body / Regular Body wash silicones as support material inside individual impression tray or standard stainless-steel impression tray.

Kromopan Sil Bite and Oklurest used by dentists to take impressions of occlusal surfaces in order to confirm the occlusal surfaces onto the plaster models assembled on an articulator.

Kromopan Sil Bite and Oklurest and products are indicated for orthodontic occlusion registration keys for gnathological registrations, inter-maxillary registration keys for centered positions, eruptions and ectopic eruptions, registration for cephalometric analysis which also require subsequent scanning with CAD systems.

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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510k Summary

1. DateApril 29, 2020
2. SubmitterLascod Spa
Via L Longo 18-50019
Sesto Fiorentino
Florence, Italy
Phone: +39 055 4215768
E-mail: lascod.italy@lascod.it
3. ContactGualtiero Cozzi
General Manager
Phone +39 055 4215768
4. Submission CorrespondentSrinagesh Koushik Ph.D. RAC
Managing Partner
BDRA Consulting LLC
1 Clearwater Court
Damascus, MD 20872.
Phone: 301-922-7231
Email: bdraconsulting@gmail.com
5. Predicate DeviceHySil Impression Materials
510k numberK170736
Common NameImpression Material
Classification NameMaterial, Impression
Regulation Number21 CFR 872.3660
Device ClassificationClass II
Product CodeELW

6. Indications for Use

The Lascod family of silicone impression materials includes the brand names: Ghenesyl, Kromopan Sil are used by dentists to take the anatomical data of the patient's mouth and subsequently realize a plaster mold useful to diagnose problems, define required interventions, and/or check their effectiveness.

The Ghenesyl Putty and Kromopan Sil Putty products are indicated for obtaining preliminary impressions for the two-step putty/wash and base for the sandwich technique. The impression can be electroplated.

The Ghenesyl Body and Kromopan Sil Body products are indicated for the two-step putty/wash and for the sandwich technique. The impression can be electroplated.

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The Ghenesyl Mono and Kromopan Sil mono products are indicated for monophasic technique, though it can be used also with Super Light Body / Light Body / Regular Body wash silicones as support material inside individual impression tray or standard stainlesssteel impression tray.

Kromopan Sil Bite and Oklurest used by dentists to take impressions of occlusal surfaces in order to confirm the occlusal surfaces onto the plaster models assembled on an articulator.

Kromopan Sil Bite and Oklurest and products are indicated for orthodontic occlusion registration, registration keys for gnathological registrations, inter-maxillary registration keys for centered positions, eruptions and ectopic eruptions, registration for cephalometric analysis which also require subsequent scanning with CAD systems.

7. Device Description

Lascod Impression Materials are addition-curing polyvinylsiloxane silicones. They exhibit excellent accuracy, maximum thixotropy, and hydrophilicity. Additional elastomeric properties include, fast in the mouth setting time, high resistance to tear, dimensional accuracy, and resistance to permanent deformation. The Lascod impression material product line boasts multiple different variants: hard and soft putty; heavy, regular, light and superlight body – all putties and bodies, are available both as normal and fast set; mono and bite. Putties are provided in 300 or 150 ml plastic jars. The body and the bite product lines, are usually offered in the standard (1: 1) 50 ml dual barrel cartridges. The Mono product line is provided in two forms; a standard (1: 1) 50 ml dual cartridge, and a (5: 1) 380 ml, large dual cartridge.

8. Performance testing and Shelf Life

Lascod Impression Materials have been tested and are compliant with the requirements of ISO 4823:2015 "Dentistry Elastomeric Impression Materials." Shelf Life testing demonstrated that the silicones could be stored for three years. The performance requirements that Lascod Silicones comply with are provided in Table 1.

9. Biocompatibility testing

The FDA guidance "Use of International Standard ISO 10993-1, "Biological evaluation of medical devices - Part 1: Evaluation and testing within a risk management process" was used to determine biocompatibility testing requirements. Cytotoxicity, Irritation, and Sensitization testing conducted demonstrate that the Lascod Impression Materials are biocompatible.

10. Substantial Equivalence

Lascod Impression Materials have identical intended use and highly similar indications for use as the predicate device. Biocompatibility testing demonstrated that both predicate and subject devices were safe for intended use. Performance testing demonstrated that both subject

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and predicate device complied with requirements of ISO 4823:2015 and are effective for the stated intended use. Based on the information presented above Lascod concludes that the Lascod Impression Materials are substantially equivalent to HySil Silicones.

| Descriptive

informationPredicateLascod Impression Material
CompanyOsstem Implant Co., Ltd.Lascod Spa
Device NameHySil Impression MaterialLascod Impression Material
510k numberK170736N/A
ClassificationIIII
Regulation21 CFR 872.366021 CFR 872.3660
Descriptive
informationPredicateLascod Impression Material
Product CodeELWELW
Intended UseTo be placed on an impression tray (or
injected directly into the mouth,
depending on the technique and device)
and used to reproduce the structure of
patient's teeth and gums. To provide
models for study and for production of
restorative prosthetic devices.The Lascod impression materials includes the brand
names: Ghenesyl, Kromopan Sil are used by dentists
to take the anatomical data of the patient's mouth
and subsequently realize a plaster mold useful to
diagnose problems, define required interventions,
and/or check their effectiveness.
Kromopan Sil Bite and Oklurest used by dentists to
take impressions of occlusal surfaces in order to
confirm the surfaces onto the plaster models
assembled on an articulator. The impression taken
with Oklurest and/or Kromopan Sil can be scanned
and used for occlusal surfaces registration and other
diagnostic evaluation with CAD systems.
Indications for UseHySil Putty is to be used as preliminary
materials for:
• Two-step Putty-wash impression
technique
• One-step Putty-wash impression
technique
HySil Heavy is to be used as heavy-
bodied materials for:
• One-step impression technique
(simultaneous technique) using single or
dual viscosities
• Two-step impression technique using
dual viscosities
• Functional impressions HySil Mono is
to be used as a medium-bodied tray or
syringeable impression material
for:The Lascod impression materials includes the brand
names: Ghenesyl, Kromopan Sil are used by dentists
to take the anatomical data of the patient's mouth
and subsequently realize a plaster mold useful to
diagnose problems, define required interventions,
and/or check their effectiveness.
The Ghenesyl Putty and Kromopan Sil Putty products
are indicated for obtaining preliminary impressions for
the two-step putty/wash and base for the sandwich
technique. The impression can be electroplated.
The Ghenesyl Body and Kromopan Sil Body products
are indicated for the two-step putty/wash and for the
sandwich technique. The impression can be
electroplated.
Taking impressions over fixed/removable restorations and implants (i.e., transferring impression posts and bridge components) Functional impressions Fabricating crown and bridgework or inlays Fabricating full or partial dentures Reline impressions Use in the simultaneous mixing technique as well as the putty-wash and triple tray techniques Transferring root posts when fabricating posts and cores indirectly HySil Light is to be used as syringeable impression materials for: Two-step putty-wash impression technique One-step putty-wash impression technique Two-step impression technique using dual viscosities Reline impressions Fabricating full or partial dentures HySil Extra Light is to be used as syringeable impression materials for: Two-step putty-wash impression technique One-step putty-wash impression technique Two-step impression technique using dual viscosities Reline impressions Fabricating full or partial dentures HySil Bite is used for impression as below. Taking occlusal surfacesThe Ghenesyl Mono and Kromopan Sil mono products are indicated for monophasic technique, though it can be used also with Super Light Body / Light Body / Regular Body wash silicones as support material inside individual impression tray or standard stainless-steel impression tray.

Kromopan Sil Bite and Oklurest used by dentists to take impressions of occlusal surfaces in order to confirm the occlusal surfaces onto the plaster models assembled on an articulator.

Kromopan Sil Bite and Oklurest and products are indicated for for orthodontic occlusion registration, registration keys for gnathological registrations, inter-maxillary registration keys for centered positions, eruptions and ectopic eruptions, registration for cephalometric analysis which also require subsequent scanning with CAD systems. |
| Materials | Vinylpolysiloxane | Vinylpolysiloxane |
| Performance Testing | | |
| Standard | ISO 4823:2015 | ISO 4823:2015 |
| Type | Type 0 and Type 3 | Type 0, 1, 2 and 3 |
| Consistency | Pass | Pass |
| Working time | Pass | Pass |
| Mixing time | Pass | Pass |
| Detail Reproduction | Pass | Pass |
| Compatibility with
Gypsum | Pass | Pass |
| Linear Dimensional
Change | Pass | Pass |
| Elastic Recovery | Pass | Pass |
| Strain in
Compression | Pass | Pass |
| Shore A Hardness | Pass | Pass |
| Shelf Life | 3 Years | 3 Years |
| Biocompatibility | ISO 10993 | ISO 10993 |
| Cytotoxicity | Pass | Pass |
| Irritation | Pass | Pass |
| Sensitization | Pass | Pass |

Table 1: Substantial Equivalence

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11. Conclusion:

Comparison results demonstrate that the specifications and performance of the device are same as the legally marketed predicate device.

Based on the same intended use, similar indications for use, technological characteristics, and chemical properties between HySil Silicones and Lascod Silicones, Lascod concludes that Lascod Impression Materials are substantially equivalent to HySil Silicones.