K Number
K220252
Device Name
High Retention Attachment System
Manufacturer
Date Cleared
2022-04-14

(73 days)

Product Code
Regulation Number
872.3630
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The High Retention Attachment System is designed to support fixed, partial or full arch restorations on endosseous dental implants in the mandible or maxilla for the purpose of restory function. It is used in fixed hybrid restorations that can be attached with a snap-in system. The High Retention Attachment System is compatible with the following implants: (list of compatible implants and diameters provided in the document).
Device Description
The High Retention Attachment System is a system that provides rigid connection of fixed, partial, and full arch restorations (fixed/detachable hybrid dentures) to endosseous dental implants. It consists of abutments, attachment housings, inserts and seating and removal tools. The abutments are provided in various cuff heights with the implant and abutment connection specific to the Zest Anchors, LLC or OEM implant. The subject device abutments are made of titanium alloy conforming to ASTM F136 Standard Specification for Wrought Titanium-6Aluminum-4Vanadium ELI (Extra Low Interstitial) Alloy for Surgical Implant Applications (UNS R56401) and are TiN (titanium nitride) coated. The High Retention Attachment System is as provided with an abutment (LOCATOR Attachment) and the surgical instrumentation necessary to place the implant. The High Retention Attachment System is designed to accommodate a path of insertion diverqence of up to 20° per implant and no more than 40° of divergence between implants.
More Information

No
The document describes a mechanical dental attachment system and does not mention any AI or ML components, image processing, or data-driven performance metrics.

No.

The device is designed to support dental restorations, not to directly treat or cure a disease or condition for therapeutic purposes.

No

The device is designed to support fixed, partial, or full arch restorations on dental implants to restore function, which is a therapeutic purpose, not a diagnostic one.

No

The device description explicitly states it consists of physical components like abutments, attachment housings, inserts, and tools, and is made of titanium alloy.

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

Here's why:

  • Intended Use: The intended use is to "support fixed, partial or full arch restorations on endosseous dental implants in the mandible or maxilla for the purpose of restory function." This describes a device used in vivo (within the body) for structural support and functional restoration, not for testing samples in vitro (outside the body) to diagnose a condition.
  • Device Description: The description details a system of physical components (abutments, housings, inserts, tools) made of materials like titanium alloy, designed for mechanical connection to dental implants. This aligns with a surgical or prosthetic device, not a diagnostic test.
  • Lack of Diagnostic Elements: There is no mention of analyzing biological samples (blood, tissue, etc.), detecting biomarkers, or providing diagnostic information about a patient's health status.
  • Performance Studies: The performance studies focus on mechanical properties (fatigue testing), sterilization, biocompatibility, and MR safety, which are relevant to implantable or surgically placed devices, not IVDs.

In summary, the High Retention Attachment System is a dental prosthetic attachment system, not a device used for in vitro diagnostic testing.

N/A

Intended Use / Indications for Use

The High Retention Attachment System is designed to support fixed, partial or full arch restorations on endosseous dental implants in the mandible or maxilla for the purpose of restory function. It is used in fixed hybrid restorations that can be attached with a snap-in system. The High Retention Attachment System is compatible with the following implants:

Implant ManufacturerImplant SystemImplant Diameter
Ace SurgicalInfinity OCTAGON3.3, 4.1, 4.8
Infinity TRI-CAM3.5, 4.3, 5.0
Infinity Internal Hex3.7, 4.1, 4.7, 5.1
BioHorizonsTapered Internal3.0
Tapered Plus3.8
Laser-Lok3.0
Biomet 3i3iT3, NanoTite, OSSEOTITE3.25, 3.75, 4.0
Blue Sky BioQuattro3.3, 4.1, 4.8
One Stage3.3, 4.1, 4.8
CamlogSCREW-LINE ROOT-LINE 23.3, 3.8, 4.3, 5.0
SCREW-LINE3.3, 3.8, 4.3, 5.0
DentsplyAstra Tech OsseoSpeed EV3.6, 4.2, 4.8
Xive Frialit-23.4, 3.8, 4.5, 5.5
Ankylos C/X3.5
Astra Tech OsseoSpeed TX3.5, 4.0, 4.5, 5.0
Hiossen, Inc.SS3.5, 4.0, 4.5
ET, TS3.5, 4.0, 4.5, 5.0, 6.0, 7.0
US3.5, 3.3, 4.5, 4.0, 5.0, 6.0, 7.0
Implant DirectSwish Plus4.1, 4.8
SwishTapered4.1, 4.8
InterActive3.2, 3.7, 4.3, 5.0
ReActive3.7, 4.2, 4.7, 5.7
RePlant3.5, 4.3, 5.0
Legacy 1, 2, 3, 43.7, 4.2
Legacy 2, 3, 43.2, 4.7, 5.2
Legacy 1, 35.7
Legacy 2, 45.7, 7.0
Legacy 14.7
IDSMegaGen Any Ridge3.5, 4.0, 4.5, 5.0, 5.5, 6.0, 6.5, 7.0, 7.5, 8.0
KeystonePrimaConnex3.5, 4.1, 5.0
Genesis3.5
TILOBEMAXX7.0, 8.0, 9.0
MISC13.3, 3.75, 4.2
V33.3, 3.9, 4.3, 5.0
SEVEN3.3
M43.3
NobelReplace, Replace Select, Nobel Speedy3.5, 4.3, 5.0
NobelActive, NobelParallel CC, NobelReplace CC3.5, 4.3, 5.5
Branemark, Nobel Speedy, Groovy3.3, 3.75, 4.0, 5.0
OCO BiomedicalEngage3.25, 4.0, 5.0
Southern ImplantsTri-Nex3.5, 4.3, 5.0
Tri-MAX77.0
StraumannRoxolid SLActive, Roxolid SLA3.3, 4.1, 4.8
Zest Dental SolutionsLocator Overdenture Implant System2.4, 2.9, 3.5, 3.9, 4.4, 4.9
Zimmer DentalTrabecular Metal, Tapered Screw-Vent, Screw-Vent, Advent3.7, 4.1, 4.7, 6.0
Spline Reliance Cylinder3.25, 4.0, 5.0
Spline Twist3.75

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

NHA

Device Description

The High Retention Attachment System is a system that provides rigid connection of fixed, partial, and full arch restorations (fixed/detachable hybrid dentures) to endosseous dental implants. It consists of abutments, attachment housings, inserts and seating and removal tools. The abutments are provided in various cuff heights with the implant and abutment connection specific to the Zest Anchors, LLC or OEM implant. The subject device abutments are made of titanium alloy conforming to ASTM F136 Standard Specification for Wrought Titanium-6Aluminum-4Vanadium ELI (Extra Low Interstitial) Alloy for Surgical Implant Applications (UNS R56401) and are TiN (titanium nitride) coated.

The High Retention Attachment System is as provided with an abutment (LOCATOR Attachment) and the surgical instrumentation necessary to place the implant.

The High Retention Attachment System is designed to accommodate a path of insertion diverqence of up to 20° per implant and no more than 40° of divergence between implants.

The abutments are identical to the High Retention Attachment System devices cleared in the predicate. K213391, with the main difference being an additional implant system compatibility. The additional compatible implant system, Zest Anchors, LLC's Locator Overdenture Implant (LODI) implants, were previously cleared in K120198 and K203701 and are included as reference devices, in the K220252 submission.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

mandible or maxilla

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)

No new testing was performed as a part of this submission for the determination of substantial equivalence. Fatigue testing according to ISO 14801: 2016 was performed for Zest Anchors, LLC's Locator Overdenture Implant (LODI) implants (K120198/K203701) and leveraged to support modifications to the K213391 compatibility table. Fatigue testing, sterilization, and biocompatibility testing are all leveraged from previous submissions. MR safety for the subject device system was based on the "worst-case" of the entire system including all variations (all compatible implant bodies, dental abutments, and fixation screws) and material composition. The "worst-case" assessment includes an evaluation of the High Retention Attachment System devices in the MRI environment using scientific rationale and published literature (i.e., Woods, Terry O., Jana G. Delfino, and Sunder Rajan. "Assessment of Magnetically Induced Displacement Force and Torque on Metal Alloys Used in Medical Devices." Journal of Testing and Evaluation 49.2 (2019): 783-795). In addition, the "worst-case" MR Safety rationale addressed parameters per the FDA guidance, "Testing and Labeling Medical Devices for Safety in the Magnetic Resonance (MR) Environment," including magnetically induced displacement force and torque.

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

Not Found

Predicate Device(s): If the device was cleared using the 510(k) pathway, identify the Predicate Device(s) K/DEN number used to claim substantial equivalence and list them here in a comma separated list exactly as they appear in the text. List the primary predicate first in the list.

K213391

Reference Device(s): Identify the Reference Device(s) K/DEN number and list them here in a comma separated list exactly as they appear in the text.

K120198, K203701

Predetermined Change Control Plan (PCCP) - All Relevant Information for the subject device only (e.g. presence / absence, what scope was granted / cleared under the PCCP, any restrictions, etc).

Not Found

§ 872.3630 Endosseous dental implant abutment.

(a)
Identification. An endosseous dental implant abutment is a premanufactured prosthetic component directly connected to the endosseous dental implant and is intended for use as an aid in prosthetic rehabilitation.(b)
Classification. Class II (special controls). 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.)

0

Image /page/0/Picture/0 description: The image contains 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.

Zest Anchors, LLC Richard Hines Regulatory Affairs Manager 2875 Loker East Carlsbad, California 92026

Re: K220252

Trade/Device Name: High Retention Attachment System Regulation Number: 21 CFR 872.3630 Regulation Name: Endosseous Dental Implant Abutment Regulatory Class: Class II Product Code: NHA Dated: March 24, 2022 Received: March 28, 2022

Dear Richard Hines:

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

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

1

Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencies. You must comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); medical device reporting of medical device-related adverse events) (21 CFR 803) for devices or postmarketing safety reporting (21 CFR 4, Subpart B) for combination products (see https://www.fda.gov/combination-products/guidance-regulatory-information/postmarketing-safety-reportingcombination-products); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820) for devices or current good manufacturing practices (21 CFR 4, Subpart A) for combination products; and, if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to https://www.fda.gov/medical-device-safety/medical-device-reportingmdr-how-report-medical-device-problems.

For comprehensive regulatory information about 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

2

Indications for Use

510(k) Number (if known)

K220252

Device Name

High Retention Attachment System

Indications for Use (Describe)

The High Retention Attachment System is designed to support fixed, partial or full arch restorations on endosseous dental implants in the mandible or maxilla for the purpose of restory function. It is used in fixed hybrid restorations that can be attached with a snap-in system. The High Retention Attachment System is compatible with the following implants:

Implant ManufacturerImplant SystemImplant Diameter
Ace SurgicalInfinity OCTAGON3.3, 4.1, 4.8
Infinity TRI-CAM3.5, 4.3, 5.0
Infinity Internal Hex3.7, 4.1, 4.7, 5.1
BioHorizonsTapered Internal3.0
Tapered Plus3.8
Laser-Lok3.0
Biomet 3i3iT3, NanoTite, OSSEOTITE3.25, 3.75, 4.0
Blue Sky BioQuattro3.3, 4.1, 4.8
One Stage3.3, 4.1, 4.8
CamlogSCREW-LINE ROOT-LINE 23.3, 3.8, 4.3, 5.0
SCREW-LINE3.3, 3.8, 4.3, 5.0
DentsplyAstra Tech OsseoSpeed EV3.6, 4.2, 4.8
Xive Frialit-23.4, 3.8, 4.5, 5.5
Ankylos C/X3.5
Astra Tech OsseoSpeed TX3.5, 4.0, 4.5, 5.0
Hiossen, Inc.SS3.5, 4.0, 4.5
ET, TS3.5, 4.0, 4.5, 5.0, 6.0, 7.0
US3.5, 3.3, 4.5, 4.0, 5.0, 6.0, 7.0
Implant DirectSwish Plus4.1, 4.8
SwishTapered4.1, 4.8
InterActive3.2, 3.7, 4.3, 5.0
ReActive3.7, 4.2, 4.7, 5.7
RePlant3.5, 4.3, 5.0
Legacy 1, 2, 3, 43.7, 4.2
Legacy 2, 3, 43.2, 4.7, 5.2
Legacy 1, 35.7
Legacy 2, 45.7, 7.0
Legacy 14.7
IDSMegaGen Any Ridge3.5, 4.0, 4.5, 5.0, 5.5, 6.0, 6.5, 7.0, 7.5, 8.0
KeystonePrimaConnex3.5, 4.1, 5.0
Genesis3.5
TILOBEMAXX7.0, 8.0, 9.0
MISC13.3, 3.75, 4.2
V33.3, 3.9, 4.3, 5.0
SEVEN3.3
M43.3
NobelReplace, Replace Select, Nobel Speedy3.5, 4.3, 5.0
NobelActive, NobelParallel CC, NobelReplace CC3.5, 4.3, 5.5
Branemark, Nobel Speedy, Groovy3.3, 3.75, 4.0, 5.0
OCO BiomedicalEngage3.25, 4.0, 5.0
Southern ImplantsTri-Nex3.5, 4.3, 5.0
Tri-MAX77.0
StraumannRoxolid SLActive, Roxolid SLA3.3, 4.1, 4.8
Zest Dental SolutionsLocator Overdenture Implant System2.4, 2.9, 3.5, 3.9, 4.4, 4.9
Zimmer DentalTrabecular Metal, Tapered Screw-Vent, Screw-Vent,
Advent3.7, 4.1, 4.7, 6.0
Spline Reliance Cylinder3.25, 4.0, 5.0
Spline Twist3.75

3

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/4/Picture/0 description: The image shows the logo for Zest Dental Solutions. The logo has the letters "ZD" in a bold, teal font on the left side. To the right of the letters, the words "ZEST DENTAL" are written in a bold, dark teal font, with the word "SOLUTIONS" written in a lighter teal font below it. The logo is simple and modern, and the colors are clean and professional.

510(K) Summary – K220252 High Retention Attachment System

i. General Information on Submitter

Applicant:Zest Anchors, LLC
Address:2875 Loker Avenue, East
Carlsbad, CA 92010 USA
Telephone:442-244-4835, ext. 480
Cellphone:949-395-8795
Contact Person:Richard Hines
Contact Title:Regulatory Affairs Manager
Email:richard.hines@zestdent.com
Date Prepared:April 13, 2022
Establishment Registration:3006796211

ii. General Information on Device

Proprietary Name:High Retention Attachment System
Common Name:Dental Implant Abutment
Classification Name:Endosseous dental implant abutment
(21 CFR 872.3630)
Regulatory Class:II
Product Code:NHA (Abutment, Implant, Dental, Endosseous)
  • iii. Predicate Device
Predicate Device510(k) Number
High Retention Attachment System: Zest Anchors, LLCK213391
Reference Devices510(k) Number
Locator Overdenture Implant System, Zest Anchors, LLCK120198
Locator Overdenture Implant System, Zest Anchors, LLCK203701

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Image /page/5/Picture/0 description: The image shows the logo for Zest Dental Solutions. The logo has the letters "ZD" on the left side in a blue gradient color. To the right of the letters is the text "ZEST DENTAL" in a bold, sans-serif font, with the word "SOLUTIONS" underneath in a smaller font.

iv. Description of Device

The High Retention Attachment System is a system that provides rigid connection of fixed, partial, and full arch restorations (fixed/detachable hybrid dentures) to endosseous dental implants. It consists of abutments, attachment housings, inserts and seating and removal tools. The abutments are provided in various cuff heights with the implant and abutment connection specific to the Zest Anchors, LLC or OEM implant. The subject device abutments are made of titanium alloy conforming to ASTM F136 Standard Specification for Wrought Titanium-6Aluminum-4Vanadium ELI (Extra Low Interstitial) Alloy for Surgical Implant Applications (UNS R56401) and are TiN (titanium nitride) coated.

The High Retention Attachment System is as provided with an abutment (LOCATOR Attachment) and the surgical instrumentation necessary to place the implant.

The High Retention Attachment System is designed to accommodate a path of insertion diverqence of up to 20° per implant and no more than 40° of divergence between implants.

The abutments are identical to the High Retention Attachment System devices cleared in the predicate. K213391, with the main difference being an additional implant system compatibility. The additional compatible implant system, Zest Anchors, LLC's Locator Overdenture Implant (LODI) implants, were previously cleared in K120198 and K203701 and are included as reference devices, in the K220252 submission.

6

Image /page/6/Picture/0 description: The image is a logo for Zest Dental Solutions. The logo features the letters "ZD" in a bold, blue font on the left side. To the right of the letters, the words "ZEST DENTAL" are written in a dark blue, sans-serif font. Below "ZEST DENTAL", the word "SOLUTIONS" is written in a smaller, light blue font.

Indication for Use V.

The High Retention System is designed to support fixed, partial or full arch restorations on endosseous dental implants in the mandible or maxilla for the purpose of restoring masticatory function. It is used in fixed hybrid restorations that can be attached with a snap-in system. The High Retention Attachment System is compatible with the following implants:

Implant ManufacturerImplant SystemImplant Diameter
Ace SurgicalInfinity OCTAGON3.3, 4.1, 4.8
Infinity TRI-CAM3.5, 4.3, 5.0
Infinity Internal Hex3.7, 4.1, 4.7, 5.1
BioHorizonsTapered Internal3.0
Tapered Plus3.8
Laser-Lok3.0
Biomet 3i3iT3, NanoTite, OSSEOTITE3.25, 3.75, 4.0
Blue Sky BioQuattro3.3, 4.1, 4.8
One Stage3.3, 4.1, 4.8
CamlogSCREW-LINE ROOT-LINE 23.3, 3.8, 4.3, 5.0
SCREW-LINE3.3, 3.8, 4.3, 5.0
DentsplyAstra Tech OsseoSpeed EV3.6, 4.2, 4.8
Xive Frialit-23.4, 3.8, 4.5, 5.5
Ankylos C/X3.5
Astra Tech OsseoSpeed TX3.5, 4.0, 4.5, 5.0
Hiossen, Inc.SS3.5, 4.0, 4.5
ET, TS3.5, 4.0, 4.5, 5.0, 6.0, 7.0
US3.5, 3.3, 4.5, 4.0, 5.0, 6.0, 7.0
Implant DirectSwish Plus4.1, 4.8
SwishTapered4.1, 4.8
InterActive3.2, 3.7, 4.3, 5.0
ReActive3.7, 4.2, 4.7, 5.7
RePlant3.5, 4.3, 5.0
Legacy 1, 2, 3, 43.7, 4.2
Legacy 2, 3, 43.2, 4.7, 5.2
Legacy 1, 35.7
Legacy 2, 45.7, 7.0
Legacy 14.7
IDSMegaGen Any Ridge3.5, 4.0, 4.5, 5.0, 5.5, 6.0, 6.5, 7.0, 7.5, 8.0
KeystonePrimaConnex3.5, 4.1, 5.0
Genesis3.5
TILOBEMAXX7.0, 8.0, 9.0
MISC13.3, 3.75, 4.2
V33.3, 3.9, 4.3, 5.0
SEVEN3.3
M43.3
NobelReplace, Replace Select, NobelSpeedy3.5, 4.3, 5.0
NobelActive, NobelParallel CC, NobelReplace CC3.5, 4.3, 5.5
Branemark, Nobel Speedy, Groovy3.3, 3.75, 4.0, 5.0
OCO BiomedicalEngage3.25, 4.0, 5.0
Southern ImplantsTri-Nex3.5, 4.3, 5.0
Tri-MAX77.0
StraumannRoxolid SLActive, Roxolid SLA3.3, 4.1, 4.8
Zest Dental SolutionsLocator Overdenture Implant System2.4, 2.9, 3.5, 3.9, 4.4, 4.9
Zimmer DentalTrabecular Metal, Tapered Screw-Vent, Screw-
Vent, Advent3.7, 4.1, 4.7, 6.0
Spline Reliance Cylinder3.25, 4.0, 5.0
Spline Twist3.75

7

Image /page/7/Picture/0 description: The image contains the logo for Zest Dental Solutions. The logo features the letters "ZD" in a bold, blue font on the left side. To the right of the letters, the words "ZEST DENTAL" are stacked on top of the word "SOLUTIONS" in a smaller, blue font. The logo is simple and professional, and it is likely used to represent the company's brand.

vi. Predicate Device Comparison

The following table compares the Indications for Use and key technological

characteristics of the subject and predicate device:

| Characteristic
/ Feature | High Retention
Attachment System
(Subject Device) | High Retention
Attachment
System
(Predicate Device

  • K213391) | Locator
    Overdenture
    Implant System
    (Reference
    Device #1 -
    K120198) | The Locator
    Overdenture
    Implant System
    (Reference
    Device #2 -
    K203701) | Comparison |
    |--------------------------------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
    | Reason for
    predicate or
    reference | n/a | Indications, function,
    material of insert,
    mechanical (retention)
    performance | Design of implant added to compatibility table | | Predicate is unchanged and
    reference device is added to
    cleared compatibility table |
    | Indication
    for use | Locator High
    Retention
    Attachment System
    is designed to
    support fixed, partial
    or full arch
    restorations on
    endosseous dental
    implants in the
    mandible or maxilla
    for the purpose of
    restoring masticatory
    function. It is used in
    fixed hybrid
    restorations that can
    be attached with a
    snap-in system. | High Retention
    Attachment System is
    designed to support
    fixed, partial or full arch
    restorations on
    endosseous dental
    implants in the mandible
    or maxilla for the purpose
    of restoring masticatory
    function. It is used in
    fixed hybrid restorations
    that can be attached with
    a snap-in system. | Locator
    Overdenture
    Implant System is
    designed to retain
    overdentures or
    partial dentures in
    the mandible or
    maxilla. | The Locator
    Overdenture
    Implant System is
    designed to retain
    overdentures or
    partial dentures in
    the mandible or
    maxilla.
    Immediate loading is
    indicated when good
    primary stability has
    been achieved and with
    appropriate occlusal
    loading. | Similar:
    The subject and the primary
    predicate K223391 have identical
    indications for use, with the
    exception of an additional implant
    system compatibility for the subject
    devices.
    The additional compatible implant
    system, Zest Anchors, LLC's
    Locator Overdenture Implant
    (LODI) implants, were previously
    cleared in K120198 and K203701,
    and are included as reference
    devices. |
    | FDA
    Product
    Code | NHA (Abutment, Implant,
    Dental, Endosseous) 21 CFR
    872.3630 | NHA (Abutment,
    Implant, Dental,
    Endosseous) 21
    CFR 872.3630 | DZE (Implant,
    Endossesous,
    Root-Form) 21
    CFR 872.3640 | DZE (Implant,
    Endossesous, Root-
    Form) 21 CFR
    872.3640 | Substantially Equivalent:
    The subject device have
    demonstrated substantial
    equivalence to the primary
    predicate device, K213391, in that
    they utilize identical materials,
    fundamental designs, intended
    use and principles of operation.
    The reference devices, K120198
    and K203701, are only included
    as reference devices for additional
    implant system compatibilities. |
    | | | | DESIGN | | |
    | Abutment
    platform
    diameter | 2.3 mm to 7.0 mm,
    multiple systems | 2.3 mm to 7.0
    mm, multiple
    systems | N/A | N/A | Substantially Equivalent.
    Predicate and subject
    abutment platform
    diameters are identical. |
    | Abutment
    angle | Straight | Straight | N/A | N/A | Substantially Equivalent.
    Predicate and subject abutment
    angles are identical |
    | Abutment /
    implant
    interface | Conical, External Hex,
    Internal Hex, Internal
    Multi Lobe | Conical,
    External Hex,
    Internal Hex,
    Internal Multi
    Lobe | External Hex | External Hex | Substantially Equivalent.
    Predicate and subject device
    abutment/implant interfaces are
    identical. |
    | | | | | | |
    | Divergence
    Allowance | 20°/40° (except when
    not allowed by the
    implant manufacturer) | 20°/40° (except
    when not allowed
    by the implant
    manufacturer) | N/A | N/A | Substantially Equivalent.
    Divergence allowance is
    unchanged from the predicate
    device. |
    | Prosthesis
    attachment
    type | PEEK insert retained
    in denture attachment
    housing | PEEK insert
    retained in
    denture
    attachment
    housing | N/A | N/A | Substantially Equivalent.
    Predicate and subject device
    prosthesis attachment type are
    identical. |
    | Materials | | | | | |
    | Abutment
    or Implant
    Material | Abutment: Ti-6AI-4V
    ELI | Abutment: Ti-
    6AI-4V ELI | Implant: Ti
    6AI-4V ELI | Implant: Ti
    6AI-4V ELI | Substantially Equivalent.
    both the abutment and the
    implants in the subject,
    predicate, and reference
    devices are made from the
    same titanium alloy (Ti-6Al-
    4V ELI). |
    | Device
    Material
    Surface
    Treatment | Abutment: TiN | Abutment: TiN | Implant:
    Resorbable
    Blast Media
    (RBM) using
    MCD Apatatic
    Abrasive | Implant:
    Resorbable
    Blast Media
    (RBM) using
    MCD Apatatic
    Abrasive | Substantially Equivalent.
    Predicate and subject device use
    identical surface treatment
    process. |
    | Prosthetic
    retention
    component | PEEK | PEEK | N/A | N/A | Substantially Equivalent.
    Predicate and subject device
    retention components are
    identical. |
    | Reference
    Implant
    Size | N/A | N/A | 2.4mm, 2.9mm | 3.5mm, 3.9mm,
    4.4mm, 4.9mm | Reference Devices are cleared
    for implants of 2.4mm to 4.9mm
    in diameter |
    | Sterilization | | | | | |
    | Sterile | No | No | Yes | Yes | Substantially Equivalent.
    Predicate and subject device are
    both supplied non-sterile. |

8

Image /page/8/Picture/0 description: The image shows the logo for Zest Dental Solutions. The logo has the letters "ZD" in a bold, blue font on the left side. To the right of the letters are the words "ZEST DENTAL" in a smaller, blue font, with the word "SOLUTIONS" underneath in a lighter blue. The logo is simple and modern, and the use of blue gives it a professional and trustworthy feel.

As noted in the table above, the subject and predicate devices are identical. Fatigue testing according to ISO 14801: 2016 was performed for Zest Anchors, LLC's Locator Overdenture Implant (LODI) implants (K120198/K203701) and leveraged to support modifications to the K213391 compatibility table.

Summary of Non-Clinical Performance Testing vii.

No new testing was performed as a part of this submission for the determination of substantial equivalence.

Fatigue testing, sterilization, and biocompatibility testing are all leveraged from previous submissions

9

Image /page/9/Picture/0 description: The image shows the logo for Zest Dental Solutions. The logo features the letters "ZD" in a bold, blue font on the left side. To the right of the letters, the words "ZEST DENTAL" are written in a similar bold, blue font. Below "ZEST DENTAL", the word "SOLUTIONS" is written in a lighter blue color.

MR safety for the subject device system was based on the "worst-case" of the entire system including all variations (all compatible implant bodies, dental abutments, and fixation screws) and material composition. The "worst-case" assessment includes an evaluation of the High Retention Attachment System devices in the MRI environment using scientific rationale and published literature (i.e., Woods, Terry O., Jana G. Delfino, and Sunder Rajan. "Assessment of Magnetically Induced Displacement Force and Torque on Metal Alloys Used in Medical Devices." Journal of Testing and Evaluation 49.2 (2019): 783-795).

In addition, the "worst-case" MR Safety rationale addressed parameters per the FDA guidance, "Testing and Labeling Medical Devices for Safety in the Magnetic Resonance (MR) Environment," including magnetically induced displacement force and torque.

viii. Substantial Equivalence

The risk management activities and results of the other activities described above provide reasonable assurance that the subject devices have demonstrated substantial equivalence to the predicate devices in the that they utilize the same materials and fundamental designs and also have the same intended use and principles of operation.