K Number
K210080
Manufacturer
Date Cleared
2021-06-04

(143 days)

Product Code
Regulation Number
872.3640
Panel
Dental
Predicate For
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

Dentis s-Clean s-Line Mini is indicated for use in partially or fully edentulous mandibles and maxillae, in support of single or multiple unit restorations including; cemented retained, screw retained, or overdenture restorations, and terminal or intermediate abutment support for fixed bridgework. This system is dedicated for one and two stage surgical procedures. This system is intended for delayed loading.

Device Description

Dentis s-Clean s-Line Mini is composed of Fixture and Abutments. s-Clean SO-SL Fixture Mini is a thread type implant made of Pure titanium according to ASTM F67 which will be placed in the alveolar bone to replace the function of the missing tooth. This device has connection between the upper prosthesis and the internal Hex. The subject implant body has a two screw-joint (structured with Upper and Lower screw joints) and a hex anti-rotation design connection. The two-screw-joint feature is for diverse screw connection with other abutment that has 1.6M screw or 2.0M Screw. The surface of fixture is treated with SLA (Sandblasted with Large-grit and Acid-etching). It is only part to be implanted into bone, and to provide connection of prosthetic devices or other components of a dental implant set with human body (mandibular or maxillary bone). The system includes various abutments (Cover Screw, Healing Abutment, Sole Abutment, TiN Half Coating Sole Abutment, Couple Abutment, TiN Half Coating Couple Abutment, Angled Abutment, TiN Half Coating Angled Abutment, Abutment Screw, Temporary Abutment, MU Straight Abutment, MU Angled Abutment, MU Angled Abutment Screw) made from Pure titanium (ASTM F67), Ti-6Al-4V (ASTM F136), or PEEK material. Some abutments have Anodizing (Gold Color) or TiN-Coating surface treatments.

AI/ML Overview

This document (K210080) describes the Dentis s-Clean s-Line Mini, an endosseous dental implant system, and its substantial equivalence to predicate devices, rather than an AI/ML-driven device requiring a study to prove meeting acceptance criteria in the context of diagnostic performance (e.g., sensitivity, specificity, AUC).

The acceptance criteria described in this document are related to the physical, chemical, and mechanical properties, as well as the sterility and biocompatibility of the dental implant components, and their substantial equivalence to already marketed devices. The "study" proving acceptance is a series of non-clinical tests and comparisons to predicate devices.

Therefore, I cannot provide a table with "acceptance criteria and reported device performance" as typically found for AI/ML diagnostic devices (e.g., sensitivity, specificity). Instead, I will describe the non-clinical tests and their outcomes as presented in the document to demonstrate the device meets its acceptance criteria for safety and effectiveness as a physical medical device.

1. Table of Acceptance Criteria (for a physical dental implant) and Reported Device Performance

Since this is a physical dental implant, the "acceptance criteria" are based on meeting established standards and demonstrating substantial equivalence to predicate devices in terms of material, design, performance, and biocompatibility.

Acceptance Criteria CategorySpecific Criteria (as implied by tests/comparisons)Reported Device Performance / Method of Proof
Material CompositionConformance to ASTM F67 (Pure titanium) and ASTM F136 (Ti-6Al-4V ELI) standards.Subject device components (fixture, cover screw, healing abutment, temporary abutment) are fabricated from Pure titanium (ASTM F67). Other abutments are fabricated from Ti-6Al-4V ELI (ASTM F136). Temporary abutment also made of PEEK. This demonstrates material compatibility with predicates.
BiocompatibilityMeet ISO 10993 standards (e.g., cytotoxicity, sensitization, irritation, genotoxicity, systemic toxicity, implantation).Biocompatibility testing was performed on predicate devices (K153639, K171027, K150344, K171694) and was leveraged for the subject device because both products are manufactured with the same materials and manufacturing process. Results met ISO 10993 criteria.
SterilizationEffective sterilization and maintenance of sterility.Fixture sterilization validation (ISO 11137-1,2,3) leveraged from predicate K192688. End User Sterilization Validation Test Report on Abutments (ANSVAAMI ST79, ISO 17665-1, ISO 17665-2, ISO 11737-1, ISO 11737-2, ISO 11138-1) leveraged from predicate K11364. Fixtures provided sterilized; other abutments provided non-sterilized for end-user sterilization.
Shelf-LifeMaintain integrity and performance over specified shelf-life.Shelf-Life Test on fixtures leveraged from predicate K153639 (ASTM F1980), as material, sterilization, packaging, and manufacturing are the same.
Bacterial EndotoxinMeet endotoxin limits for medical devices.Bacterial Endotoxin Test Report on fixtures leveraged from predicate K192688 (ANSVAAMI ST72:2011, USP <161>, USP <85>).
Mechanical Performance (Fatigue)Withstand cyclic loading without failure, demonstrating structural integrity comparable to or better than predicates.Fatigue Testing under worst-case scenario (ISO 14801:2016) was performed on the subject device. A comparative fatigue test between single-screw and dual-screw joint implants showed that the device performance was substantially equivalent.
Surface CharacteristicsComparable surface treatment properties to predicates.Fixture surface treated with SLA (Sandblasted with Large-grit and Acid-etching). Surface roughness, surface composition analysis, and SEM imaging were provided (compared to K153639) to demonstrate substantial equivalence.
Dimensional ToleranceDimensions within acceptable manufacturing tolerances.Reported tolerance of dimension for fixtures and abutments is within ± 1% range. This is a manufacturing acceptance criterion rather than a test result.
Indications for UseAligned with predicate devices for safe and effective use.Identical indications for use as the primary predicate device (K153639), including use in partially/fully edentulous mandibles/maxillae, support for single/multiple unit restorations (cemented, screw-retained, overdenture, fixed bridgework), one/two-stage surgical procedures, and delayed loading.
Design CharacteristicsOverall design comparable and functionally equivalent to predicates.Detailed comparison tables are provided for each component (fixture, cover screw, various abutments, screws) against multiple predicate/reference devices, highlighting similarities in design, diameter, length, angulation (where applicable), coating, and material. Any differences are explained and justified by comparison to other referenced devices.

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

  • Sample Size for Test Set: The document doesn't specify a "test set" in the context of an AI/ML diagnostic algorithm. For the physical device, fatigue testing per ISO 14801 would involve a specific number of samples, but the exact count is not provided. Other tests like biocompatibility, sterilization, and shelf-life are typically performed on a limited number of samples representative of the product. The document states a comparative fatigue test was conducted.
  • Data Provenance: Not applicable in the context of AI/ML. The "data" here refers to the results of non-clinical bench testing and material characterization. The manufacturer is Dentis Co., Ltd. from South Korea. The testing was performed according to international standards (ISO, ASTM, USP) and FDA-recognized guidance. It's a "prospective" assessment in that the tests were done on the manufactured devices to demonstrate their properties.

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

  • This is not applicable for a physical medical device submission like this one. "Ground truth" in this context refers to established standards (e.g., ISO for fatigue, ASTM for materials, ISO/AAMI for sterilization), which are derived from broad expert consensus in relevant fields (engineering, microbiology, toxicology, dentistry).

4. Adjudication Method for the Test Set:

  • Not applicable as this is not an AI/ML diagnostic study with human readers. Test results are compared against defined standard criteria.

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

  • No, this type of study is not relevant for a physical dental implant. MRMC studies are typically for evaluating the diagnostic performance of AI/ML systems, often with human readers.

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

  • Not applicable. There is no algorithm or AI component in this dental implant.

7. The Type of Ground Truth Used:

  • The "ground truth" for proving the device's acceptance is based on:
    • International Standards: Conformance to recognized standards such as ISO 14801 (fatigue), ISO 10993 series (biocompatibility), ISO 11137 series (sterilization), ASTM F67, F136, F1980 (materials, shelf-life), and AAMI/USP guidelines for bacterial endotoxins.
    • Predicate Device Comparison: Substantial equivalence is established by demonstrating that the subject device has the "same intended use and fundamental scientific technology" as legally marketed predicate devices, and any differences "do not raise different questions of safety and effectiveness."

8. The Sample Size for the Training Set:

  • Not applicable. There is no AI/ML training set for this physical device.

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

  • Not applicable. There is no AI/ML training set.

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

Dentis Co., Ltd. % April Lee Consultant Withus Group Inc 106 Superior Irvine, California 92620

Re: K210080

Trade/Device Name: Dentis s-Clean s-Line Mini Regulation Number: 21 CFR 872.3640 Regulation Name: Endosseous Dental Implant Regulatory Class: Class II Product Code: DZE, NHA Dated: May 3, 2021 Received: May 6, 2021

Dear April 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.

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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 (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.

Andrew I. Steen Assistant Director DHT1B: Division of Dental and ENT 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) K210080

Device Name Dentis s-Clean s-Line Mini

Indications for Use (Describe)

Dentis s-Clean s-Line Mini is indicated for use in partially or fully edentulous mandibles and maxillae, in support of single or multiple unit restorations including; cemented retained, or overdenture restorations, and terminal or intermediate abutment support for fixed bridgework. This system is dedicated for one and two stage surgical procedures. This system is intended for delayed loading.

Type of Use (Select one or both, as applicable)
X Prescription Use (Part 21 CER 801 Subpart D)□ Over-The-Counter Use (21 CER 801 Subpart C)

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510(K) Summary

Submitter

Dentis Co., Ltd. Gyu Ri Kim 99, Seongseoseo-ro, Dalseo-gu Daegu, 42718 Korea Email: kgr1026@dentis.co.kr Tel. +82-53-589-3541 Fax. +82-53-289-7922

Device Information

  • Trade Name: Dentis s-Clean s-Line Mini ●
  • Common Name: Dental Implant System
  • Classification Name: Endosseous dental implant ●
  • Product Code: DZE
  • Secondary Product Code: NHA ●
  • Panel: Dental
  • Regulation Number: 872.3640
  • Device Class: Class II
  • Date Prepared: 06/04/2021

Predicate Devices:

Primary Predicate

  • K153639, Dentis Dental Implant System manufactured by Dentis Co., Ltd. ●

Reference devices

  • K123155, Luna Dental Implant System manufactured by SHINHUNG MST Co., Ltd. ●
  • K123988. AnyOne Internal Implant System by MegaGen implant Co., Ltd
  • K150344, Dentis Dental Implant System manufactured by Dentis Co., Ltd.
  • K161689, OSSTEM Implant System - Abutment by OSSTEM Implant Co., Ltd
  • K171027, Dentis Dental Implant System manufactured by Dentis Co., Ltd. ●
  • K171694, s-Clean TiN Coating Abutment manufactured by Dentis Co., Ltd.
  • K192436, Healing Abutments and Cover Screws manufactured by Dentium Co., Ltd.
  • K200099, s-Clean SQ-SL Implant System Mini manufactured by Dentis Co., Ltd. ●
  • K202773. s-Clean SO-SL Implant System Mini manufactured by Dentis Co., Ltd. ●

Indication for Use:

Dentis s-Clean s-Line Mini is indicated for use in partially or fully edentulous mandibles and maxillae, in support of single or multiple unit restorations including; cemented retained, screw retained, or overdenture restorations, and terminal or intermediate abutment support for fixed bridgework. This system is dedicated for one and two stage surgical procedures. This system is intended for delayed loading.

Withus Group Inc. April Lee 106 Superior, Irvine, CA 92620 USA Email: withus6664@gmail.com Phone: 1-909-274-9971 Fax: 1-909-460-8122

Official Correspondent

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Device Description:

Dentis s-Clean s-Line Mini is composed of Fixture and Abutments. s-Clean SO-SL Fixture Mini is a thread type implant made of Pure titanium according to ASTM F67 which will be placed in the alveolar bone to replace the function of the missing tooth. This device has connection between the upper prosthesis and the internal Hex.

The subject implant body has a two screw-joint (structured with Upper and Lower screw joints) and a hex anti-rotation design connection. The two-screw-joint feature is for diverse screw connection with other abutment that has 1.6M screw or 2.0M Screw. s-Clean Sole Abutment s-Line Mini and s-Clean TiN Half Coating Sole Abutment s-Line Mini have Upper M2.0 screw and s-Clean Couple Abutment s-Line Mini, s-Clean TiN Half Coating Couple Abutment s-Line Mini, s-Clean Angled Abutment s-Line Mini and s-Clean TiN Half Coating Angled Abutment s-Line Mini have Lower M1.6 screw. When dividing screw assemble design, screw assembled one-piece abutment is connected with upper screw and screw separated two-piece abutment is connected with lower screw.

The surface of fixture is treated with SLA (Sandblasted with Large-grit and Acid-etching). It is only part to be implanted into bone, and to provide connection of prosthetic devices or other components of a dental implant set with human body (mandibular or maxillary bone).

No.Device NameDimension Ranges
1s-Clean SQ-SL Fixture MiniØ5.8, 6.8 and 7.8 (D) X 7.5, 9.5, 11.4 and 11.5mm

The dimensions of fixtures are as following:

Tolerance of dimension shall be within ± 1% range.

No.Device NameDimension RangesAngulation
1s-Clean Cover Screw MiniØ3.2 (D) x 5.0mm (L)
2s-Clean Healing Abutment s-LineMiniØ4.3, 4.8 and 5.8 (D) X 7.61, 8.61, 9.61, 10.61, 11.61,12.61 and 14.61mm (L)
3s-Clean Sole Abutment s-LineMiniØ4.5 and 5.5 (D) X 11.01, 12.01, 12.51, 13.01, 13.51,14.01, 14.51, 15.01, 15.51, 16.01 and 17.01mm (L)
4s-Clean TiN Half Coating SoleAbutment s-Line MiniØ4.5 and 5.5 (D) X 11.01, 12.01, 12.51, 13.01, 13.51,14.01, 14.51, 15.01, 15.51, 16.01 and 17.01mm (L)
5s-Clean Couple Abutment s-LineMiniØ4.0, 4.5 and 5.5 (D) X 8.35, 8.6, 9.35, 9.6, 9.85, 10.1,10.35, 10.6, 10.85, 11.1, 11.35, 11.6, 11.85, 12.1, 12.35,12.6, 12.85, 13.1, 13.35, 13.6, 14.35 and 14.6mm (L)
6s-Clean TiN Half Coating CoupleAbutment s-Line MiniØ4.0, 4.5 and 5.5 (D) X 8.35, 8.6, 9.35, 9.6, 9.85, 10.1,10.35, 10.6, 10.85, 11.1, 11.35, 11.6, 11.85, 12.1, 12.35,12.6, 12.85, 13.1, 13.35, 13.6, 14.35 and 14.6mm (L)
7s-Clean Angled Abutment s-LineMiniØ4.0, 4.5 and 5.5 (D) X 12.09, 12.34, 12.51, 12.76,13.09, 13.34, 13.51 and 13.76mm (L)15° and 25°
8s-Clean TiN Half Coating AngledAbutment s-Line MiniØ4.0, 4.5 and 5.5 (D) X 12.09, 12.34, 12.51, 12.76,13.09, 13.34, 13.51 and 13.76mm (L)15° and 25°
9s-Clean Abutment Screw s-LineMiniØ2.03 (D) X 10.2mm (L)
10s-Clean Temporary AbutmentMiniØ4.0, 4.5 and 5.5 (D) X 13.45, 13.7, 15.45 and 15.7mm
11s-Clean MU Straight AbutmentMiniØ4.8 (D) X 8.71, 9.71, 10.71, 11.71 and 12.71mm (L)

The dimensions of abutments are as following:

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12s-Clean MU Angled AbutmentMiniØ1.56 (D) X 7.25, 7.74, 8.25, 8.74, 9.25, 9.74, 10.25and 10.74mm (L)17° and 30°
13s-Clean MU Angled AbutmentScrew MiniØ1.56 (D) X 9.3mm (L)

The Abutments have below featured:

NameUsesSurfaceConnection
s-Clean Cover Screw MiniIt is used for protecting inner hole andconnecting part with exposed upper partof structure during the healing period afterinserting dental implant fixtureAnodizing(Gold Color)ScrewRetained
s-Clean Healing Abutments-Line MiniThe healing Abutment is used forprotecting inner hole of fixture andadjusting the appropriate height during thehealing periodAnodizing(Gold Color)ScrewRetained
s-Clean Sole Abutment s-Line MiniN/A
s-Clean TiN Half Coating SoleAbutment s-Line MiniThe Abutment is connected with fixtureTiN-CoatingInternal Hex
s-Clean Couple Abutment s-Line MiniThe Abutment is connected with fixtureand it supports prosthesis which restorestooth function.N/A
s-Clean TiN Half Coating CoupleAbutment s-Line MiniThe Abutment is connected with fixtureTiN-CoatingInternal Hex
s-Clean Angled Abutment s-LineMiniThe Abutment is connected with fixtureand it supports prosthesis which restorestooth functionN/A
s-Clean TiN Half Coating AngledAbutment s-Line MiniTiN-CoatingInternal Hex
s-Clean Abutment Screw s-Line MiniThis screw is used for connect fixture andabutmentN/AScrewRetained
s-Clean Temporary Abutment MiniThis Abutment is used for prostheticrestore temporaryN/AInternal Hex
s-Clean MU Straight Abutment MiniMU Abutment is useful for variousTiN-CoatingInternal Hex
s-Clean MU Angled Abutment Miniangulation implanted fixture and gingivalangulation.TiN-CoatingInternal Hex
s-Clean MU Angled Abutment ScrewMiniThis Screw is used for fixture and MUAngled AbutmentN/AScrewRetained

Tolerance of dimension for Abutments shall be within ± 1% range.

The multi-unit abutments are only intended to be used in multi-unit restorations.

The purpose of Anodizing for s-Clean Cover Screw Mini and s-Clean Healing Abutment s-Line Mini is to distinguish the sizes with the naked eyes for convenience.

s-Clean SQ-SL Fixture Mini, s-Clean Cover Screw Mini and s-Clean Healing Abutment s-Line Mini are provided sterilized. And the other Abutments are provided non-sterilized.

s-Clean SO-SL Fixture Mini is enclosed with s-Clean Cover Screw Mini in a set packing. s-Clean Cover Screw Mini is also provided separately.

Materials:

  • s-Clean SQ-SL Fixture Mini, s-Clean Cover Screw Mini, s-Clean Healing Abutment s-Line Mini and ● s-Clean Temporary Abutment Mini are fabricated from Pure titanium of ASTM F67
  • The s-Clean (TiN Half Coating) Sole Abutment s-Line Mini, s-Clean (TiN Half Coating) Couple ● Abutment s-Line Mini, s-Clean (TiN Half Coating) Angled Abutment s-Line Mini, s-Clean Abutment Screw s-Line Mini, s-Clean MU Straight Abutment Mini, s-Clean MU Angled Abutment Mini and s-Clean MU Angled Abutment Screw Mini are fabricated from Ti-6Al-4V of ASTM F136
  • The s-Clean Temporary Abutment Mini is fabricated from PEEK material. ●

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Summaries of Technological Characteristics & Substantial Equivalence Discussion

s-Clean SO-SL Fixture Mini
------------------------------
Subject DevicePredicate DeviceReference Device
K numberNAK153639K202773
ManufacturerDentis Co., LtdDentis Co., LtdDentis Co., Ltd.
Trade NameDentis s-Clean s-LineMiniDentis Dental ImplantSystems-Clean SQ-SL Implant SystemMini
DesignImage: Dentis s-Clean s-Line MiniImage: Dentis Dental Implant SystemImage: s-Clean SQ-SL Implant System Mini
Indications forUseDentis s-Clean s-LineMini is indicated for usein partially or fullyedentulous mandibles andmaxillae, in support ofsingle or multiple unitrestorations including;cemented retained, screwretained, or overdenturerestorations, and terminalor intermediate abutmentsupport for fixedbridgework. This systemis dedicated for one andtwo stage surgicalprocedures. This system isintended for delayedloading.The OneQ-SL s-CleanImplant System isindicated for use inpartially or fullyedentulous mandibles andmaxillae, in support ofsingle or multiple unitrestorations including;cemented retained, screwretained, or overdenturerestorations, and terminalor intermediate abutmentsupport for fixedbridgework. This system isdedicated for one and twostage surgical proceduresand not dedicated forimmediate loading. Thissystem is intended fordelayed loadings-Clean SQ-SL Implant SystemMini is indicated for use inpartially or fully edentulousmandibles and maxillae, insupport of single or multiple unitrestorations including; cementedretained, screw retained, oroverdenture restorations, andterminal or intermediateabutment support for fixedbridgework. This system isdedicated for one and two stagesurgical procedures.This system is intended fordelayed loading.
DiameterØ5.8, 6.8 and 7.8Ø3.7, 3.9, 4.2, 4.7, 5.2, 6.0,7.0 and 8.0Ø3.7, 4.1
Length7.5, 9.5, 11.4, 11.5mm7, 8, 10, 12, 14mm7.5, 9.5, 11.5, 13.5mm
SurfaceTreatmentSLASLASLA
MaterialCP Titanium Gr4 (ASTMF67)CP Titanium Gr4 (ASTMF67)CP Titanium Grade4 (ASTMF67)
SterilizationGamma IrradiationGamma IrradiationGamma Irradiation
ComparisonThe Subject Device and primary predicate have same characteristics such as indications forUse, design, diameter, length, surface treatment, material, abutment connection, andsterilization.The difference between subject and primary predicate is only design of screw joint betweenfixture and abutment. Subject device has two screw-joint of fixture and abutment but primarypredicate has only one screw-joint of fixture and abutment. This difference is mitigatedthrough our own device, K202773. Any differences in technology characteristics areaccompanied by information that demonstrated the device is substantially equivalent as thepredicate and do not raise different questions of safety and effectiveness than the predicate.

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s-Clean Cover Screw Mini

Subject DeviceReference DeviceReference Device
K numberNAK200099K192436
ManufacturerDentis Co., LtdDentis Co., LtdDentium Co., Ltd
Trade NameDentis s-Clean s-Line Minis-Clean SQ-SL Implant System MiniHealing Abutments and Cover Screws
Models-Clean Cover screw Minis-Clean Mini Fixture Cover screwCover screw
DesignImage: Subject Device DesignImage: Reference Device K200099 DesignImage: Reference Device K192436 Design
Diameter$Ø$ 3.2$Ø$ 3.1$Ø$ 3.10, 3.18, 3.37, 3.50, 3.55, 4.12 and 4.30
Length5.0mm5.4mm4.70, 5.40, 5.70, 5.75, 6.35, 6.36, 6.88 and 8.92mm
CoatingAnodizing (Gold Color)NonAnodizing (Black, Blue, Green Color) / Non
MaterialTitanium Gr4 (ASTM F67)Titanium Gr4 (ASTM F67)Ti-6Al-4V ELI (ASTM F136)
SterilizationSterileSterileSterile
ComparisonSubject Device and Reference Device, K200099 have same indications and material. The diameter and length are different from K200099, but this difference is not important factor to the device performance. Subject device is anodized to make a division according to device size. To support the surface coating and dimension differences from K200099, K192436 is added as the reference device. Therefore, the subject device is substantial equivalent.

s-Clean Healing Abutment s-Line Mini

Subject DeviceReference DeviceReference Device
K numberNAK171027K123155
ManufacturerDentis Co., LtdDentis Co., LtdSHINHUNG MST CO.,Ltd
Trade NameDentis s-Clean s-Line MiniDentis Dental Implant SystemLuna Dental ImplantSystem
Models-Clean Healing Abutment s-Line MiniHealing AbutmentHealing Abutment
DesignImage: Subject Device DesignImage: Reference Device K171027 DesignImage: Reference Device K123155 Design
DiameterØ4.3, 4.8 and 5.8Ø4.0, 4.5, 4.8, 5.0, 5.5, 6.0, 6.5,7.0 and 7.5Ø4.5~7.0
Length7.61, 8.61, 9.61, 10.61, 11.61,12.61 and 14.61mm9.5, 10.0, 10.5, 11.0, 11.5, 12.0,12.5, 13.0, 13.5 and 14.0mm2.0, 3.5, 5.0 and 7.0
CoatingAnodizing (Gold Color)NonAnodizing(Purple, Blue Color)
MaterialTitanium Gr4 (ASTM F67)Titanium Gr4 (ASTM F67)Titanium Gr4 (ASTM F67)
SterilizationSterileSterileSterile
ComparisonSubject Device and reference device, K171027 have same Indications and material. The diameterand length are different from K171027 but this difference is not important factor to the deviceperformance. Subject device is anodized to make a division according to device size. Thisdifference about surface coating is explained through Reference Device, K123155. Therefore, thesubject device is substantial equivalent.

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Subject DeviceReference DeviceReference Device
K numberNAK171694K171027
ManufacturerDentis Co., LtdDentis Co., LtdDentis Co., Ltd
Trade NameDentis s-Clean s-LineMinis-Clean TiN Coating AbutmentDentis Dental ImplantSystem
Models-Clean SoleAbutment s-Line Mini& s-Clean TiN HalfCoating SoleAbutment s-Line Minis-Clean TiN Partial Coating SoleAbutmentSole Abutment
DesignImage: Design of subject deviceImage: Design of reference device K171694Image: Design of reference device K171027
DiameterØ4.5 and 5.5Ø4.5, 4.8, 5.5, 6.0 and 6.5Ø4.5, 4.8, 5.5, 6.0 and6.5
Gingival Height1.8, 2.8, 3.8, 4.80.8, 1.3, 1.8, 2.3, 3.3, 4.3 and 5.30.8, 1.3, 1.8, 2.3, 3.3,4.3, and 5.3
Length11.01, 12.01, 12.51,13.01, 13.51, 14.01,14.51, 15.01, 15.51,16.01 and 17.01mm10.6, 11.0, 11.5, 11.6, 12.0, 12.1,12.5, 13.0, 13.1, 13.5, 13.6, 14.0,14.1, 14.5, 15.0, 15.1, 15.5, 16.0,16.1, 16.5, 16.6, 17.0, 17.1, 17.5,18.1 and 18.5mm12.5, 13.0, 13.5, 14.0,15.0, 16.0 and 17.0mm
CoatingNon & TiN CoatingTiN CoatingNon
MaterialTi-6Al-4V ELI(ASTM F136)Ti-6Al-4V ELI(ASTM F136)Ti-6Al-4V ELI(ASTM F136)
SterilizationEnd User SterilizationEnd User SterilizationEnd User Sterilization
ComparisonSubject Device and Reference Devices, K171694 and K171027 have same diameter,length, material and sterilization method. The subject device has two types of surfacecoating, non-coating and TiN coating. K171027 is selected for non-coating abutment andK171694 is selected for TiN coating abutment as predicates. The subject device issubstantial equivalent.

s-Clean Sole Abutment s-Line Mini & s-Clean TiN Half Coating Sole Abutment s-Line Mini

s-Clean Couple Abutment s-Line Mini & s-Clean TiN Half Coating Couple Abutment s-Line Mini

Subject DeviceReference DeviceReference Device
K numberNAK171694K171027
ManufacturerDentis Co., LtdDentis Co., LtdDentis Co., Ltd
Trade NameDentis s-Clean s-Line Minis-Clean TiN CoatingAbutmentDentis Dental Implant System
Models-Clean Couple Abutments-Line Mini & s-Clean TiNHalf Coating CoupleAbutment s-Line Minis-Clean TiN Half CoatingCouple AbutmentCouple Abutment
DesignImage: Subject Device DesignImage: Reference Device K171694 DesignImage: Reference Device K171027 Design
DiameterØ4.0, 4.5 and 5.5Ø4.5, 4.8, 5.5, 6.0 and Ø6.5Ø4.0, 4.5, 4.8, 5.5, 6.0 and Ø6.5
Gingival Height1.8, 2.8, 3.8, 4.80.8, 1.3, 1.8, 2.3, 3.3, 4.3and 5.3mm0.8, 1.3, 1.8, 2.3, 3.3, 4.3 and5.3mm
Length8.35, 8.6, 9.35, 9.6, 9.85,10.1, 10.35, 10.6, 10.85,11.1, 11.35, 11.6, 11.85,12.1, 12.35, 12.6, 12.85,7.3, 7.44, 7.8, 7.94, 8.3,8.44, 8.8, 8.94, 9.3, 9.44,9.8, 9.94, 10.3, 10.44, 10.8,10.94, 11.3, 11.44, 11.8,7.3, 7.44, 7.8, 7.94, 8.3, 8.44,8.8, 8.94, 9.3, 9.44, 9.8, 9.94,10.3, 10.4, 10.44, 10.8, 10.9,10.94, 11.3, 11.4, 11.44, 11.8,

{9}------------------------------------------------

13.1, 13.35, 13.6, 14.35,14.611.94, 12.3, 12.44, 12.8,12.94, 13.3, 13.44, 13.8,13.94, 14.8 and 14.94mm11.9, 11.94, 12.3, 12.44, 12.8,12.9, 12.94, 13.3, 13.44, 13.8,13.9, 13.94, 14.8, 14.9 and14.94mm
CoatingNonTiN CoatingNon
MaterialTi-6Al-4V ELI(ASTM F136)Ti-6Al-4V ELI(ASTM F136)Ti-6Al-4V ELI(ASTM F136)
SterilizationEnd User SterilizationEnd User SterilizationEnd User Sterilization
ComparisonSubject Device and Reference Devices, K171694 and K171027 have same diameter, length,material and sterilization method. The subject device has two types of surface coating, non-coating and TiN coating. K171027 is selected for non-coating abutment and K171694 isselected for TiN coating abutment as predicates. The subject device is substantial equivalent.

s-Clean Angled Abutment s-Line Mini & s-Clean TiN Half Coating Angled Abutment s-Line Mini

Subject DeviceReference DeviceReference Device
K numberNAK171694K123988
ManufacturerDentis Co., LtdDentis Co., LtdMegaGemImpalnt Co., Ltd
Trade NameDentis s-Clean s-Line Minis-Clean TiN Coating AbutmentAnuOne Imternal Implant System
Models-Clean Angled Abutment s-Line Mini & s-Clean TiN Half Coating Angled Abutment s-Line Minis-Clean TiN Half Coating Angled AbutmentAngld Abutment
DesignImage: s-Clean Angled Abutment s-Line Mini & s-Clean TiN Half Coating Angled Abutment s-Line MiniImage: s-Clean TiN Half Coating Angled AbutmentImage: Angld Abutment
DiameterØ4.0, 4.5 and 5.5Ø4.5, 5.0,5.5 and Ø6.5Ø3.8~10.0
GingivalHeight2.8 and 3.80.8, 1.8 and 3.8mm2.5 and 4.5mm
Length12.09, 12.34, 12.51, 12.76, 13.09,13.34, 13.51, 13.76,10.18, 10.4, 10.46, 10.6,11.18, 11.6, 12.4, 13.18 and13.67.7~18.7
Angulation15° and 25°15° and 25°15° and 25°
CoatingNonTiN CoatingTiN Coating
MaterialTi-6Al-4V ELI(ASTM F136)Ti-6Al-4V ELI(ASTM F136)Ti-6Al-4V ELI(ASTM F136)
SterilizationEnd User SterilizationEnd User SterilizationEnd User Sterilization
ComparisonSubject Device and Reference Devices, K171694 and K171027 have same diameter, length,material, angulation and sterilization method. The subject device has two types of surfacecoating, non-coating and TiN coating. K171027 is selected for non-coating abutment andK171694 is selected for TiN coating abutment as predicates. The subject device is substantialequivalent.

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s-Clean Abutment Screw s-Line Mini

Subject DeviceReference Device
K numberNAK171027
ManufacturerDentis Co., LtdDentis Co., Ltd
Trade NameDentis s-Clean s-Line Minis-Clean TiN Coating Abutment
Models-Clean Abutment Screw s-Line MiniAbutment Screw
DesignImage: Subject Device DesignImage: Reference Device Design
Head Diameter$Ø$ 2.03$Ø$ 2.32
Length10.2mm8.8, 9.8, 9.95 and 10.5mm
CoatingNonNon
MaterialTi-6Al-4V ELI (ASTM F136)Ti-6Al-4V ELI (ASTM F136)
SterilizationEnd User SterilizationEnd User Sterilization
ComparisonSubject Device and Reference Device, K171694 have same material and applications andsimilar dimensions. The diameter is different but this difference is not important factor tothe device performance. Therefore, the subject device is substantial equivalent.

s-Clean Temporary Abutment Mini

Subject DeviceReference DeviceReference Device
K numberNAK171027K161689
ManufacturerDentis Co., LtdDentis Co., LtdOSSTEM Implant Co., Ltd
Trade NameDentis s-Clean s-Line MiniDentis Dental Implant SystemOSSTEM Implant System - Abutment
Models-Clean Temporary Abutment MiniTemporary AbutmentQuick Temporary Abutment
DesignImage: Design of s-Clean Temporary Abutment MiniImage: Design of Temporary AbutmentImage: Design of Quick Temporary Abutment
Diameter$Ø$ 4.0, 4.5, and 5.5$Ø$ 4.5, 4.8, 5.5, 6.0 and 6.5$Ø$ 4.0 and 4.5
Length13.45, 13.7, 15.45 and 15.7mm13.4 and 13.54mm11.5mm
CoatingNonNonNon
MaterialPEEKPEEKPEEK
SterilizationEnd User SterilizationEnd User SterilizationEnd User Sterilization
ComparisonSubject Device and Reference Device, K171027 have same material and applications and similar dimensions. Difference are lengths but this difference is not important factor for performance because this device is used for temporary and explained through Reference Device, K161689

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s-Clean Temporary Abutment Mini

Subject DeviceReference DeviceReference Device
K numberNAK171027K161689
ManufacturerDentis Co., LtdDentis Co., LtdOSSTEM Implant Co., Ltd
Trade NameDentis s-Clean s-Line MiniDentis Dental ImplantSystemOSSTEM Implant System -Abutment
Models-Clean TemporaryAbutment MiniTemporary AbutmentQuick Temporary Abutment
DesignImage: Design of s-Clean Temporary Abutment MiniImage: Design of Temporary AbutmentImage: Design of Quick Temporary Abutment
Diameter⌀4.0, 4.5, and 5.5⌀4.5, 4.8, 5.5, 6.0 and 6.5⌀4.0 and 4.5
Length13.45, 13.7, 15.45 and15.7mm13.4 and 13.54mm13.0, 13.5, 13.6, 15.0, 15.5and 15.6mm
CoatingNonNonNon
MaterialCP Titanium Gr4(ASTM F67)CP Titanium Gr4(ASTM F67)Ti-6Al-4V ELI(ASTM F136)
SterilizationEnd User SterilizationEnd User SterilizationEnd User Sterilization
ComparisonSubject Device and Reference Device, K171027 have same material and applications andsimilar dimensions. Difference are diameter but this difference is not important factor forperformance because this device is used for temporary and explained through ReferenceDevice. K161689.

s-Clean MU Straight Abutment Mini

Subject DeviceReference DeviceReference Device
K numberNAK150344K171694
ManufacturerDentis Co., LtdDentis Co., LtdDentis Co., Ltd
Trade NameDentis s-Clean s-LineMiniDentis Dental ImplantSystems-Clean TiN Coating Abutment
Models-Clean MU StraightAbutment MiniMU Solid Abutments-Clean TiN Partial Coating SoleAbutment
DesignImage: s-Clean MU Straight Abutment MiniImage: MU Solid AbutmentImage: s-Clean TiN Partial Coating Sole Abutment
Diameter$Ø4.8$$Ø4.8$$Ø4.5$ , 4.8, 5.5, 6.0 and 6.5
Length8.71, 9.71, 10.71, 11.71and 12.71mm4.34, 5.34, 6.08, 6.34, 6.69,7.34, 8.08, 8.69, 9.2, 10.2,11.2 and 12.2mm10.6, 11.0, 11.5, 11.6, 12.0, 12.1,12.5, 13.0, 13.1, 13.5, 13.6, 14.0,14.1, 14.5, 15.0, 15.1, 15.5, 16.0,16.1, 16.5, 16.6, 17.0, 17.1, 17.5,18.1 and 18.5mm
CoatingTiN CoatingNonTiN Coating
MaterialTi-6Al-4V ELI(ASTM F136)Ti-6Al-4V ELI(ASTM F136)Ti-6Al-4V ELI(ASTM F136)
SterilizationEnd User SterilizationEnd User SterilizationEnd User Sterilization
ComparisonSubject Device and Reference Device, K150344 have same material, diameter andapplications. Differences between subject device and reference device is surface coating andlengths. To support this discrepancy, K171694 is added. The length difference doesn't affectproduct performance because the subject device's lengths are in range of the predicate's.Therefore, the subject device is substantial equivalent.

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Subject DeviceReference DeviceReference Device
K numberNAK150344K171694
ManufacturerDentis Co., LtdDentis Co., LtdDentis Co., Ltd
Trade NameDentis s-Clean s-LineMiniDentis Dental ImplantSystemMulti-unit Abutmentss-Clean TiN Coating Abutment
Models-Clean MU AngledAbutment MiniMU Angled Abutments-Clean TiN Half Coating AngledAbutment
DesignImage: s-Clean MU Angled Abutment MiniImage: MU Angled AbutmentImage: s-Clean TiN Half Coating Angled Abutment
DiameterØ4.8Ø4.8Ø4.5, 5.0,5.5 and Ø 6.5
Length7.25, 7.74, 8.25, 8.74,9.25, 9.74, 10.25 and10.74mm4.34, 5.34, 6.08, 6.34, 6.69,7.34, 8.08, 8.69, 9.2, 10.2,11.2 and 12.2mm10.18, 10.4, 10.46, 10.6, 11.18,11.6, 12.4, 13.18 and 13.6
Angulation17° and 30 °17° and 30 °15° and 25°
CoatingTiN CoatingNonTiN Coating
MaterialTi-6Al-4V ELI(ASTM F136)Ti-6Al-4V ELI(ASTM F136)Ti-6Al-4V ELI(ASTM F136)
SterilizationEnd User SterilizationEnd User SterilizationEnd User Sterilization
ComparisonSubject Device and Reference Device, K150344 have same indications, material, diameter,angulation, and sterilization method. Differences between subject device and reference deviceis surface coating and lengths. To support this discrepancy, K171694 is added. The lengthdifference doesn't affect product performance because the subject device's lengths are in rangeof the predicate's. Therefore, the subject device is substantial equivalent.

s-Clean MU Angled Abutment Mini

s-Clean MU Angled Abutment Screw Mini

Subject DeviceReference Device
K numberNAK150344
ManufacturerDentis Co., LtdDentis Co., Ltd
Trade NameDentis s-Clean s-Line MiniDentis Dental Implant System
Models-Clean MU Angled Abutment Screw MiniMU Abutment Screw
DesignImage: Subject Device DesignImage: Reference Device Design 1, Image: Reference Device Design 2
Head Diameter$Ø$ 1.56$Ø$ 1.96 and 2.32
Length9.37.8, 9.2, 10.2, 11.2 and 12.2mm
MaterialTi-6Al-4V ELI (ASTM F136)Ti-6Al-4V ELI (ASTM F136)
SterilizationEnd User SterilizationEnd User Sterilization
ComparisonSubject Device and Reference Device, K150344 have same indications and material and similar dimensions. The diameter and length is different but this difference is not important factor to the device performance. Therefore, the subject device is substantial equivalent.

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Non-Clinical Test Data

Below tests were performed on subject device:

  • Fatigue Testing under the worst-case scenario according to ISO 14801:2016 .
    Below tests were performed for predicate devices and leveraged for the subject device:

  • Sterilization Validation Test on Fixtures according to ISO 11137-1.2,3 referenced in K192688

  • End User Sterilization Validation Test Reort on Abutments according to ANSVAAMI ST79. ● ISO 17665-1, ISO 17665-2, ISO 11737-1, ISO 11737-2, and ISO 11138-1 referenced in K11364

  • Shelf-Life Test on Fixtures according to ASTM F1980 referenced in K153639

  • Biocompatibility testing on fixtures according to ISO 10993-1:2009. ISO 10993-3:2014. ISO ● 10993-5:2009, ISO 10993-6:2007, ISO 10993-10:2010 and ISO 10993-11:2006 referenced in K153639

  • . Biocompatibility testing on Abutments made with Ti-6Al-4V ELI according to ISO 10993-1:2009, ISO 10993-3:2014, ISO 10993-5:2009, ISO 10993-6:2007, ISO 10993-10:2010 and ISO 10993-11:2006 referenced in K171027 and K150344

  • Biocompatibility testing on TiN Coating Abutments according to ISO 10993-1:2009, ISO 10993-5:2009, ISO 10993-10:2010 and ISO 10993-11:2006 referenced in K171694

  • Biocompatibility evaluation on abutments made with PEEK referenced in K171027

  • Bacterial Endotoxin Test Report on Fixtures according to ANSVAAMI ST72:2011, USP <161>, and USP <85> referenced in K192688

The results of the above tests have met the criteria of the standards, and demonstrated the substantial equivalence with the predicate device.

The surface modification information with SLA (Sandblasted with Large-grit and Acid-etching) for fixtures was provided. To compare surface modification between the subject and predicate devices, K153639, surface roughness, surface composition analysis, and SEM imaging were provided and it demonstrate the substantial equivalence.

The Sterilization validation test and shelf-life test for fixtures were performed for predicate device, K192688 and K153639 and leveraged for the subject device the material, sterilization method, packaging methods, and manufacturing process of the both products are exactly same.

The end user sterilization test was performed for predicate device, K111364 and leveraged for the subject device because the product category, material, manufacturing process, facility, and packaging of the both products are exactly same.

The Biocompatibility Test was conducted on the predicate device and leveraged for the subject device because both products are manufactured with same materials and manufacturing process.

The fatigue testing per ISO 14801 was conducted under the worst-case scenario. To demonstrate the substantial equivalence of the device performance between single screw joint implant and dual screw joint implant, two fatigue tests were performed comparatively, and result say that device performance was substantial equivalent.

The non-clinical testing results demonstrate that the subject device is substantially equivalent to the predicate device.

Conclusion

Dentis s-Clean s-Line Mini constitutes a substantially equivalent medical device, meeting all the declared requirements of its intended use. This system has the same intended use and fundamental scientific technology as its predicate devices. Therefore, Dentis s-Clean s-Line Mini and its predicates are substantially equivalent.

§ 872.3640 Endosseous dental implant.

(a)
Identification. An endosseous dental implant is a prescription device made of a material such as titanium or titanium alloy that is intended to be surgically placed in the bone of the upper or lower jaw arches to provide support for prosthetic devices, such as artificial teeth, in order to restore a patient's chewing function.(b)
Classification. (1) Class II (special controls). The device is classified as class II if it is a root-form endosseous dental implant. The root-form endosseous dental implant is characterized by four geometrically distinct types: Basket, screw, solid cylinder, and hollow cylinder. 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.)(2)
Classification. Class II (special controls). The device is classified as class II if it is a blade-form endosseous dental implant. The special controls for this device are:(i) The design characteristics of the device must ensure that the geometry and material composition are consistent with the intended use;
(ii) Mechanical performance (fatigue) testing under simulated physiological conditions to demonstrate maximum load (endurance limit) when the device is subjected to compressive and shear loads;
(iii) Corrosion testing under simulated physiological conditions to demonstrate corrosion potential of each metal or alloy, couple potential for an assembled dissimilar metal implant system, and corrosion rate for an assembled dissimilar metal implant system;
(iv) The device must be demonstrated to be biocompatible;
(v) Sterility testing must demonstrate the sterility of the device;
(vi) Performance testing to evaluate the compatibility of the device in a magnetic resonance (MR) environment;
(vii) Labeling must include a clear description of the technological features, how the device should be used in patients, detailed surgical protocol and restoration procedures, relevant precautions and warnings based on the clinical use of the device, and qualifications and training requirements for device users including technicians and clinicians;
(viii) Patient labeling must contain a description of how the device works, how the device is placed, how the patient needs to care for the implant, possible adverse events and how to report any complications; and
(ix) Documented clinical experience must demonstrate safe and effective use and capture any adverse events observed during clinical use.