K Number
K212103
Device Name
StarX-1, StarX-2, StarX PRO-1 and StarX PRO-2
Manufacturer
Date Cleared
2021-08-30

(55 days)

Product Code
Regulation Number
872.1800
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
Acquisition of intraoral X-Ray image of the human dental arch. In particular: • The STARX-1/ STARX PRO-1 sensors (active area 20 x 30 mm) allow to acquire the majority of intraoral images both vertically and horizontally. • The STARX-2/ STARX PRO-2 sensors (active area 26 x 34 mm) allow to acquire horizontal bitewing images.
Device Description
The StarX-1, StarX-2, StarX PRO-1 and the StarX PRO-2 are digital intraoral sensors based on CMOS technology for intraoral X-Ray image acquisition of the human dental arch. The sensors are available in two sizes; in particular: • StarX-1 / StarX PRO-1 sensors: active area 20 x 30 mm • StarX-2 / StarX PRO-2 sensors: active area 26 x 34 mm The differences between the sensors are the sizes and the different kind of scintillator (Cesium lodide - Csl and Gadolinium Oxysulfide - GOS). StarX-1, StarX-2, StarX PRO-1 and StarX PRO-2 are directly connected to the acquisition PC through the USB connection. Up to three sensors can be connected to one PC at time. The type of X-ray systems that integrate with the sensors are wall-mounted Xray intraoral generators (both AC and DC) with a tube current between 1 and 15 mA inclusive, and with a tube voltage between 50 and 100 kV inclusive, with in-built controls to set exposure parameters. Generators allow variable mA/kV to be selected, which will control the exposure time. The sensor is supplied with an acquisition (TWAIN) module to acquire images from the sensor via the USB. The user can further process these images via a patient management software to process, filter and modify images using a software such as the Oris Win DG software which is not part of this submission. The device cannot act as an x-ray generator controller. All control of x-ray generation is done by controls built into the generator itself. There is no connection between the subject device and the x-ray generator. The subject device does not control the generator, it is a receiver only. Before FONA sells this device, the team discuss the hardware and software requirements of the user to make sure that their systems are compatible with the FONA sensors. FONA provides technical support for this device to ensure proper operation and to answer any questions regarding the functioning of the device. Contact details are provided to all end users and in the user manual.
More Information

No
The description focuses on the hardware (CMOS sensor, sizes, scintillator) and basic image acquisition and transfer via USB. It mentions image processing via separate software (not part of the submission) but does not describe any AI/ML capabilities within the submitted device itself. The "Mentions AI, DNN, or ML" field is also "Not Found".

No.
The device is used for acquiring X-Ray images, which is a diagnostic function, not a therapeutic one. It receives X-rays but does not generate or apply any treatment.

Yes
The device is described as an "Acquisition of intraoral X-Ray image of the human dental arch" device. Acquiring images to inform a diagnosis falls under the definition of a diagnostic device.

No

The device description clearly states that the device is a "digital intraoral sensor based on CMOS technology" and describes physical components like "active area 20 x 30 mm" and "USB connection." This indicates it is a hardware device, not software-only.

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

Here's why:

  • Intended Use: The intended use is the "Acquisition of intraoral X-Ray image of the human dental arch." This is a medical imaging device used to capture images of anatomical structures.
  • Device Description: The device is a digital intraoral sensor based on CMOS technology for acquiring X-ray images. It's a receiver of X-rays, not a device that analyzes biological samples or performs tests on them.
  • No mention of biological samples or analysis: The description focuses entirely on the acquisition of X-ray images of the dental arch. There is no mention of analyzing blood, urine, tissue, or any other biological sample.
  • Input Imaging Modality: The input is X-Ray, which is a physical imaging modality, not a method for analyzing biological samples.
  • Anatomical Site: The anatomical site is the "human dental arch," which is a physical structure, not a biological sample being tested.

IVD devices are specifically designed to examine specimens derived from the human body to provide information for the diagnosis, prevention, monitoring, treatment, or alleviation of disease. This device's function is to capture images for visual interpretation by a healthcare professional, not to perform in vitro analysis of biological samples.

N/A

Intended Use / Indications for Use

Acquisition of intraoral X-Ray image of the human dental arch. In particular:

• The STARX-1/ STARX PRO-1 sensors (active area 20 x 30 mm) allow to acquire the majority of intraoral images both vertically and horizontally.

· The STARX-2/ STARX PRO-2 sensors (active area 26 x 34 mm) allow to acquire horizontal bitewing images.

Product codes

MUH

Device Description

The StarX-1, StarX-2, StarX PRO-1 and the StarX PRO-2 are digital intraoral sensors based on CMOS technology for intraoral X-Ray image acquisition of the human dental arch. The sensors are available in two sizes; in particular:

  • . StarX-1 / StarX PRO-1 sensors: active area 20 x 30 mm
  • . StarX-2 / StarX PRO-2 sensors: active area 26 x 34 mm

The differences between the sensors are the sizes and the different kind of scintillator (Cesium lodide - Csl and Gadolinium Oxysulfide - GOS).

StarX-1, StarX-2, StarX PRO-1 and StarX PRO-2 are directly connected to the acquisition PC through the USB connection. Up to three sensors can be connected to one PC at time.

The type of X-ray systems that integrate with the sensors are wall-mounted Xray intraoral generators (both AC and DC) with a tube current between 1 and 15 mA inclusive, and with a tube voltage between 50 and 100 kV inclusive, with in-built controls to set exposure parameters. Generators allow variable mA/kV to be selected, which will control the exposure time.

The sensor is supplied with an acquisition (TWAIN) module to acquire images from the sensor via the USB. The user can further process these images via a patient management software to process, filter and modify images using a software such as the Oris Win DG software which is not part of this submission.
The device cannot act as an x-ray generator controller. All control of x-ray generation is done by controls built into the generator itself. There is no connection between the subject device and the x-ray generator. The subject device does not control the generator, it is a receiver only.

Mentions image processing

Yes

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

X-Ray

Anatomical Site

human dental arch

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Not Found

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)

Summary of Non Clinical Testing: IEC standards have been employed for Electrical Safety, Electromagnetic Compatibility, performance and usability. The panel power supply is UL Listed. The CMOS area image sensor manufacturer conducted performance testing according to the FDA quidance document for solid state digital X-ray panels. Risk Analysis and System operation verification tests were conducted in accordance with FDA guidance documents. Labelling was developed to comply with the FDA solid state panel guidance document.

Summary of Clinical Testing: Sample clinical images from the FONA device were evaluated as per the FDA guidance document for solid state digital X-ray panels and found to be clinically adequate.

Key Metrics (Sensitivity, Specificity, PPV, NPV, etc.)

Not Found

Predicate Device(s)

K151926

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 872.1800 Extraoral source x-ray system.

(a)
Identification. An extraoral source x-ray system is an AC-powered device that produces x-rays and is intended for dental radiographic examination and diagnosis of diseases of the teeth, jaw, and oral structures. The x-ray source (a tube) is located outside the mouth. This generic type of device may include patient and equipment supports and component parts.(b)
Classification. Class II.

0

August 30, 2021

Image /page/0/Picture/1 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.

FONA S.r.1. % Krupa Srivastava RA Consultant Via G. Galilei 11 Assago, Milan 20057 ITALY

Re: K212103

Trade/Device Name: StarX-1, StarX-2, StarX PRO-1 and StarX PRO-2 Regulation Number: 21 CFR 872.1800 Regulation Name: Extraoral source x-ray system Regulatory Class: Class II Product Code: MUH Dated: June 30, 2021 Received: July 6, 2021

Dear Krupa Srivastava:

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 requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part

1

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

Thalia T. Mills, Ph.D. Director Division of Radiological Health OHT7: Office of In Vitro Diagnostics and Radiological Health Office of Product Evaluation and Quality Center for Devices and Radiological Health

Enclosure

2

Indications for Use

510(k) Number (if known) K212103

Device Name StarX-1, StarX-2, StarX PRO-1 and StarX PRO-2

Indications for Use (Describe)

Acquisition of intraoral X-Ray image of the human dental arch. In particular:

• The STARX-1/ STARX PRO-1 sensors (active area 20 x 30 mm) allow to acquire the majority of intraoral images both vertically and horizontally.

· The STARX-2/ STARX PRO-2 sensors (active area 26 x 34 mm) allow to acquire horizontal bitewing images.

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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Image /page/3/Picture/0 description: The image shows the logo for FONA. The word "FONA" is written in large, gray, sans-serif letters. Above the word is a yellow arc. Below the word "FONA" are the words "CLOSER TO YOU" in smaller, gray, sans-serif letters.

K212103

510(k) SUMMARY

Date Prepared:

June 30, 2021

Submitters Information Name

Address

Contact Person

Contact Telephone

FONA s.r.l. Via G.Galilei 11 20057 Assago (MI), Italy Luigi Germanò +39 0245712171

Device Information

StarX-1, StarX-2, StarX PRO-1 and StarX Device/ Trade Name PRO-2 Intraoral Digital X-Ray Sensor Common Name Classification Name Extraoral source x-ray system 21 CFR 872.1800 Classification Regulation MUH Product code

Predicate Devices:

The following legally marketed predicate device has been chosen for the determination of substantial equivalence:

Trade NameQuick Ray HD
510(k) NumberK151926
Classification NameExtraoral source x-ray system
Classification Regulation21 CFR 872.1800
Product codeMUH

Indications for use

Acquisition of intraoral X-Ray image of the human dental arch. In particular:

  • The STARX-1/ STARX PRO-1 sensors (active area 20 x 30 mm) allow to ● acquire the majority of intraoral images both vertically and horizontally.
  • The STARX-2/ STARX PRO-2 sensors (active area 26 x 34 mm) allow to ● acquire horizontal bitewing images.

Traditional 510(k)- StarX & StarX PRC

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Image /page/4/Picture/0 description: The image shows the logo for FONA. The word "FONA" is written in large, bold, gray letters. Above the word "FONA" is a curved yellow line. Below the word "FONA" are the words "CLOSER TO YOU" in smaller, gray letters.

Device Description:

The StarX-1, StarX-2, StarX PRO-1 and the StarX PRO-2 are digital intraoral sensors based on CMOS technology for intraoral X-Ray image acquisition of the human dental arch. The sensors are available in two sizes; in particular:

  • . StarX-1 / StarX PRO-1 sensors: active area 20 x 30 mm
  • . StarX-2 / StarX PRO-2 sensors: active area 26 x 34 mm

The differences between the sensors are the sizes and the different kind of scintillator (Cesium lodide - Csl and Gadolinium Oxysulfide - GOS).

StarX-1, StarX-2, StarX PRO-1 and StarX PRO-2 are directly connected to the acquisition PC through the USB connection. Up to three sensors can be connected to one PC at time.

The type of X-ray systems that integrate with the sensors are wall-mounted Xray intraoral generators (both AC and DC) with a tube current between 1 and 15 mA inclusive, and with a tube voltage between 50 and 100 kV inclusive, with in-built controls to set exposure parameters. Generators allow variable mA/kV to be selected, which will control the exposure time.

The sensor is supplied with an acquisition (TWAIN) module to acquire images from the sensor via the USB. The user can further process these images via a patient management software to process, filter and modify images using a software such as the Oris Win DG software which is not part of this submission.

The device cannot act as an x-ray generator controller. All control of x-ray generation is done by controls built into the generator itself. There is no connection between the subject device and the x-ray generator. The subject device does not control the generator, it is a receiver only.

Before FONA sells this device, the team discuss the hardware and software requirements of the user to make sure that their systems are compatible with the FONA sensors.

FONA provides technical support for this device to ensure proper operation and to answer any questions regarding the functioning of the device. Contact details are provided to all end users and in the user manual.

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Image /page/5/Picture/0 description: The image shows the logo for FONA. The word "FONA" is written in large, gray, sans-serif letters. Below the word "FONA" is the phrase "CLOSER TO YOU" in smaller, gray, sans-serif letters. Above the word "FONA" is a yellow swoosh.

Substantial Equivalence:

The subject device and predicate device are identical in firmware/hardware and supplied by the same company, Hamamatsu. The firmware in the FONA devices has already been cleared in the Predicate Device.

The sensor technology and principle of operation remain the same. The FONA StarX-1 and StarX-2 utilise the GOS scintillator which work on similar principles as the CSi scintillator found in the StarX PRO and the predicate devices. Clinical as well as the Non-Clinical testing performed on these FONA devices do not raise any concern of safety or effectiveness as compared to the predicate device.

The predicate device comes with Xray Vision (OTS package from Apteryx, USA) which performs image acquisition, archiving, image enhancements, electronic transmission and diagnostic review system.

The FONA sensor is supplied only with an acquisition (TWAIN) module to acquire images from the sensor via the USB. The user can further process these images via a patient management software to process, filter and modify images using a software such as the Oris Win DG software which is not part of this submission.

A comparison of the FONA sensors to the predicate device is tabulated below:

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Image /page/6/Picture/0 description: The image shows the logo for FONA, a company that uses the tagline "Closer to You". The word "FONA" is written in large, bold, gray letters. Above the word "FONA" is a yellow swoosh. Below the word "FONA" is the tagline "Closer to You", which is written in smaller, gray letters.

Subject DevicePredicate Device
Device NameSTARX-1, STARX-2, STARX PRO-1 and STARX PRO-2Quick Ray HD
Manufacturer NameFONA S.r.lDenterprise International
Device Classification
Regulation21 CFR 872.180021 CFR 872.1800
Common NameIntraoral Digital X-Ray SensorIntraoral Digital X-Ray Sensor
Classification NameExtraoral Source X-Ray SystemExtraoral Source X-Ray System
Product Code(s)MUHMUH
Regulatory Class22
510(k)Not yet assignedK151926
Intended UseThe acquisition of intraoral X-Ray image of the
human dental arch. In particular:
• The size 1 sensor allows to acquire the majority
of intraoral images both vertically and
horizontally.
• The size 2 sensor allows to acquire horizontal
bitewing images.Radiographic examination to assist
with diagnosis of diseases of the teeth,
jaw, and oral structure.
The QuickRay HD dental sensor is
intended to replace film and to capture an
intraoral x-ray image, when exposed to X-
rays, for dental diagnostic purposes.
SoftwareTWAIN (Standard) Module which is a communication
protocol used for image acquisition only. It works with
any compatible patient management system.Xray Vision (OTS package from Apteryx,
USA) K983111- performs image
acquisition, archiving, image
enhancements, electronic transmission
and diagnostic review system.
Principles of
OperationX-ray (radiation) => scintillator (convert to light) =>
fiber optic (filtering) => CMOS (convert to digital) =>
electronics => PC (capture & display image)X-ray (radiation) => scintillator (convert to
light) => fiber optic (filtering) => CMOS
(convert to digital) => electronics => PC
(capture & display image)
Subject DevicePredicate Device
Device NameSTARX-1, STARX-2, STARX PRO-1 and STARX
PRO-2Quick Ray HD
Software-FirmwareFirmware combined on sensor electronic boardFirmware combined on sensor electronic
board
Sensor technologySTARX PRO: CMOS + Optical fiber plate + CSi
STARX: CMOS+ Optical Fiber plate + GOSCMOS chip + optical fiber plate + CSi
Matrix dimensions
(mm²)(Size 1) STARX-1 and STARX PRO-1: 600mm²
(Size 2) STARX-2 and STARX PRO-2: 884mm²Active area: 600mm² (Size 1)
884mm² (Size 2)
Matrix dimensions
(pixels)1000 x 1500 (STARX-1 and STARX PRO-1)
1300 x 1700 (STARX-2 and STARX PRO-2)1000 lines X 1500 columns (Size 1)
1300 X 1700 (Size 2).
ResolutionSTARX 12lp/mm
STARX PRO 20lp/mmReal ≥ 20lp/mm
Pixel Size20x20 µm20x20 µm
SterilizationNot sterile. Disinfect and useNot sterile. Disinfect and use
Shelf life/ Lifespan
CMOSMin. 125,000 cyclesMin. 100,000 cycles
Grey Levels14 bits14 bits
Sensor BoardAll control electronics directly integrated on CMOS
sensor chipAll control electronics directly integrated on
CMOS sensor chip
Sensor shellEnclosure for sensor is ABS and the flammability is
HB of UL-94 (UL File No.49895)Specific shape design; material is ABS and
the flammability is HB if YK- 94 (UL File
No. 49895)
Cable material and
designCable consists of PVC, ETFE, Copper, plug
connector and sensor connector, diameter ø3.7 ±0.3
and cable length of 2 metersCable consists of PVC, ETFE, copper, plug
connector and sensor connector, diameter
ø3.7 ±0.3 and cable length 2 meters.
Connection to
imaging practice PCUSB 2.0 High-SpeedUSB 2.0 High-Speed
Subject DevicePredicate Device
Device NameSTARX-1, STARX-2, STARX PRO-1 and STARX
PRO- 2Quick Ray HD
Operating
temperature0°C to 35°C0°C to 35°C
Sensor input voltage
and current5V (via USB connection); 0.15A Max5V (via USB connection); 0.15A Max
Performance
StandardsIEC 60601-1 (Electrical)
IEC 60601-1-2 (EMC)
IEC 60601-1-6 & IEC 62366-1 (Usability)
IEC 61223-3-4 (performance)
IEC 62220-1 (DQE-performance)
IEC 60529 (IP Code)IEC 60601-1 (Electrical);
IEC 60601-1-2 (EMC)
62220-1 (Performance)
60529 (IP Code)

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Image /page/7/Picture/0 description: The image shows the logo for FONA, a company that provides dental imaging solutions. The logo consists of the word "FONA" in large, gray, sans-serif font, with the tagline "CLOSER TO YOU" in smaller, gray, sans-serif font underneath. A yellow arc is positioned above the word "FONA", adding a visual element to the logo.

Traditional 510(k)- StarX & StarX PRO FONA S.r.l

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ll FONA S.r.l.– Socio Unico - Sede legale, 11 - 2005 Assago (M) Mala - Capitale Sociale Sociale Sociale Sociale Social .V.A.: 1283700159 - Isozione Registo Inpose di Milano REA:1606385 - Telefono: +39 02 45712171 - Fax: +39 02 45703385 - E-mail: info@fonaitaly.com - Web: www.fonadental.it

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Image /page/8/Picture/0 description: The image shows the logo for FONA, a company with the tagline "CLOSER TO YOU". The word "FONA" is written in large, bold, gray letters. Above the word "FONA" is a yellow curved line. Below the word "FONA" is the tagline "CLOSER TO YOU" in smaller, gray letters.

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ll FONA S.r.l.– Socio Unico - Sede legale, 11 - 2005 Assago (M) Mala - Capitale Sociale Sociale Sociale Sociale Social .V.A.: 1283700159 - Isozione Registo Inpose di Milano REA:1606385 - Telefono: +39 02 45712171 - Fax: +39 02 45703385 - E-mail: info@fonaitaly.com - Web: www.fonadental.it

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Image /page/9/Picture/0 description: The image shows the logo for FONA. The word "FONA" is written in large, gray, sans-serif letters. Above the word is a yellow arc. Below the word "FONA" is the phrase "CLOSER TO YOU" in smaller, gray, sans-serif letters.

The comparison table reveals there are no new technical issues of safety or effectiveness raised by the substitution of the scintillator. Professional evaluation of imaging samples were found to be of good quality, high resolution, clinically acceptable and substantially equivalent to the predicate device.

Summary of Non Clinical Testing: IEC standards have been employed for Electrical Safety, Electromagnetic Compatibility, performance and usability. The panel power supply is UL Listed. The CMOS area image sensor manufacturer conducted performance testing according to the FDA quidance document for solid state digital X-ray panels. Risk Analysis and System operation verification tests were conducted in accordance with FDA guidance documents. Labelling was developed to comply with the FDA solid state panel guidance document.

Summary of Clinical Testing: Sample clinical images from the FONA device were evaluated as per the FDA guidance document for solid state digital X-ray panels and found to be clinically adequate.

Conclusion: After analysing non-clinical data, electrical safety as well as clinical evaluation, it can be concluded that the FONA devices are as safe and effective as the predicate device, has few technological differences, and has no new intended use, thus rendering it substantially equivalent to the predicate device.