K Number
K221428
Date Cleared
2022-12-22

(220 days)

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

PerioStom™ Dental Dressing is an oral wound dressing intended as a physical barrier for temporary protection of oral mucosal tissue and to provide pain relief.

PerioStom™ Dental Dressing can be utilized for the pain relief and protection of oral mucosa due to irritation, trauma, or following iatrogenic procedures such as scaling and root planing.

Device Description

PerioStom™ Dental Dressing is a powder based wound dressing comprised entirely of spray-dried chitosan. PerioStom™ Dental Dressing is provided to the clinician in a stainless steel container and can be applied to the tissue via a dental instrument of their choice (e.g. a Prichard or Howard Periosteal Elevator) or a dry gloved finger. PerioStom™ Dental Dressing is also supplied in preloaded cartridges for application to harder to reach areas of the oral mucosa via the FS Dispenser™.

AI/ML Overview

This FDA submission describes a medical device, the PerioStom™ Dental Dressing, and seeks substantial equivalence to a predicate device. However, this submission does not contain information about acceptance criteria or a study that proves the device meets those criteria in the context of an AI/ML medical device.

The provided document describes a dental dressing, which is a physical barrier intended for temporary protection of oral mucosal tissue and to provide pain relief. This is a traditional medical device, not an AI/ML-driven device. Therefore, the requested information pertaining to AI/ML device testing (such as performance metrics like sensitivity/specificity, sample sizes for test/training sets, expert qualifications for ground truth, MRMC studies, standalone performance, etc.) is not applicable to this submission.

The document focuses on demonstrating substantial equivalence to a predicate device (HemCon® Dental Bandage K060363) through:

  • Comparison of technological characteristics: Both are spray-dried chitosan-based dressings that form a bioadherent gel.
  • Non-clinical performance testing: Viscosity, pH, microbial testing, and wound barrier testing. The results were found to be "substantially equivalent" for the subject and predicate devices.
  • Biocompatibility testing: According to ISO 10993 standards (Cytotoxicity, Sensitization, and Irritation/Intracutaneous Reactivity). The device met these requirements.

No clinical performance testing was conducted or deemed necessary for this type of device and submission.

Therefore, I cannot provide the requested table and information as it pertains to AI/ML device performance and testing. This document describes a non-AI physical medical device.

N/A