K Number
K211237
Device Name
UltraTemp Rez II
Date Cleared
2021-07-13

(78 days)

Product Code
Regulation Number
872.3275
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
UltraTemp REZ II is indicated for temporization of provisional prosthesis or restorative provisional crowns, bridges, inlays, and on lays).
Device Description
UltraTemp™ REZ II temporary resin cement is a low viscosity, temporary luting/filling material featuring a hydrophilic resin-based formula which is recommended for the retention of provisional restorations of provisional prosthesis. UltraTemp REZ II temporary resin cement may also be used for temporary restorative procedures (i.e. provisional crowns, bridges, inlays, and on lays). It is available in Fast Set (1 to 2 minutes) and Regular Set (2 to 3 minutes).
More Information

None

No
The device is a temporary resin cement and the description focuses on its physical and chemical properties, not on any computational or analytical capabilities. There is no mention of AI, ML, image processing, or data analysis.

No
The device is a temporary luting/filling material (cement) used for the retention of provisional restorations and not a device intended to treat or cure a disease or condition.

No

UltraTemp REZ II is a temporary resin cement used for the retention of provisional restorations or for temporary restorative procedures, not for diagnosing conditions.

No

The device description clearly states it is a "temporary resin cement," which is a physical material, not software. The performance studies also focus on material properties like strength and setting time.

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

Here's why:

  • Intended Use: The intended use is for the temporization of provisional dental prostheses and restorations. This is a direct application to the patient's teeth and mouth, not for testing samples taken from the body.
  • Device Description: The description details a temporary resin cement used for luting and filling in the mouth. This aligns with a dental material used in a clinical setting, not a diagnostic test.
  • Lack of Diagnostic Purpose: There is no mention of the device being used to diagnose a disease, condition, or state of health. Its purpose is purely for temporary dental restoration.
  • Anatomical Site: The device is applied to "prepared surfaces of enamel or dentin," which are parts of the tooth structure within the body. IVDs typically analyze samples from the body (like blood, urine, tissue).

In summary, the UltraTemp REZ II is a dental material used for temporary restorative procedures, not a diagnostic test performed on samples outside the body.

N/A

Intended Use / Indications for Use

UltraTemp REZ II is indicated for temporization of provisional prosthesis or restorative provisional crowns, bridges, inlays, and on lays).

Product codes

EMA

Device Description

UltraTemp™ REZ II temporary resin cement is a low viscosity, temporary luting/filling material featuring a hydrophilic resin-based formula which is recommended for the retention of provisional restorations of provisional prosthesis. UltraTemp REZ II temporary resin cement may also be used for temporary restorative procedures (i.e. provisional crowns, bridges, inlays, and on lays). It is available in Fast Set (1 to 2 minutes) and Regular Set (2 to 3 minutes).

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Applied to the prepared surfaces of enamel or dentin

Indicated Patient Age Range

All ages; to be assessed by administering dental professional.

Intended User / Care Setting

Licensed Dentist or Dental Professional

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

Not Found

Key Metrics

Not Found

Predicate Device(s)

UltraTemp REZ (UltraTemp Firm, Fast and Regular Set (K080768)

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 872.3275 Dental cement.

(a)
Zinc oxide-eugenol —(1)Identification. Zinc oxide-eugenol is a device composed of zinc oxide-eugenol intended to serve as a temporary tooth filling or as a base cement to affix a temporary tooth filling, to affix dental devices such as crowns or bridges, or to be applied to a tooth to protect the tooth pulp.(2)
Classification. Class I (general controls). The device is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to § 872.9.(b)
Dental cement other than zinc oxide-eugenol —(1)Identification. Dental cement other than zinc oxide-eugenol is a device composed of various materials other than zinc oxide-eugenol intended to serve as a temporary tooth filling or as a base cement to affix a temporary tooth filling, to affix dental devices such as crowns or bridges, or to be applied to a tooth to protect the tooth pulp.(2)
Classification. Class II.

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July 13, 2021

Ultradent Products, Inc. Adam Black Regulatory Affairs Manager 505 W. Ultradent Drive (10200 South) South Jordan, Utah 84095

Re: K211237

Trade/Device Name: UltraTemp Rez II Regulation Number: 21 CFR 872.3275 Regulation Name: Dental Cement Regulatory Class: Class II Product Code: EMA Dated: May 13, 2021 Received: May 14, 2021

Dear Adam Black:

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

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

Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencies. You must comply with all the Act's

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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 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) K211237

Device Name UltraTemp Rez II

Indications for Use (Describe)
Indications for use:
UltraTemp BEZ II is indicated

UltraTemp REZ II is indicated for temporization of provisional prosthesis or restorative provisional crowns, bridges, inlays, and on lays).

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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510(k) Summary-K211237

This summary of the traditional 510(k) substantial equivalence information is being submitted in accordance with the requirements of 21 CFR 807.92 UltraTemp REZ II.

l. Applicant's Name and Address

Ultradent Product, Inc. 505 West Ultradent Drive (10200 South) South Jordan, UT 84095

Contact Person:Mr. Adam Black
Title:Regulatory Affairs Manager
Telephone:801-553-4425
Cell Phone:435-459-9302
Fax:801-553-4609

Date Summary Prepared: 08 July 2021

II. Name of the Device

Device:Cement, Dental
Trade/Device Name:UltraTemp REZ II
Common Name:Cement, Dental
Review Panel:Dental
Regulation Number:21 CFR 872.3275
Device Class:Class II
Classification Product Code:EMA

III. Device Description

UltraTemp™ REZ II temporary resin cement is a low viscosity, temporary luting/filling material featuring a hydrophilic resin-based formula which is recommended for the retention of provisional restorations of provisional prosthesis. UltraTemp REZ II temporary resin cement may also be used for temporary restorative procedures (i.e. provisional crowns, bridges, inlays, and on lays). It is available in Fast Set (1 to 2 minutes) and Regular Set (2 to 3 minutes).

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IV. Statement of Intended Use

UltraTemp REZ II is indicated for temporization of provisional prosthesis or restorative procedures (i.e. provisional crowns, bridges, inlays, and on lays)

V. Predicate Device

UltraTemp REZ II identified primary predicate: UltraTemp REZ (UltraTemp Firm, Fast and Regular Set (K080768)

VII. Comparison of Technological Characteristics

Predicate technological comparison:

The technology, delivery, and intended use of UltraTemp REZ II are substantially equivalent to the identified predicate as outlined in Table 5-1:

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Table 5-1: UltraTemp REZ II substantial equivalence comparison

| Descriptive
Information/
Characteristic | Predicate: UltraTemp Firm, Fast
and Regular Set (K080768) | Device: UltraTemp REZ II
(K211237) | Identified Characteristic
Differences and Rationale for
Differences |
|------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|----------------------------------------------------------------------------------------------|
| Intended Use | For temporary application of
provisional crowns, bridges, inlays,
and on lays. | For temporization of provisional
prosthesis or restorative procedures
(i.e. provisional crowns, bridges, inlays,
and on lays) | No identified differences |
| Intended User | Licensed Dentist or Dental
Professional | Licensed Dentist or Dental Professional | Same intended user. No identified
differences. |
| Characteristics | Low viscosity, non-eugenol, resin
based temporary luting and filling
material | Low viscosity, resin based temporary
luting and filling material | The UTR and UTRII products vary
in product formulas, see below for
further discussions |
| Types of Materials | Polycarboxylate | Polycarboxylate | N/A |
| Formulation | Zinc Oxide Cement | Zinc Oxide Cement | N/A |
| Delivery System or
Deployment Methods | Product is packaged in a dual-barrel
syringe (catalyst and base) for use.
When use is required, a mixing tip
is attached to the dual barrel
syringe, the product is then mixed
within the syringe tip as it is
expressed from the syringe into the
treatment site. The product is
workable for 2-3 minutes or 1-2 for
the Regular Set configuration and
Fast Set configuration respectively
prior to the product becoming fully
set | Same as predicate | N/A |
| Principles of Operation
and Critical
Performance
Requirements | COA Release Testing:
Appearance, Setting Time, Two-
Spense Syringe Delivery Test | Same as predicate | N/A |
| Physical Properties | Ultratemp Rez Regular Set and
Fast Set

Stability (internal Procedure):
Accelerated in-house study
performed on UltraTemp Firm
Regular and Firm Fast set. 18
months shelf life at refrigerated
temperatures | Ultratemp Rez II Regular Set and Fast
Set

Stability: 12 to 18 months Shelf life, 2°C

  • 8°C

Compression Strength
(SOP_TST_0413.03): $ \le $ 35 MPa and $ \ge $ 5 MPa | N/A |

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Ultradent Products, Inc. 505 West Ultradent Drive (10200 South) South Jordan, UT 84095 Est. Reg. No. 1718912

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| Tensile Strength (Crown pulls)
(internal Procedure): Analysis
performed on UltraTemp REZ
regular and UltraTemp REZ fast set.
Results recorded. Regular Set: 9.73
$\pm$ 2.44 (Lbs). Fast Set: 11.32 $\pm$ 6.09
(Lbs} | Micro Leakage (test method as written
in PRO_RD_00076.14): Minimal to no
microleakage when compared to
control |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Compressive Strength and
Modulus(internal Procedure):
Analysis performed on UltraTemp
REZ regular and UltraTemp REZ fast
set. Results recorded. Regular
Set: 29.25 $\pm$ 3.21 (MPa) Fast Set:
14.62 $\pm$ 1. 79 (MPa) | Radio-Opacity (ISO4049:2019 Section
7.14): Radio-opacity $\geq$ 1mm Al |
| Work and cure Time Test (internal
Procedure): Analysis performed on
UltraTemp REZ regular and
UltraTemp REZ fast set. Results
recorded. Regular Set: 45
seconds - 4 minutes to pass TST131
Fast Set: 30 seconds - 2 minutes to
pass TST131 | Film Thickness (ISO 3107:2011 section
7.4): $\leq$ 25 $\mu$ m |
| | UV Fluorescence (test method as
written in PRO_RD_00071): Sample
will fluoresce under UV light |
| | Shear Bond Strength
(SOP_TST_0170.16): Control average –
sample average Regular Set:
Setting time $\geq$ 1.5 min and not $\geq$ 10
min. Additionally 45 seconds - 4
minutes as tested in TST131. Fast Set:
30 seconds - 2 minutes as tested in
TST131 |
| | Water Removal (test method as
written in PRO_TST_0413.03): Uncured
chemical will easily come off glass slide
after 10 seconds air/water spray |

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Ultratemp Rez II Fast Set Only
Acid-soluble arsenic mass fraction
2mg/kg maximum
Patient PopulationIndividuals of all ages and gender
and shall be assessed by the
administering dental professional.Age:
All ages; to be assessed by
administering dental professional.
Weight, gender, health and physical
condition:
All Conditions; to be assessed by
administering dental professional.
Part of the body interacted with:
Applied to the prepared surfaces of
enamel or dentinN/A
Biocompatibility and
SafetyTested per ISO-10993-1 and ISO-
7405
Cytotoxicity, Sensitization,
irritation, and Genotoxicity testing
passed. Literature and testing to
demonstrate
product is safe when used as
directed
Also, Considering the intended
clinical applications and the results
of the studies outlined in the
biocompatibility summary found in
section 8.1 of TF-00251, theBiological risks associated to patient
safety for the UTRII product have been
identified, assessed, and
controlled/mitigated through the
appropriate documentation. Chemical
characterization, biocompatibility
testing, and a health-based risk
assessment was completed following
ISO 10993-1 and subsequent standards.
After review of the pertinent, objective
evidence available, Ultradent Products,
Inc. concludes that the biological and
toxicological risks associated with the
UTRII product are low and acceptable.N/A
evidence for the biological safety of
UltraTemp REZ, regular and fast
set, is adequate and there do not
appear to be any significant
toxicological risks associated with
this product when used according
to the manufacturer's instructions.
Because UltraTemp REZ, regular
and fast set is for professional use
only, it is our belief that the
available evidence for the
biocompatibility of this product is
adequate and no further studies
are indicated .It can therefore be stated that the
UltraTemp REZ II product has been
evaluated for biological risks and the
UltraTemp REZ II product has been
determined to be biologically safe for
its intended uses.

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VII Conclusion:

UltraTemp REZ II product was designed and developed to be the replacement product for UltraTemp REZ. As outlined in the comparison table above, UltraTemp REZ II is similar to the identified predicate device with respect to its intended Use, its Intended User, the Device Design, Types of Material used, Delivery System and or Deployment Method, Physical Properties and Patient Population. Also, UltraTemp REZ II does not introduce any new safety or efficacy issues, questions or concerns per Biocompatibility and Safety testing has been completed.

In summary it can be stated that the development of the subject UltraTemp REZ II product is based on a well-established technology in the form of the predicate UltraTemp REZ product. Based on these comparisons to the predicate device, we believe that UltraTemp REZ II is substantially equivalent to the predicate device and do not raise new concerns of safety or efficacy.