K Number
K210817
Device Name
C&B 5.0 Hybrid
Date Cleared
2021-12-08

(265 days)

Product Code
Regulation Number
872.3770
Panel
Dental
Reference & Predicate Devices
Predicate For
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

C&B 5.0 Hybrid resin is a light-curable resin to fabricate, by additive manufacturing, temporary crowns or bridges. The fabricated temporary crowns or bridges are an alternative to preformed temporary crowns or bridges and require digital models of crowns or bridges, a stereolithographic additive printer , and curing lightequipment.

The C&B 5.0 Hybrid is indicated for the fabrication of temporary dental restorations in conjunction with extra-oral curing light equipment. Duration is less than 30 days in oral environment.

Device Description

The C&B 5.0 Hybrid is made from Methacrylate Oligomer based on the Urethane Acrylate Oligomer with 0.01~0.1 wt% inorganic filler. It has stored in a brown 1000ml of HDPE bottle. It contains materials with colors of A2 based on the shade guide. The subject device is liquid photo-curable material that is polymerized by UV laser at 405nm. The liquid UV curing resin is cured at a specific wavelength (405nm) by the photo-initiator contained in the resin. Curing in a 3D printer is related to the printer equipment, and is typically 0.1 to 0.010mm in thickness, and is output at a resolution of 0.1 to 0.03 mm on the x, y axis. This device should use DLP/LCD 3D Printer equipment using UV light source and it is possible to produce three dimensional printed matter by curing lamination step by step a thicknesses of 100, 50 and 16 um.

AI/ML Overview

The provided text describes a 510(k) premarket notification for a dental resin, "C&B 5.0 Hybrid." This document focuses on demonstrating the substantial equivalence of this new device to an existing predicate device rather than presenting a study proving a device meets specific acceptance criteria related to AI or clinical performance. Therefore, most of the requested information regarding AI studies, sample sizes, expert ground truth, and adjudication methods is not applicable or cannot be extracted from this particular document.

However, I can extract information related to the performance data and the standards it meets.

1. A table of acceptance criteria and the reported device performance

The document references ISO standards as the "Referenced Standard" for various tests, which implicitly define the acceptance criteria for these physical and biological properties. The reported device performance is that it "Meets" these standards.

Test ItemReferenced Standard (Implicit Acceptance Criteria)Reported Device Performance
Shelf-Life Validation Tests
Visual Inspection-Test Performed
PackagingISO 10477Test Performed
Flexural StrengthISO 10477Test Performed
Biocompatibility Tests
CytotoxicityISO 10993-10Meets ISO 10993
SensitizationISO 10993-10Meets ISO 10993
Acute ToxicityISO 10993-11Meets ISO 10993
Oral Mucosal IrritationISO 10993-10Meets ISO 10993
Performance Tests
Visual Inspection-Test Performed
Packaging-Test Performed
Capacity-Test Performed
Color Consistency-Test Performed
Color StabilityISO 10477Meets ISO 10477
Flexural StrengthISO 10477Meets ISO 10477
Water AbsorptionISO 10477Meets ISO 10477
Solubility TestISO 10477Meets ISO 10477

Regarding the other requested information:

  • 2. Sample sized used for the test set and the data provenance: Not specified in the document. The document refers to "the following tests were performed," but details about sample sizes for each test are not provided. The data provenance is implied to be from the manufacturer's testing (Arum Dentistry Co., Ltd., South Korea), but no country of origin of patient data or retrospective/prospective nature is applicable as this is a material science and biocompatibility study, not a clinical study involving patients.
  • 3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts: Not applicable. The ground truth for material properties and biocompatibility is established by adherence to recognized international standards (ISO), not by expert consensus in the context of clinical interpretation or image analysis.
  • 4. Adjudication method (e.g., 2+1, 3+1, none) for the test set: Not applicable. This is not a study requiring adjudication of expert opinions.
  • 5. If a multi reader multi case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance: Not applicable. This document does not describe an AI medical device or an MRMC study.
  • 6. If a standalone (i.e., algorithm only without human-in-the-loop performance) was done: Not applicable. This document is not about an AI algorithm.
  • 7. The type of ground truth used (expert consensus, pathology, outcomes data, etc.): The ground truth for this device's performance is based on established scientific and engineering principles and adherence to international standards (e.g., ISO 10477 for dental polymer materials, ISO 10993 for biological evaluation of medical devices).
  • 8. The sample size for the training set: Not applicable. This is not an AI device requiring a training set.
  • 9. How the ground truth for the training set was established: Not applicable. This is not an AI device.

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Image /page/0/Picture/0 description: The image shows the logo of the U.S. Food and Drug Administration (FDA). On the left is the Department of Health & Human Services logo. To the right of that is the FDA logo, which is a blue square with the letters "FDA" in white. To the right of the blue square is the text "U.S. FOOD & DRUG ADMINISTRATION" in blue.

December 8, 2021

Arum Dentistry Co., Ltd % Priscilla Chung Regulatory Affairs Consultant LK Consulting Group USA, Inc. 1150 Roosevelt, STE 200 Irvine, California 92620

Re: K210817

Trade/Device Name: C&B 5.0 Hybrid Regulation Number: 21 CFR 872.3770 Regulation Name: Temporary Crown And Bridge Resin Regulatory Class: Class II Product Code: EBG Dated: October 11, 2021 Received: November 08, 2021

Dear Priscilla Chung:

We have reviewed your Section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food, Drug, and Cosmetic Act (Act) that do not require approval of a premarket approval application (PMA). You may, therefore, market the device, subject to the general controls provisions of the Act. Although this letter refers to your product as a device, please be aware that some cleared products may instead be combination products. The 510(k) Premarket Notification Database located at https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm identifies combination product submissions. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you, however, that device labeling must be truthful and not misleading.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.

Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal

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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,

Michael E. Adjodha, M.ChE. Assistant Director DHT1B: Division of Dental and ENT Devices OHT1: Office of Ophthalmic, Anesthesia, Respiratory, ENT and Dental Devices Office of Product Evaluation and Quality Center for Devices and Radiological Health

Enclosure

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Indications for Use

510(k) Number (if known) K210817

Device Name C&B 5.0 Hybrid

Indications for Use (Describe)

C&B 5.0 Hybrid resin is a light-curable resin to fabricate, by additive manufacturing, temporary crowns or bridges. The fabricated temporary crowns or bridges are an alternative to preformed temporary crowns or bridges and require digital models of crowns or bridges, a stereolithographic additive printer , and curing lightequipment.

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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510(k) Summary (K210817)

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

Date: Oct 12, 2021

1. Applicant / Submitter:

Arum Dentistry Co., Ltd. 44, Techno 8-ro, Yuseong-gu, Daejeon, 34028 South Korea Tel. +82-42-935-3644

2. Submission Correspondent:

Priscilla Chung LK Consulting Group USA, Inc. 1150 Roosevelt STE 200, Irvine CA 92620 Phone: 714-202-5789 Fax: 714-409-3357 Email: juhee.c@lkconsultinggroup.com

3. Device:

Proprietary Name:C&B 5.0 Hybrid
Common Name:3D temporary crown and bridge resin
Classification Name:Temporary crown and bridge resin
Classification:Class II, 21 CFR 872.3770
Classification Product Code:EBG

4. Predicate Device:

Resin for Temporary Crown & Bridge (K180657) by Dentis Co., Ltd.

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5. Device Description:

The C&B 5.0 Hybrid is made from Methacrylate Oligomer based on the Urethane Acrylate Oligomer with 0.01~0.1 wt% inorganic filler. It has stored in a brown 1000ml of HDPE bottle. It contains materials with colors of A2 based on the shade guide. The subject device is liquid photo-curable material that is polymerized by UV laser at 405nm. The liquid UV curing resin is cured at a specific wavelength (405nm) by the photo-initiator contained in the resin. Curing in a 3D printer is related to the printer equipment, and is typically 0.1 to 0.010mm in thickness, and is output at a resolution of 0.1 to 0.03 mm on the x, y axis. This device should use DLP/LCD 3D Printer equipment using UV light source and it is possible to produce three dimensional printed matter by curing lamination step by step a thicknesses of 100, 50 and 16 um.

6. Indications for Use:

The C&B 5.0 Hybrid is indicated for the fabrication of temporary dental restorations in conjunction with extra-oral curing light equipment. Duration is less than 30 days in oral environment.

7. Performance Data (Non-Clinical):

The following tests were performed on the subject device and the test results support that the subject device is substantially equivalent to the predicate devices.

TestTest ItemReferenced Standard
Shelf-Life Validation TestsVisual inspection-
PackagingISO 10477
Flexural strengthISO 10477
Biocompatibility TestsCytotoxicity
SensitizationISO 10993-10
Acute ToxicityISO 10993-11
Oral Mucosal IrritationISO 10993-10
Performance TestsVisual Inspection-
Packaging-
Capacity-
Color Consistency-
Color StabilityISO 10477
Flexural StrengthISO 10477
Water AbsorptionISO 10477
Solubility TestISO 10477

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8. Substantial Equivalence

The following table compares technological and other characteristics of the subject and a predicate device.

Subject DevicePredicate DeviceComparison
ApplicantArum Dentistry Co., Ltd.Dentis Co., Ltd
Trade NameC&B 5.0 HybridResin for Temporary Crown &Bridge-
510(K) No.K210817K180657-
Regulation NameDenture Relining, Repairing, OrRebasing ResinDenture Relining, Repairing, OrRebasing Resinsame
Product CodeEBGEBGsame
ClassClass IIClass IIsame
DeviceIdentificationLight-cured resinLight-cured resinsame
Indications forUseThe C&B 5.0 Hybrid is indicated forthe fabrication of temporary dentalrestorations in conjunction withextra-oral curing light equipment.Duration is less than 30 days in oralenvironment.Resin for Temporary Crown &Bridge is indicated for thefabrication oftemporary dental restorations inconjunction with extra-oral curinglightequipment. Duration is less than 30days in oral environment.same
Materials of UseTitanium dioxideTrimethylolpripanetrimethacrylateDiphenyl phosphine oxideSilicon OxideUrethane DimethacrylateYellowRedPigmentsBlackTitanium dioxideEthyl acrylateDiphenyl phosphine oxideMethyl methacrylateUrethane methacrylateCesium oxide (Pigments)similar
Device statePre-mixed liquid resin provided in acontainerPre-mixed liquid resin provided ina containersame
Polymerization(Curing) MethodVisible lightVisible lightsame
Fabrication ofDenture BaseCAD/CAM additive printing processCAD/CAM additive printingprocesssame
Post CuringVisible light-curing unitVisible light-curing unitsame
Product StatePre-mix resinPre-mix resinsame
Teeth AssembleBondingBondingsame
SterilizationNoneNonesame
BiocompatibilityMeets ISO 10993Meets ISO 10993same
Performance TestMeets ISO 10477Meets ISO 10477same

The subject device has the same indications for use as the predicate device. Both devices are methacrylate-based resin and uses the same technology of CAD/CAM system to make the final prosthetic appliances. The major differences would be raw material compositions. We have

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performed the biocompatibility and performance tests to support that the subject device is substantially equivalent to the predicate device despite this difference. Based on the test results submitted here in, we conclude that the subject device is substantially equivalent to the predicate device.

9. Conclusion:

Based on the testing results, Arum Dentistry Co., Ltd. concludes that the C&B 5.0 Hybrid is substantially equivalent to the predicate devices.

§ 872.3770 Temporary crown and bridge resin.

(a)
Identification. A temporary crown and bridge resin is a device composed of a material, such as polymethylmethacrylate, intended to make a temporary prosthesis, such as a crown or bridge, for use until a permanent restoration is fabricated.(b)
Classification. Class II.