K Number
K222778
Device Name
Osstem Implant System
Date Cleared
2023-09-23

(374 days)

Product Code
Regulation Number
872.3640
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Osstem Implant System is indicated for use in partially or fully edentulous mandibles and maxillae, in support of single or multiple-units restorations including; cemented retained, or overdenture restorations, and final or temporary abutment support for fixed bridgework. It is intended for delayed loading. Ultra wide Implant System is intended to be used in the molar region. Products with diameter of less than 3.25mm should be used exclusively for the lateral incisor in the maxilla and a central or lateral incisor in the mandible.
Device Description
The Osstem Implant System is a dental implant made of titanium metal intended to be surgically placed in the bone of the upper or lower jaw arches. The Ultra-Wide implants are intended to be used only to replace molar teeth and angled abutments are not to be used with the Ultra-Wide implants. Osstem Implant System is similar to other commercially available products based on the intended use, technology used, claims, material composition employed and performance characteristics.
More Information

No
The summary describes a dental implant system made of titanium and focuses on its mechanical properties, biocompatibility, and sterilization. There is no mention of AI, ML, image processing, or data sets typically associated with AI/ML technologies.

No
The device is described as a dental implant system used to support restorations in partially or fully edentulous mandibles and maxillae, which falls under the category of a prosthetic or restorative device rather than one that directly treats a disease or condition.

No

The device description clearly states it is a "dental implant made of titanium metal intended to be surgically placed in the bone," indicating it is a prosthetic or restorative device, not one used for diagnosis.

No

The device description explicitly states it is a dental implant made of titanium metal, which is a physical hardware component. The performance studies also focus on physical properties like fatigue, sterilization, and biocompatibility.

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

Here's why:

  • Intended Use: The intended use clearly describes a surgically implanted device used to support dental restorations in the jawbone. This is a direct medical intervention, not a test performed on samples taken from the body to diagnose or monitor a condition.
  • Device Description: The description confirms it's a dental implant made of titanium, surgically placed in the bone.
  • Lack of IVD Characteristics: There is no mention of analyzing samples (blood, urine, tissue, etc.), detecting biomarkers, or providing diagnostic information. The device's function is mechanical support for dental prosthetics.

Therefore, the Osstem Implant System falls under the category of a surgical implant, not an In Vitro Diagnostic device.

N/A

Intended Use / Indications for Use

The Osstem Implant System is indicated for use in partially or fully edentulous mandibles and maxillae, in support of single or multiple-units restorations including; cemented retained, or overdenture restorations, and final or temporary abutment support for fixed bridgework. It is intended for delayed loading. Ultra wide Implant System is intended to be used in the molar region.

Products with diameter of less than 3.25mm should be used exclusively for the lateral incisor in the maxilla and a central or lateral incisor in the mandible.

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

DZE, NHA

Device Description

The Osstem Implant System is a dental implant made of titanium metal intended to be surgically placed in the bone of the upper or lower jaw arches. The Ultra-Wide implants are intended to be used only to replace molar teeth and angled abutments are not to be used with the Ultra-Wide implants.

Osstem Implant System is similar to other commercially available products based on the intended use, technology used, claims, material composition employed and performance characteristics.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

mandibles and maxillae

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)

Below tests were performed on subject device:

  • Fatigue Testing under the worst-case scenario according to ISO 14801:2016

Below tests were performed for predicate devices and leveraged for the subject device:

  • Gamma Sterilization Validation Test on Implants according to ISO 11137-1,2,3 referenced in K121585
  • . Shelf-Life Test on Implants according to ASTM F1980 referenced in K121585
  • . Biocompatibility testing according to ISO 10993-1:2009, ISO 10993-6:2007, ISO 10993-10:2006, ISO 10993-11:2006 referenced in K121995
  • . Bacterial Endotoxin Test Report on implants according to ISO 10993-11:2006 and USP referenced in K161604

The results of the above tests have met the standards and demonstrated the substantial equivalence with the predicate device.

Validation of the gamma irradiation process was previously conducted for the predicate device, K121585. There has been no change to the manufacturing or sterilization processes.

The Biocompatibility Test was conducted on the predicate device and leveraged for the subject device because both products are manufactured with same materials, manufacturing process etc. It demonstrates that the subject device is biocompatible and substantial equivalence with the predicate.

The non-clinical testing result demonstrate that the subject device is substantially equivalent to the predicate device.

Osstem Implant System has SA (Sand blasted and Acid etched surface treatment that is exactly same with the predicate devices, K121585. There has been no change to the manufacturing or surface treatment processes.

Fatigue testing was considered according to the FDA Guidance for Industry and FDA Staff Class II Special Controls Guidance Document Root-form Endosseous Dental Inplants and Endosseous Dental Abutment and ISO 14801 standard with the worst case scenario.

For proposed TSIII SA Implant (Non-Hex), fatigue testing was conducted according to ISO 14801:2016 Dental-implants Dynamic Fatigue Test for Endosseous Dental Implants. The worst-case implant-abutment combination of the proposed device was chosen based on the FDA Guidance, ClassII Special Controls Guidance Document: Root-form Endosseous Dental Implants and Endosseous Dental Implant Abutments. Test results demonstrate that the proposed devices perform as intended and support substantial equivalence to the predicate devices.

Non-clinical worst-case MRI review was performed to evaluate the Subject device components in the MRI environment using scientific rationale and published literature (e.g., 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), based on the entire system including all compatible implant bodies, abutments, and fixation screws) and material composition. 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.

No clinical studies are submitted.

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.

K161604

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.

K121995, K163557, K163634

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

§ 872.3640 Endosseous dental implant.

(a)
Identification. An endosseous dental implant is a prescription device made of a material such as titanium or titanium alloy that is intended to be surgically placed in the bone of the upper or lower jaw arches to provide support for prosthetic devices, such as artificial teeth, in order to restore a patient's chewing function.(b)
Classification. (1) Class II (special controls). The device is classified as class II if it is a root-form endosseous dental implant. The root-form endosseous dental implant is characterized by four geometrically distinct types: Basket, screw, solid cylinder, and hollow cylinder. 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.)(2)
Classification. Class II (special controls). The device is classified as class II if it is a blade-form endosseous dental implant. The special controls for this device are:(i) The design characteristics of the device must ensure that the geometry and material composition are consistent with the intended use;
(ii) Mechanical performance (fatigue) testing under simulated physiological conditions to demonstrate maximum load (endurance limit) when the device is subjected to compressive and shear loads;
(iii) Corrosion testing under simulated physiological conditions to demonstrate corrosion potential of each metal or alloy, couple potential for an assembled dissimilar metal implant system, and corrosion rate for an assembled dissimilar metal implant system;
(iv) The device must be demonstrated to be biocompatible;
(v) Sterility testing must demonstrate the sterility of the device;
(vi) Performance testing to evaluate the compatibility of the device in a magnetic resonance (MR) environment;
(vii) Labeling must include a clear description of the technological features, how the device should be used in patients, detailed surgical protocol and restoration procedures, relevant precautions and warnings based on the clinical use of the device, and qualifications and training requirements for device users including technicians and clinicians;
(viii) Patient labeling must contain a description of how the device works, how the device is placed, how the patient needs to care for the implant, possible adverse events and how to report any complications; and
(ix) Documented clinical experience must demonstrate safe and effective use and capture any adverse events observed during clinical use.

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.

Osstem Implant CO., LTD. % Peter Lee RA/QA Manager HioSSEN Inc. 85 Ben Fariless Dr. Fariless Hills, Pennsylvania 19030

Re: K222778

Trade/Device Name: Osstem Implant System Regulation Number: 21 CFR 872.3640 Regulation Name: Endosseous Dental Implant Regulatory Class: Class II Product Code: DZE Dated: July 3, 2023 Received: August 9, 2023

Dear Peter Lee:

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.

U.S. Food & Drug Administration 10903 New Hampshire Avenue Silver Spring, MD 20993 www.fda.gov

9/23/23

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.

Sherrill Lathrop Blitzer

for Andrew 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 Quality Center for Devices and Radiological Health

2

Indications for Use

510(k) Number (if known)

K222778

Device Name OSSTEM Implant System

Indications for Use (Describe)

The Osstem Implant System is indicated for use in partially or fully edentulous mandibles and maxillae, in support of single or multiple-units restorations including; cemented retained, or overdenture restorations, and final or temporary abutment support for fixed bridgework. It is intended for delayed loading. Ultra wide Implant System is intended to be used in the molar region.

Products with diameter of less than 3.25mm should be used exclusively for the lateral incisor in the maxilla and a central or lateral incisor in the mandible.

X Prescription Use (Part 21 CFR 801 Subpart D)

Over-The-Counter Use (21 CFR 801 Subpart C)

CONTINUE ON A SEPARATE PAGE IF NEEDED.

This section applies only to requirements of the Paperwork Reduction Act of 1995.

DO NOT SEND YOUR COMPLETED FORM TO THE PRA STAFF EMAIL ADDRESS BELOW.

The burden time for this collection of information is estimated to average 79 hours per response, including the time to review instructions, search existing data sources, gather and maintain the data needed and complete and review the collection of information. Send comments regarding this burden estimate or any other aspect of this information collection, including suggestions for reducing this burden, to:

Department of Health and Human Services Food and Drug Administration Office of Chief Information Officer Paperwork Reduction Act (PRA) Staff PRAStaff(@fda.hhs.gov

"An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB number."

3

510(k) Summary

Date: September 23, 2023

Company and Correspondent making the submission 1.

  • Submitter's Name -Osstem Implant Co., Ltd. : -Address : 66-16, Bansong-ro 513beon-gil, Haeundae-gu, Busan, 48002, Republic of Korea Contact Ms. Seungju Kang -: +82-51-850-2500 -Phone : Correspondent's Name Hiossen Inc. : --Address : 85 Ben Fairless Dr. Fairless Hills, PA 19030 Contact Mr. Peter Lee -: -Phone +1-267-759-7031 :

2. Proposed Device

  • -Trade or (Proprietary) Name Osstem Implant System : -Classification Name Endosseous dental implant : Regulation Number 21CFR872.3640 -. •
  • Devce Classification Class II -:
  • Classification Product Code -DZE :
  • -Subsequent Product Code NHA . •

3. Predicate Device

Primary Predicate
K161604OSSTEM Implant System
Reference Device
K121995TS Fixture System
K163557SS SA Fixture
K163634External Hex Implants

4. Indication for use

The Osstem Implant System is indicated for use in partially or fully edentulous mandibles and maxillae, in support of single or multiple-units restorations including; cemented retained, or overdenture restorations, and final or temporary abutment support for fixed bridgework. It is intended for delayed loading. Ultra wide Implant System is intended to be used in the molar region.

Products with diameter of less than 3.25mm should be used exclusively for the lateral incisor in the maxilla and a central or lateral incisor in the mandible.

4

Image /page/4/Picture/2 description: The image contains the logo for Osstem Implant. The logo is orange and gray. The word "OSSTEM" is in orange, and the word "IMPLANT" is in gray. There is a small circle above the right side of the word "OSSTEM".

OSSTEM Implant Co., Ltd. 66-16, Bansong-ro 513beon-gil, Haeundae-gu, Busan, Republic of Korea

Tel: +82 51 850 2500 Fax: +82 51 861 4693 www.osstem.com

5. Device Description

The Osstem Implant System is a dental implant made of titanium metal intended to be surgically placed in the bone of the upper or lower jaw arches. The Ultra-Wide implants are intended to be used only to replace molar teeth and angled abutments are not to be used with the Ultra-Wide implants.

Osstem Implant System is similar to other commercially available products based on the intended use, technology used, claims, material composition employed and performance characteristics.

DeviceDescriptionContent
TSIII SA ImplantDescriptionIntended to be surgically placed in the bone of the upper or lower jaw arches.
MaterialTitanium Grade 4 (ASTM F67)
SurfaceSA surface treatment
Diameter (D) and Length (L)ø3.75 x L 18, 20 mm
ø3.77 x L 7 mm
ø4.25 x L 7 mm
ø4.65 x L 7 mm
ø5.45 x L 10, 11.5, 13, 15 mm
ø5.48 x L 8.5 mm
ø5.5 x L 7mm
TSIII SA Implant (Non-Hex) Ø3.2DescriptionIntended to be surgically placed in the bone of the upper or lower jaw arches.
MaterialTitanium Alloy (ASTM F136)
SurfaceSA surface treatment
Diameter (D) and Length (L)ø3.2 x L 8.5, 10, 11.5, 13, 15 mm
TSIII SA Implant (Non-Hex)DescriptionIntended to be surgically placed in the bone of the upper or lower jaw arches.
MaterialTitanium Grade 4 (ASTM F67)
SurfaceSA surface treatment
Diameter (D) and Length (L)ø3.75 x L 10, 11.5, 13 mm
ø3.77 x L 8.5 mm
ø3.8 x L 8.5, 10, 11.5, 13, 15, 18 mm
ø4.2 x L 10, 11.5, 13, 15, 18 mm
ø4.25 x L 7, 8.5 mm
04.6 x L 10, 11.5, 13, 15, 18 mm
ø4.63 x L 8.5 mm
ø4.65 x L 7 mm
05.05 x L 10, 11.5, 13, 15, 18 mm
05.08 x L 8.5 mm
ø5.1 x L 7 mm
TSIV SA ImplantDescriptionIntended to be surgically placed in the bone of the upper or lower jaw arches.
MaterialTitanium Grade 4 (ASTM F67)
SurfaceSA surface treatment
Diameter (D) and Length (L)ø4.4 x L 18 mm
04 8 x L. 18 mm

The specifications of the proposed device are as follow;

5

Image /page/5/Picture/3 description: The image shows the logo for Osstem Implant. The logo is orange and features the word "OSSTEM" in a stylized font. Below the word "OSSTEM" is the word "IMPLANT" in a smaller, gray font. The logo is simple and modern.

66-16, Bansong-ro 513beon-gil, Haeundae-gu, Busan, Republic of Korea Tel: +82 51 850 2500 Fax: +82 51 861 4693 www.osstem.com

| TS Scan Healing Abutment | Description | Ø5.25 x L 18 mm
It is used to make a natural soft tissue shape before
setting up prosthetics and removing cover screw after
osseointegration. | | | | | | | | | | | | | | | |
|-----------------------------------|--------------------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--|--|--|--|--|--|--|--|--|--|--|--|--|--|--|
| | Material | Titanium Grade 4 (ASTM F67) | | | | | | | | | | | | | | | |
| | Diameter (D) and
Length (L) | Ø4.3 x L 5.5, 5.6, 6.5, 6.6, 7.5, 7.6, 9.5, 9.6, 11.6 mm
Ø4.8 x L 5.5, 5.6, 6.5, 6.6, 7.5, 7.6, 9.5, 9.6, 11.5 mm
Ø5.3 x L 5.5, 6.5, 7.5, 9.5, 11.5 mm
Ø6.3 x L 5.5, 6.5, 7.5, 9.5, 11.5 mm
Ø7.3 x L 5.5, 6.5, 7.5, 9.5 mm | | | | | | | | | | | | | | | |
| TS Scan Healing Abutment
Screw | Description | It is used to make a natural soft tissue shape before
setting up prosthetics and removing cover screw after
osseointegration. | | | | | | | | | | | | | | | |
| | Material | Titanium Alloy (ASTM F136) | | | | | | | | | | | | | | | |
| | Diameter (D) and
Length (L) | Ø2.2 x L 10, 11, 12, 14, 16 mm
Ø2.3 x L 8, 9, 10, 12, 14 mm | | | | | | | | | | | | | | | |
| SSII SA Implant | Description | Intended to be surgically placed in the bone of the
upper or lower jaw arches. | | | | | | | | | | | | | | | |
| | Material | Titanium Grade 4 (ASTM F67) | | | | | | | | | | | | | | | |
| | Surface | SA surface treatment | | | | | | | | | | | | | | | |
| | Dimension | G/H D L 1.8 4.8, 6.0 7, 8.5, 10, 11.5, 13, 15mm 2.8 4.8, 6.0 7, 8.5, 10, 11.5, 13, 15mm | | | | | | | | | | | | | | | |
| SSIII SA Implant | Description | Intended to be surgically placed in the bone of the
upper or lower jaw arches. | | | | | | | | | | | | | | | |
| | Material | Titanium Grade 4 (ASTM F67) | | | | | | | | | | | | | | | |
| | Surface | SA surface treatment | | | | | | | | | | | | | | | |
| | Dimension | G/H D L 0.8 4.8, 6.0 7 mm 1.8 4.8, 6.0 7, 8.5, 10, 11.5, 13, 15 mm 2.0 6.0 15.0 mm 2.8 4.8, 6.0 7, 8.5, 10, 11.5, 13, 15 mm | | | | | | | | | | | | | | | |
| SSIII SA Ultra-Wide Implant | Description | Intended to be surgically placed in the bone of the
upper or lower jaw arches. | | | | | | | | | | | | | | | |
| | Material | Titanium Grade 4 (ASTM F67) | | | | | | | | | | | | | | | |
| | Surface | SA surface treatment | | | | | | | | | | | | | | | |
| | Dimension | G/H D L 1.8 6.0 7, 8.5, 10, 11.5, 13 mm 2.8 6.0 7, 8.5, 10, 11.5, 13 mm | | | | | | | | | | | | | | | |

6. Substantial Equivalence Matrix

These subject devices are adding additional dimensions to otherwise identical implant bodies cleared in past 510(k)s; therefore, indication for use, shape, connection structure, material, surface treatment, manufacturer and etc. are the same with predicate devices except dimension of additional products.

6

Image /page/6/Picture/3 description: The image contains the logo for Osstem Implant. The word "OSSTEM" is in orange, with a small superscript circle containing the number 6. Below the brand name, the word "IMPLANT" is written in gray, in a smaller font size. The logo is simple and clean, with a focus on the brand name.

66-16, Bansong-ro 513beon-gil, Haeundae-gu, Busan, Republic of Korea
Tel: +82 51 850 2500 Fax: +82 51 861 4693 www.osstem.com

1) TSIII SA Implant
Subject devicePrimary predicate
devicePredicate deviceReference deviceRemark
Device NameTSIII SA ImplantTSIII SA ImplantTSIII SA ImplantExternal Hex
ImplantsSame
510(k)
Number-K161604K121995K163634-
ManufacturerOsstem Implant Co.,
LtdOsstem Implant Co.,
LtdOsstem Implant Co.,
LtdNASame
DesignImage: Implant designImage: Implant designImage: Implant designNASimilar
Indication for
UseThe Osstem Implant
System is indicated
for use in partially or
fully edentulous
mandibles and
maxillae, in support
of single or multiple-
units restorations
including; cemented
retained, screw
retained, or
overdenture
restorations, and final
or temporary
abutment support for
fixed bridgework. It is
intended for delayed
loading. Ultra wide
Implant system is
intended to be used in
the molar region.
Products with
diameter or less than
3.25mm should be
used exclusively for
the lateral incisor in
the maxilla and a
central or lateral
incisor in the
mandible.The Osstem Implant
System is indicated
for use in partially or
fully edentulous
mandibles and
maxillae, in support
of single or multiple-
units restorations
including; cemented
retained, screw
retained, or
overdenture
restorations, and final
or temporary
abutment support for
fixed bridgework. It is
intended for delayed
loading. Ultra wide
Implant system is
intended to be used in
the molar region.
Products with
diameter or less than
3.25mm should be
used exclusively for
the lateral incisor in
the maxilla and a
central or lateral
incisor in the
mandible.The Osstem Implant
System is indicated
for use in partially or
fully edentulous
mandibles and
maxillae, in support
of single or multiple-
units restorations
including; cemented
retained, screw
retained, or
overdenture
restorations, and final
or temporary
abutment support for
fixed bridgework.
Products with
diameter of less than
3.25mm should be
used exclusively for
the lateral incisor in
the maxilla and a
central or lateral
incisor in the
mandible.Southern Implants'
External Hex
Implants are intended
for surgical placement
in the upper or lower
jaw to provide a
means for prosthetic
attachment of crowns,
bridges or
overdentures utilizing
delayed or immediate
loading.
Southern Implants'
External Hex
Implants are intended
for immediate
function when good
primary stability with
appropriate occlusal
loading is achieved.Same
Diameter (D)ø3.75 x L 18, 20 mmø4.6 x L 18 mmø3.75 x L 10, 11.5ø 3.25 x L 8.5, 10Different
and Length
(L)ø3.77 x L 7 mm
ø4.25 x L 7 mm
ø4.65 x L 7 mm
ø5.45 x L 10, 11.5,
13, 15 mm
ø5.48 x L 8.5 mm
ø5.5 x L 7mmø5.05 x L 18 mm13, 15 mm
ø3.77 x L 8.5 mm
ø4.2 x L 10, 11.5, 13,
15, 18 mm
ø4.25 x L 7, 8.5 mm
ø4.6 x L 10, 11.5, 13,
15 mm
ø4.63 x L 8.5 mm
ø4.65 x L 7 mm
ø5.05 x L 10, 11.5,
13, 15 mm
ø5.08 x L 8.5 mm
ø5.1 x L 6.2, 7
mmø3.5 x L 8.5, 10,
11.5, 13, 15 mm
ø4.2 x L 7, 8.5, 10,
11.5, 13, 15 mm
ø4.4 x L 7, 8.5, 10,
11.5, 13, 15 mm
ø4.9 x L 7, 8.5, 10,
11.5, 13, 15 mm11.5, 13, 15, 18 mm
ø 3.75 x L 7, 8.5, 10,
11.5, 13, 15, 18, 20
mm
ø 4.0 x L 6, 8.5, 10,
11.5, 13, 15, 18, 20
mm
ø 4.7 x L 8.5, 10,
11.5, 13, 15, 18 mm
ø 5.0 x L 6, 7, 8.5,
11.5, 13, 15, 18 mm
ø 5.7 x L 10, 11.5, 13,
15, 18 mm
ø 6.0 x L 7, 8.5, 10,
11.5, 13, 15 mm
MaterialTitanium Grade 4
(ASTM F67)Titanium Grade 4
(ASTM F67)Titanium Grade 4
(ASTM F67)CP TitaniumSame
SurfaceSASASAGrit blasted
Machine collar
versions availableSame
ConnectionInternal HexInternal HexInternal HexExternal HexSame
SterilizationRadiation SterileRadiation SterileRadiation SterileNASame
Shelf life8 years8 years8 yearsNASame
Similarities
Proposed TSIII SA Implant has same design, function and indication for use; and is made with same
material with same manufacturing process (including surface treatment) by same manufacturer compared to
that of the predicate TSIII SA Implant, K161604 and K121995.
S.E.Differences
The proposed device has different range of dimensions than predicate device. However, the added diameter
is larger than predicate device, so it is more stable than predicate device. Although there is the additional of
extended implant lengths of 20mm, additional length is included in dimension range of predicate device,
K163634. In addition, since proposed device is compatible with the same abutment, it has same moment-

7

Image /page/7/Picture/1 description: The image shows the text 'K222778'. The text is in a simple, sans-serif font and is horizontally oriented. The text is black against a white background, providing high contrast and readability.

66-16, Bansong-ro 513beon-gil, Haeundae-gu, Busan, Republic of Korea Tel: +82 51 850 2500 Fax: +82 51 861 4693 www.osstem.com

: . The proposed TSIII SA Implant is substantially equivalent to the predicate devices.

2) TSIII SA Implant (Non-Hex) Ø 3.2

arm as predicate devices, K161604 and K121995.

Subject DevicePredicate DeviceRemark
Device NameTSIII SA Implant (Non-Hex) Ø 3.2TSIII SA Implant 3.2Different
510(k) Number-K161604-
ManufacturerOsstem Implant Co., LtdOsstem Implant Co., LtdSame
DesignImage: ImplantImage: ImplantSame
Indication for UseThe Osstem Implant System is indicated for
use in partially or fully edentulous
mandibles and maxillae, in support of
single or multiple-units restorations
including; cemented retained, screw
retained, or overdenture restorations, and
final or temporary abutment support for
fixed bridgework. It is intended for delayed
loading. Ultra wide Implant system is
intended to be used in the molar region.
Products with diameter or less than 3.25mm
should be used exclusively for the lateral
incisor in the maxilla and a central or lateral
incisor in the mandible.The Osstem Implant System is indicated for
use in partially or fully edentulous
mandibles and maxillae, in support of
single or multiple-units restorations
including; cemented retained, screw
retained, or overdenture restorations, and
final or temporary abutment support for
fixed bridgework. It is intended for delayed
loading. Ultra wide Implant system is
intended to be used in the molar region.
Products with diameter or less than 3.25mm
should be used exclusively for the lateral
incisor in the maxilla and a central or lateral
incisor in the mandible.Same
Diameter (D) and
Length (L)$Ø$ 3.2 x L 8.5, 10.0, 11.5, 13.0, 15.0 mm$Ø$ 3.2 x L 8.5, 10.0, 11.5, 13.0, 15.0 mmSame
ConnectionNon-HexHexDifferent
MaterialTitanium Alloy (ASTM F136)Titanium Alloy (ASTM F136)Same
SurfaceSASASame
SterilizationRadiation SterileRadiation SterileSame
Shelf life8 years8 yearsSame
S.E.Similarities
Proposed TSIII SA Implant (Non-Hex) $Ø$ 3.2 has same design, function and indication for use; and is
made with same material with same manufacturing process (including surface treatment) by same
manufacturer compared to that of the predicate TSIII SA Implant 3.2 (K161604).
Differences
The proposed TSIII SA Implant (Non-Hex) $Ø$ 3.2 is included in dimension range of predicate device
and has the same diameter of the embedding plane according to the ISO14801. However, proposed
TSIII SA Implant (Non-Hex) $Ø$ 3.2 has non hexagon connection that is different from predicate TSIII
SA Implant. Therefore, we conducted fatigue test according to ISO14801 and the test result does not
show any significant difference in regard of mechanical strength.
: · Proposed TSIII SA Implant (Non-Hex) $Ø$ 3.2 and the predicate TSIII SA Implant 3.2 have
common in design, function, indications for use, material, manufacturing process, manufacturer, etc .;
therefore, the proposed TSIII SA Implant (Non-Hex) $Ø$ 3.2 is substantially equivalent to the predicate
device.

8

K222778

Image /page/8/Picture/2 description: The image shows the logo for Osstem Implant. The logo is in orange and gray. The word "OSSTEM" is in orange, and the word "IMPLANT" is in gray. There is a superscript "6" after the word "OSSTEM".

OSSTEM Implant Co., Ltd.

9

OSSTEM® 66-16, Bansong-ro 513beon-gil, Haeundae-gu, Busan, Republic of Korea
Tel: +82 51 850 2500 Fax: +82 51 861 4693 www.osstem.com

3) TSIII SA Implant (Non-Hex)

Subject devicePrimary predicate devicePredicate deviceRemark
Device NameTSIII SA Implant
(Non-Hex)TSIII SA ImplantTSIII SA ImplantSame
510(k) NumberK161604K121995-
ManufacturerOsstem Implant Co., LtdOsstem Implant Co., LtdOsstem Implant Co., LtdSame
DesignImage: TSIII SA Implant (Non-Hex)Image: TSIII SA ImplantImage: TSIII SA ImplantSimilar
Indication for UseThe Osstem Implant System
is indicated for use in
partially or fully edentulous
mandibles and maxillae, in
support of single or
multiple-units restorations
including; cemented
retained, screw retained, or
overdenture restorations,
and final or temporary
abutment support for fixed
bridgework. It is intended
for delayed loading. Ultra
wide Implant system is
intended to be used in the
molar region.
Products with diameter or
less than 3.25mm should be
used exclusively for the
lateral incisor in the maxilla
and a central or lateral
incisor in the mandible.The Osstem Implant System
is indicated for use in
partially or fully edentulous
mandibles and maxillae, in
support of single or
multiple-units restorations
including; cemented
retained, screw retained, or
overdenture restorations,
and final or temporary
abutment support for fixed
bridgework. It is intended
for delayed loading. Ultra
wide Implant system is
intended to be used in the
molar region.
Products with diameter or
less than 3.25mm should be
used exclusively for the
lateral incisor in the maxilla
and a central or lateral
incisor in the mandible.The Osstem Implant System
is indicated for use in
partially or fully edentulous
mandibles and maxillae, in
support of single or
multiple-units restorations
including; cemented
retained, screw retained, or
overdenture restorations,
and final or temporary
abutment support for fixed
bridgework.
Products with diameter of
less than 3.25mm should be
used exclusively for the
lateral incisor in the maxilla
and a central or lateral
incisor in the mandible.Same
Diameter (D) and
Length (L)ø3.75 x L 10, 11.5, 13 mm
ø3.77 x L 8.5 mm
ø3.8 x L 8.5, 10, 11.5, 13,
15, 18 mm
ø4.2 x L 10, 11.5, 13, 15, 18
mm
ø4.25 x L 7, 8.5 mm
ø4.6 x L 10, 11.5, 13, 15, 18
mm
ø4.63 x L 8.5 mmø4.6 x L 18 mm
ø5.05 x L 18 mmø3.75 x L 10, 11.5, 13, 15
mm
ø3.77 x L 8.5 mm
ø4.2 x L 10, 11.5, 13, 15, 18
mm
ø4.25 x L 7, 8.5 mm
ø4.6 x L 10, 11.5, 13, 15
mm
ø4.63 x L 8.5 mm
ø4.65 x L 7 mmDifferent
ø4.65 x L 7 mm
ø5.05 x L 10, 11.5, 13, 15,
18 mm
ø5.08 x L 8.5 mm
ø5.1 x L 7 mmø5.05 x L 10, 11.5, 13, 15 mm
ø5.08 x L 8.5 mm
ø5.1 x L 6.2, 7 mmø3.5 x L
8.5, 10, 11.5, 13, 15 mm
ø4.2 x L 7, 8.5, 10, 11.5, 13,
15 mm
ø4.4 x L 7, 8.5, 10, 11.5, 13,
15 mm
ø4.9 x L 7, 8.5, 10, 11.5, 13,
15 mm
MaterialTitanium Grade 4
(ASTM F67)Titanium Grade 4
(ASTM F67)Same
SurfaceSASASame
ConnectionInternal Non-HexInternal HexDifferent
SterilizationRadiation SterileRadiation SterileSame
Shelf life8 years8 yearsSame
S.E.Similarities
Proposed TSIII SA Implant (Non-Hex) has same design, function and indication for use; and is made
with same material with same manufacturing process (including surface treatment) by same
manufacturer compared to that of the predicate TSIII SA Implant, K161604 and K121995.
Differences
The proposed TSIII SA Implant (Non-Hex) is included in dimension range of predicate device.
Proposed TSIII SA Implant (Non-Hex) has non hexagon connection that is different from predicate
TSIII SA Implant, but has the same diameter of the embedding plane as predicate device according to
the ISO14801. Therefore, we selected the proposed device with the smallest diameter as the worst
case and conducted fatigue test according to ISO14801, and the test result does not show any
significant difference in regard of mechanical strength.
Proposed TSIII SA Implant (Non-Hex) and the predicate TSIII SA Implant have common in
design, function, indications for use, material, manufacturing process, manufacturer, etc.; therefore,
the proposed TSIII SA Implant (Non-Hex) is substantially equivalent to the predicate device.

10

Image /page/10/Picture/1 description: The image shows the text 'K222778'. The text is in a simple sans-serif font. The text is black and the background is white. The text appears to be a code or identifier.

Image /page/10/Picture/2 description: The image shows the logo for Osstem Implant. The word "OSSTEM" is in orange, and the word "IMPLANT" is in gray. There is a superscript "6" next to the word "OSSTEM".

66-16, Bansong-ro 513beon-gil, Haeundae-gu, Busan, Republic of Korea
Tel: +82 51 850 2500 Fax: +82 51 861 4693 www.osstem.com

4) TSIV SA Implant

Subject DevicePredicate DeviceReference deviceRemark
Device NameTSIV SA ImplantTSIV SA ImplantExternal Hex ImplantsSame
510(k) Number-K161604K163634-
ManufacturerOsstem Implant Co., LtdOsstem Implant Co., LtdNASame
DesignImage: ImplantImage: ImplantNASame
Indication for UseThe Osstem Implant System
is indicated for use in
partially or fully edentulous
mandibles and maxillae, in
support of single or
multiple-units restorations
including; cemented
retained, screw retained, or
overdenture restorations,
and final or temporary
abutment support for fixed
bridgework. It is intended
for delayed loading. Ultra
wide Implant system is
intended to be used in the
molar region.
Products with diameter or
less than 3.25mm should be
used exclusively for the
lateral incisor in the maxilla
and a central or lateral
incisor in the mandible.The Osstem Implant System
is indicated for use in
partially or fully edentulous
mandibles and maxillae, in
support of single or
multiple-units restorations
including; cemented
retained, screw retained, or
overdenture restorations,
and final or temporary
abutment support for fixed
bridgework. It is intended
for delayed loading. Ultra
wide Implant system is
intended to be used in the
molar region.
Products with diameter or
less than 3.25mm should be
used exclusively for the
lateral incisor in the maxilla
and a central or lateral
incisor in the mandible.Southern Implants' External
Hex Implants are intended
for surgical placement in the
upper or lower jaw to
provide a means for
prosthetic attachment of
crowns, bridges or
overdentures utilizing
delayed or immediate
loading.
Southern Implants' External
Hex Implants are intended
for immediate function
when good primary stability
with appropriate occlusal
loading is achieved.Same
Diameter (D) and
Length (L)Ø4.4 x L 18 mm
Ø4.8 x L 18 mm
Ø5.25 x L 18 mmØ4.4 x L 7, 8.5, 10, 11.5, 13,
15 mm
Ø4.8 x L 7, 8.5, 10, 11.5, 13,
15 mm
Ø5.25 x L 7, 8.5, 10, 11.5,
13, 15 mmØ 3.25 x L 8.5, 10, 11.5, 13,
15, 18 mm
Ø 3.75 x L 7, 8.5, 10, 11.5,
13, 15, 18, 20 mm
Ø 4.0 x L 6, 8.5, 10, 11.5,
13, 15, 18, 20 mm
Ø 4.7 x L 8.5, 10, 11.5, 13,
15, 18 mm
Ø 5.0 x L 6, 7, 8.5, 11.5, 13,
15, 18 mm
Ø 5.7 x L 10, 11.5, 13, 15,
18 mm
Ø 6.0 x L 7, 8.5, 10, 11.5,
13, 15 mmDifferent
MaterialTitanium Grade 4 (ASTM
F67)Titanium Grade 4 (ASTM
F67)CP TitaniumSame
SurfaceSASAGrit blasted
Machine collar versionsSame
available
External Hex
SterilizationRadiation SterileRadiation SterileNASame
Shelf life8 years8 yearsNASame
S.E.Similarities
Proposed TSIV SA Implant has same design, function and indication for use; and is made with same
material with same manufacturing process (including surface treatment) by same manufacturer
compared to that of the predicate TSIV SA Implant (K161604).

Differences
There is the additional of extended implant lengths of 18mm, but additional length is included in
dimension range of predicate device. In addition, since proposed device is compatible with the same
abutment as predicate device, there is no difference in moment-arm, so the difference in length is not
a factor affecting performance. Therefore, we didn't consider additional fatigue test according to
ISO14801.

.: Proposed TSIV SA Implant and the predicate TSIV SA Implant have common in design, function,
indications for use, material, manufacturing process, manufacturer, etc.; therefore, the proposed TSIV
SA Implant is substantially equivalent to the predicate device. | | | |

11

Image /page/11/Picture/2 description: The image shows the logo for Osstem Implant. The logo is in orange and gray. The word "OSSTEM" is in orange, and the word "IMPLANT" is in gray. There is a superscript "6" next to the word "OSSTEM".

12

Image /page/12/Picture/1 description: The image shows the alphanumeric string "K222778" in a simple, sans-serif font. The characters are arranged horizontally, with consistent spacing between them. The text is black against a white background, providing high contrast and readability.

OSSTEM®

OSSTEM Implant Co., Ltd.

66-16, Bansong-ro 513beon-gil, Haeundae-gu, Busan, Republic of Korea
Tel: +82 51 850 2500 Fax: +82 51 861 4693 www.osstem.com

5) TS Scan Healing Abutment

Subject DevicePredicate DeviceRemark
Device NameTS Scan Healing AbutmentHealing AbutmentDifferent
510(k) Number-K161604-
ManufacturerOsstem Implant Co., LtdOsstem Implant Co., LtdSame
DesignImage: Subject Device DesignImage: Predicate Device DesignSimilar
DescriptionUsed to make a natural soft tissue shape
until setting up prosthetics.
It is intended use to combine with
implanted fixture after osseointegration
then removing cover screw.Used to make a natural soft tissue shape
until setting up prosthetics.
It is intended use to combine with
implanted fixture after osseointegration
then removing cover screw.Same
Diameter (D) and
Length (L)ø4.3 x L 5.5, 5.6, 6.5, 6.6, 7.5, 7.6, 9.5, 9.6,
11.6 mm
ø4.8 x L 5.5, 5.6, 6.5, 6.6, 7.5, 7.6, 9.5, 9.6,
11.5 mm
ø5.3 x L 5.5, 6.5, 7.5, 9.5, 11.5 mm
ø6.3 x L 5.5, 6.5, 7.5, 9.5, 11.5 mm
ø7.3 x L 5.5, 6.5, 7.5, 9.5 mmø4.3 x L 7.5, 8.5, 9.5, 10.5, 11.5, 12.5, 13.5,
14.5 mm
ø4.8 x L 7.5, 8.5, 9.5, 10.5, 11.5, 12.5, 13.5,
14.5 mm
ø5.3 x L 8.5, 9.5, 10.5, 12.5, 14.5 mm
ø6.3 x L 8.5, 9.5, 10.5, 12.5, 14.5 mm
ø7.3 x L 8.5, 9.5, 10.5, 12.5, 14.5 mmDifferent

13

Image /page/13/Picture/2 description: The image shows the logo for Osstem Implant. The logo is orange and features the word "OSSTEM" in a bold, sans-serif font. Below the word "OSSTEM" is the word "IMPLANT" in a smaller, italicized font. A superscript "6" is located to the right of the word "OSSTEM".

66-16, Bansong-ro 513beon-gil, Haeundae-gu, Busan, Republic of Korea
Tel: +82 51 850 2500 Fax: +82 51 861 4693 www.osstem.com

| | Screw
Ø2.2 x L 10, 11, 12, 14, 16 mm
Ø2.3 x L 8, 9, 10, 12, 14 mm | Ø8.3 x L 10.5 mm | |
|---------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-------------------------------|-----------|
| | | | |
| Material | Titanium Grade 4
(ASTMF67)

  • Screw: Titanium Alloy (ASTM F136) | Titanium Grade 4
    (ASTMF67) | Different |
    | Sterilization | Radiation Sterile | Radiation Sterile | Same |
    | Shelf life | 8 years | 8 years | Same |
    | S.E. | Similarities
    Proposed TS Scan Healing Abutment has same function and indication for use; and is made with
    same material with same manufacturing process by same manufacturer compared to that of the
    predicate Healing Abutment (K161604).

Differences
There is difference between proposed device and predicate on design. The predicate device has a
screw-combined design compared to the proposed device. In addition, since TS Scan Healing
Abutment is used temporarily to make natural soft tissue shape until setting up prosthetics, it does not
require any performance. Therefore, we didn't consider additional performance testing.

: . Proposed TS Scan Healing Abutment and the predicate Healing Abutment have common in
function, indications for use, material, manufacturing process, manufacturer, etc.; therefore, the
proposed TS Scan Healing Abutment is substantially equivalent to the predicate device | | |

6) SSII SA Implant

Subject DevicePredicate DeviceReference DeviceRemark
Device NameSSII SA ImplantSSII SA ImplantExternal Hex ImplantsSame
510(k) Number-K163557K163634-
ManufacturerOsstem Implant Co., LtdOsstem Implant Co., LtdNASame
DesignImage: Dental ImplantImage: Dental ImplantNASimilar
Indication for
UseThe Osstem Implant System
is indicated for use in
partially or fully edentulous
mandibles and maxillae, in
support of single or multiple-
units restorations including;
cemented retained, screw
retained, or overdentureThe Osstem Implant is
indicated for use in partially
or fully edentulous
mandibles and maxillae, in
support of single or multiple-
unit restorations including;
cemented retained, screw
retained, or overdentureSouthern Implants' External
Hex Implants are intended
for surgical placement in the
upper or lower jaw to
provide a means for
prosthetic attachment of
crowns, bridges or
overdentures utilizingSame
restorations, and final or
temporary abutment support
for fixed bridgework. It is
intended for delayed loading.
Ultra wide Implant system is
intended to be used in the
molar region.
Products with diameter or
less than 3.25mm should be
used exclusively for the
lateral incisor in the maxilla
and a central or lateral
incisor in the mandible.restorations, and finally or
temporary abutment support
for fixed bridgework. It is
intended for delayed loading.
Ultra Wide Implant System
is intended to be used in the
molar region.delayed or immediate
loading.
Southern Implants' External
Hex Implants are intended
for immediate function when
good primary stability with
appropriate occlusal loading
is achieved.
AppearanceImage: ImplantImage: ImplantNADifferent
Dimensionø 4.8 x L 7, 8.5, 10, 11.5, 13,
15 mm
ø 6.0 x L 7, 8.5, 10, 11.5, 13,
15 mmø 4.1 x L 7, 8.5, 10, 11.5, 13,
15 mm
ø 4.45 x L 7, 8.5, 10, 11.5,
13, 15 mm
ø 4.9 x L 7, 8.5, 10, 11.5, 13,
15 mm
ø 5.0 x L 6 mmø 3.25 x L 8.5, 10, 11.5, 13,
15, 18 mm
ø 3.75 x L 7, 8.5, 10, 11.5,
13, 15, 18, 20 mm
ø 4.0 x L 6, 8.5, 10, 11.5, 13,
15, 18, 20 mm
ø 4.7 x L 8.5, 10, 11.5, 13,
15, 18 mm
ø 5.0 x L 6, 7, 8.5, 11.5, 13,
15, 18 mm
ø 5.7 x L 10, 11.5, 13, 15, 18
mm
ø 6.0 x L 7, 8.5, 10, 11.5, 13,
15 mmDifferent
MaterialTitanium Grade 4 (ASTM
F67)Titanium Grade 4 (ASTM
F67)CP TitaniumSame
SurfaceSASAGrit blasted
Machine collar versions
availableSame
ConnectionInternal OctaInternal OctaExternal HexDifferent
SterilizationRadiation SterileRadiation SterileNASame
Shelf life8 years8 yearsNASame
S.E.Similarities
Proposed SSII SA Implant has same design, function and indication for use; and is made with same
material with same manufacturing process (including surface treatment) by same manufacturer compared
to that of the predicate SSII SA Implant (K163557).

Differences
In addition, since proposed device is compatible with the same abutment and has same moment arm as | | | |

14

Image /page/14/Picture/1 description: The image shows the text 'K222778'. The text is in a simple, sans-serif font and is presented in black against a white background. The text appears to be a code or identifier.

OSSTEM®

OSSTEM Implant Co., Ltd.

15

Image /page/15/Picture/1 description: The image shows the text "K222778" in a simple, sans-serif font. The text is black against a white background. The letters and numbers are evenly spaced and clearly legible.

66-16, Bansong-ro 513beon-gil, Haeundae-gu, Busan, Republic of Korea Tel: +82 51 850 2500 Fax: +82 51 861 4693 www.osstem.com

predicate device, K163557.
Proposed devices with the same combination of dimensions, except for gingival height only, are identical
in all implanted parts. In addition, since the diameter of embedding plane is same as predicate device, we
didn't consider additional fatigue test according to ISO14801.
∴ Therefore, the proposed SSII SA Implant is substantially equivalent to the predicate devices.

Subject Device Predicate Device Reference Device Remark SSIII SA Implant Device Name SSIII SA Implant External Hex Implants Same 510(k) Number K163557 K163634 -1 Osstem Implant Co., Ltd Osstem Implant Co., Ltd NA Manufacturer Same Design NA Similar The Osstem Implant System The Osstem Implant is Southern Implants' External is indicated for use in indicated for use in partially Hex Implants are intended for partially or fully edentulous or fully edentulous mandibles surgical placement in the mandibles and maxillae, in and maxillae, in support of upper or lower jaw to provide support of single or multiplesingle or multiple-unit a means for prosthetic units restorations including; restorations including: attachment of crowns, cemented retained, screw cemented retained, screw bridges or overdentures retained, or overdenture retained, or overdenture utilizing delayed or restorations, and final or restorations, and finally or immediate loading. temporary abutment support temporary abutment support Southern Implants' External Indication for for fixed bridgework. It is for fixed bridgework. It is Hex Implants are intended for Same Use intended for delayed loading. intended for delayed loading. immediate function when Ultra wide Implant system is Ultra Wide Implant System is good primary stability with intended to be used in the intended to be used in the appropriate occlusal loading molar region. molar region. is achieved. Products with diameter or less than 3.25mm should be used exclusively for the lateral incisor in the maxilla and a central or lateral incisor in the mandible.

7) SSIII SA Implant

16

Image /page/16/Picture/2 description: The image contains the logo for the company Osstem Implant. The logo is comprised of the word "OSSTEM" in orange, with a superscript "6" next to it. Below the word "OSSTEM" is the word "IMPLANT" in gray. The logo is simple and modern.

AppearanceImage: dental implantImage: dental implantNADifferent
Dimensionø 4.8 x L 7, 8.5, 10, 11.5, 13, 15 mm
ø 60 x L 7, 8.5, 10, 11.5, 13, 15 mmø 3.75 x L 8.5, 10, 11.5, 13 mm
ø 4.25 x L 7, 8.5, 10, 11.5, 13 mm
ø 4.6 x L 7, 8.5, 10, 11.5, 13 mm
ø 5.0 x L 10, 11.5, 13 mm
ø 5.05 x L 6, 7, 8.5 mmø 3.25 x L 8.5, 10, 11.5, 13, 15, 18 mm
ø 3.75 x L 7, 8.5, 10, 11.5, 13, 15, 18, 20 mm
ø 4.0 x L 6, 8.5, 10, 11.5, 13, 15, 18, 20 mm
ø 4.7 x L 8.5, 10, 11.5, 13, 15, 18 mm
ø 5.0 x L 6, 7, 8.5, 11.5, 13, 15, 18 mm
ø 5.7 x L 10, 11.5, 13, 15, 18 mm
ø 6.0 x L 7, 8.5, 10, 11.5, 13, 15 mmDifferent
MaterialTitanium Grade 4 (ASTM F67)Titanium Grade 4 (ASTM F67)CP TitaniumSame
SurfaceSASAGrit blasted
Machine collar versions availableSame
ConnectionInternal OctaInternal OctaExternal HexSame
SterilizationRadiation SterileRadiation SterileNASame
Shelf life8 years8 yearsNASame
S.E.Similarities
Proposed SSIII SA Implant has same design, function and indication for use; and is made with same material with same manufacturing process (including surface treatment) by same manufacturer compared to that of the predicate SSIII SA Implant (K163557).

Differences
There is the additional of extended implant lengths of 15mm, but additional length is included in dimension range of predicate device. In addition, since proposed device is compatible with the same abutment as predicate device, there is no difference in moment-arm, so the difference in length is not a factor affecting performance. Therefore, we didn't consider additional fatigue test according to ISO14801. Gingival height of the proposed device is smaller than predicate device, but the performance is not affected because it is a non-implantable part.
Proposed device has a smaller surface area due to the difference in neck shape, but has a larger surface area compared to the predicate device SS2R4007S18, which has diameter Ø4.8 and length 7mm. In addition, since the diameter of embedding plane is same as predicate device, we didn't consider additional fatigue test according to ISO14801. | | | |

17

Image /page/17/Picture/2 description: The image shows the logo and address of OSSTEM Implant Co., Ltd. The logo is in bold, with the letters "OSSTEM" being the largest. The address is located below the logo and includes the street number, street name, district, city, and country. The address is "66-16, Bansong-ro 513beon-gil, Haeundae-gu, Busan, Republic of Korea".

Tel: +82 51 850 2500 Fax: +82 51 861 4693 www.osstem.com

: Proposed SSIII SA Implant and the predicate SSIII SA Implant have common in design, function, indications for use, material, manufacturing process, manufacturer, etc.; therefore, the proposed SSIII SA Implant is substantially equivalent to the predicate device.

8) SSIII SA Ultra-Wide Implant
Subject DevicePredicate DeviceRemark
Device NameSSIII SA Ultra-Wide ImplantSSIII SA Ultra-Wide ImplantSame
510(k) Number-K163557-
ManufacturerOsstem Implant Co., LtdOsstem Implant Co., LtdSame
DesignImage: Subject DeviceImage: Predicate DeviceSame
Indication for
UseThe Osstem Implant System is indicated for
use in partially or fully edentulous mandibles
and maxillae, in support of single or multiple-
units restorations including; cemented
retained, screw retained, or overdenture
restorations, and final or temporary abutment
support for fixed bridgework. It is intended
for delayed loading. Ultra wide Implant
system is intended to be used in the molar
region.
Products with diameter or less than 3.25mm
should be used exclusively for the lateral
incisor in the maxilla and a central or lateral
incisor in the mandible.The Osstem Implant is indicated for use in
partially or fully edentulous mandibles and
maxillae, in support of single or multiple-unit
restorations including; cemented retained,
screw retained, or overdenture restorations,
and finally or temporary abutment support for
fixed bridgework. It is intended for delayed
loading. Ultra Wide Implant System is
intended to be used in the molar region.Same
DimensionØ 6.0 x L 7, 8.5, 10, 11.5, 13 mmØ 5.92 x L 11.5, 13 mm
Ø 5.95 x L 10 mm
Ø 5.96 x L 6, 8.5 mm
Ø 6.0 x L 7 mm
Ø 6.8 x L 7, 8.5, 10, 11.5, 13 mm
Ø 6.93 x L 6 mmDifferent
MaterialTitanium Grade 4 (ASTM F67)Titanium Grade 4 (ASTM F67)Same
SurfaceSASASame
ConnectionInternal OctaInternal OctaSame
SterilizationRadiation SterileRadiation SterileSame
Shelf life8 years8 yearsSame

8) SSIII SA Ultra-Wide Implant

18

Image /page/18/Picture/2 description: The image contains the logo for OSSTEM IMPLANT. The logo is in orange and gray. The word "OSSTEM" is in orange, and the word "IMPLANT" is in gray and is located below the word "OSSTEM."

66-16, Bansong-ro 513beon-gil, Haeundae-gu, Busan, Republic of Korea Tel: +82 51 850 2500 Fax: +82 51 861 4693 www.osstem.com

Similarities
S.E.Proposed SSIII SA Ultra-Wide Implant has same design, function and indication for use; and is made with same material with same manufacturing process (including surface treatment) by same manufacturer compared to that of the predicate SSIII SA Ultra-Wide Implant (K163557).
Differences
Gingival height of the proposed device is different from predicate device SSIII SA Ultra-Wide Implant (K163557), but the performance is not affected because it is a non-implantable part. In addition, since the diameter of embedding plane is same as predicate device, we didn't consider additional fatigue test according to ISO14801.
∴ Proposed SSIII SA Ultra-Wide Implant and the predicate SSIII SA Ultra-Wide Implant have common in design, function, indications for use, material, manufacturing process, manufacturer, etc.; therefore, the proposed SSIII SA Ultra-Wide Implant is substantially equivalent to the predicate SSIII SA Ultra-Wide Implant (K163557).

7. Summary of Non-clinical Performance Testing.

Below tests were performed on subject device:

  • Fatigue Testing under the worst-case scenario according to ISO 14801:2016
    Below tests were performed for predicate devices and leveraged for the subject device:

  • Gamma Sterilization Validation Test on Implants according to ISO 11137-1,2,3 referenced in K121585

  • . Shelf-Life Test on Implants according to ASTM F1980 referenced in K121585

  • . Biocompatibility testing according to ISO 10993-1:2009, ISO 10993-6:2007, ISO 10993-10:2006, ISO 10993-11:2006 referenced in K121995

  • . Bacterial Endotoxin Test Report on implants according to ISO 10993-11:2006 and USP referenced in K161604

The results of the above tests have met the standards and demonstrated the substantial equivalence with the predicate device.

Validation of the gamma irradiation process was previously conducted for the predicate device, K121585. There has been no change to the manufacturing or sterilization processes.

The Biocompatibility Test was conducted on the predicate device and leveraged for the subject device because both products are manufactured with same materials, manufacturing process etc. It demonstrates that the subject device is biocompatible and substantial equivalence with the predicate.

The non-clinical testing result demonstrate that the subject device is substantially equivalent to the predicate device.

Osstem Implant System has SA (Sand blasted and Acid etched surface treatment that is exactly same with the predicate devices, K121585. There has been no change to the manufacturing or surface treatment processes.

Fatigue testing was considered according to the FDA Guidance for Industry and FDA Staff Class II Special Controls Guidance Document Root-form Endosseous Dental Inplants and Endosseous Dental Abutment and ISO 14801 standard with the worst case scenario.

For proposed TSIII SA Implant (Non-Hex), fatigue testing was conducted according to ISO 14801:2016 Dental-implants Dynamic Fatigue Test for Endosseous Dental Implants. The worst-case implant-abutment combination of the proposed device was chosen based on the FDA Guidance, ClassII Special Controls Guidance Document: Root-form Endosseous Dental Implants and Endosseous Dental Implant Abutments. Test results demonstrate that the proposed devices perform as

19

Image /page/19/Picture/2 description: The image shows the logo and contact information for OSSTEM Implant Co., Ltd. The address is 66-16, Bansong-ro 513beon-gil, Haeundae-gu, Busan, Republic of Korea. The telephone number is +82 51 850 2500, the fax number is +82 51 861 4693, and the website address is www.osstem.com.

intended and support substantial equivalence to the predicate devices.

MR Compatibility

Non-clinical worst-case MRI review was performed to evaluate the Subject device components in the MRI environment using scientific rationale and published literature (e.g., 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), based on the entire system including all compatible implant bodies, abutments, and fixation screws) and material composition. 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.

Summary of Clinical Testing 8.

No clinical studies are submitted.

9. Conclusion

In accordance with the Federal Food, Drug and Cosmetic Act, 21 CFR Part 807, and based on the information provided in this premarket notification, Osstem Implant Co., Ltd. concludes that Osstem is substantially equivalent to the predicate devices as herein.