K Number
K223355
Device Name
Tera Harz Clear
Manufacturer
Date Cleared
2022-11-03

(1 days)

Product Code
Regulation Number
872.5470
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
TERA HARZ CLEAR is intended for the treatment of tooth malocclusions in patients with permanent dentition (i.e., all second molars). Utilizing a series of increments, it sequentially positions teeth by way of continuous gentle force. TERA HARZ CLEAR is intended exclusively for professional dental work. Fabrication of aligner with TERA HARZ CLEAR requires an additive manufacturing system (AMS) that includes compatible with the following: Design: Scanner: 3Shape A/S, TRIOS 3 Basic Design software: 3Shape A/S, 3Shape Ortho System™ Printing: 3D Printer: UNIZ, SLASH 2; SprintRay Inc., SprintRay Pro 95 Post-Curing: Post-cure unit: CureM, U102H
Device Description
TERA HARZ CLEAR is a series of clear aligners that are used to replace traditional orthodontic wires and brackets for the alignment of maloccluded or misaligned teeth. This series of aligner is intended for the treatment of tooth malocclusions in patients with permanent dentition (i.e., all second molars) by moves the teeth gently, and in small increments, from their original to their final treated position for improved dental alignment. This series of aligner is worn for approximately 1 week of 20 to 22 hours per day after (However, there are to be removed for eating and for cleaning) which it is replaced by the next stage aligners and are designed to be used in a sequence. This is repeated for duration as prescribed by the dental clinician. TERA HARZ CLEAR is a light-cured, methacrylate-based resin commonly can used in additive manufacturing for the production of dental structures such as sequential aligners. TERA HARZ CLEAR has stored in a black 1,000 g of HDPE bottle. It contains materials with colors of yellowish. This device is a liquid photo-curable material that is polymerized by UV laser at 405~412 nm. It can be used to make a tooth model with a photo-curable polymer that is cured by ultraviolet light. The liquid UV curing resin is cured at a specific wavelength (395~405 nm) by the photo-initiator contained in the resin. It is typically 100 um in thickness and is output at a resolution of 40 to 90 µm on the x, y axis, and it is possible to produce three-dimensional printed matter by curing lamination step by step a thickness of 100 um. However, scanner, design software, 3D printer and post-cure unit are not included with the device. These fabrications of TERA HARZ CLEAR are beginning with the dental clinician prescribing aligners to treat a patient's malocclusion, and decision to use methacrylatebased resins is made by the dental clinician. TERA HARZ CLEAR, an orthodontic appliance such as sequential aligner, is manufactured in a 3D printer that is compatible. The dental clinician can generate a digital file by scanning the patient's mouth directly using listed with Intraoral scanner under FDA Classification Product Code NOF, regulation 872.3661. This digital file is a series of CAD files (.stl) for building models that can be used to fabricate aligners. Commonly used standard dental software is used by dental professionals to virtually design a sequential aligner and generate an industry-standard "STL" 3D dataset which reflects the intended shape and contour. The design software used is 3Shape Ortho System™ by 3Shape A/S (K180941). The specialized orthodontic treatment planning software has a 510k clearance for the intended use under FDA Classification Product Code PNN, regulation 872.5470. This software is used for management of 3D scanned orthodontic models, orthodontic diagnosis by measuring, analyzing, inspecting and visualizing 3D scanned orthodontic models, virtual planning of orthodontic treatments by simulating tooth movements, and design of sequential aligners based on 3D scanned orthodontic models. Once dental clinic manufacturing unit receive the data that *.stl CAD files of the treatment plan the 3D printer begins additive manufacturing. The dental clinician generates sequential 3D printed models replicating the approved treatment plan. The sequential aligner is 3D printed and cured in a post-cure unit. The fabricated aligners are cut to fit dentition, the cleaned and polished to remove rough edges by the dental clinician. The prescribing physician review and approves the sequential aligners are provides them to the patient the confirming fit and design.
More Information

Dental LT Clear Resin (V2)/ Formlabs Inc.

No
The summary describes a resin material used in 3D printing for dental aligners and the associated manufacturing process, including scanning, design software, printing, and post-curing. While the design software (3Shape Ortho System™) is mentioned as having capabilities for virtual planning and simulating tooth movements, the summary does not explicitly state that this software, or any other component of the system, utilizes AI or ML for these functions. The focus is on the material properties and the manufacturing workflow.

Yes
Explanation: The device is a series of clear aligners intended for the treatment of tooth malocclusions, which is a therapeutic purpose.

No

This device, TERA HARZ CLEAR, is described as a material (light-cured, methacrylate-based resin) used to create clear aligners for teeth treatment, not a device that performs diagnosis. The diagnostic steps (scanning and design software for planning) are separate components used in conjunction with this material.

No

The device described is a physical clear aligner made from a light-cured resin. While its fabrication relies on software and hardware (scanners, design software, 3D printers, post-cure units), the device itself is a tangible medical device, not software.

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

Here's why:

  • Intended Use: The intended use is for the "treatment of tooth malocclusions" by physically moving teeth. This is a therapeutic intervention, not a diagnostic test performed in vitro (outside the body) on biological specimens.
  • Device Description: The device is a material (resin) used to fabricate clear aligners, which are physical appliances worn by the patient to apply force to teeth. It's a component in a manufacturing process for a medical device (the aligner).
  • Lack of Diagnostic Function: There is no mention of the device being used to diagnose a condition, analyze biological samples, or provide information about a patient's health status based on in vitro testing.
  • Regulatory Classification: The associated devices mentioned (intraoral scanner, design software) are classified under regulations related to dental devices and orthodontic appliances, not IVDs.

In summary, TERA HARZ CLEAR is a material used in the fabrication of a dental appliance (clear aligners) for the treatment of a physical condition (malocclusion). It does not perform any diagnostic function on biological specimens.

N/A

Intended Use / Indications for Use

TERA HARZ CLEAR is intended for the treatment of tooth malocclusions in patients with permanent dentition (i.e., all second molars). Utilizing a series of increments, it sequentially positions teeth by way of continuous gentle force. TERA HARZ CLEAR is intended exclusively for professional dental work. Fabrication of aligner with TERA HARZ CLEAR requires an additive manufacturing system (AMS) that includes compatible with the following:
Design:
Scanner: 3Shape A/S TRIOS 3 Basic
Design software: 3Shape A/S 3Shape Ortho System™
Printing:
3D Printer: UNIZ SLASH 2, SprintRay Inc. SprintRay Pro 95
Post-Curing:
Post-cure unit: CureM U102H

Product codes

NXC

Device Description

TERA HARZ CLEAR is a series of clear aligners that are used to replace traditional orthodontic wires and brackets for the alignment of maloccluded or misaligned teeth.

This series of aligner is intended for the treatment of tooth malocclusions in patients with permanent dentition (i.e., all second molars) by moves the teeth gently, and in small increments, from their original to their final treated position for improved dental alignment. This series of aligner is worn for approximately 1 week of 20 to 22 hours per day after (However, there are to be removed for eating and for cleaning) which it is replaced by the next stage aligners and are designed to be used in a sequence. This is repeated for duration as prescribed by the dental clinician.

TERA HARZ CLEAR is a light-cured, methacrylate-based resin commonly can used in additive manufacturing for the production of dental structures such as sequential aligners.

TERA HARZ CLEAR has stored in a black 1,000 g of HDPE bottle. It contains materials with colors of yellowish. This device is a liquid photo-curable material that is polymerized by UV laser at 405412 nm. It can be used to make a tooth model with a photo-curable polymer that is cured by ultraviolet light. The liquid UV curing resin is cured at a specific wavelength (395405 nm) by the photo-initiator contained in the resin. It is typically 100 um in thickness and is output at a resolution of 40 to 90 µm on the x, y axis, and it is possible to produce three-dimensional printed matter by curing lamination step by step a thickness of 100 um.

However, scanner, design software, 3D printer and post-cure unit are not included with the device.

These fabrications of TERA HARZ CLEAR are beginning with the dental clinician prescribing aligners to treat a patient's malocclusion, and decision to use methacrylate based resins is made by the dental clinician. TERA HARZ CLEAR, an orthodontic appliance such as sequential aligner, is manufactured in a 3D printer that is compatible.

The dental clinician can generate a digital file by scanning the patient's mouth directly using listed with Intraoral scanner under FDA Classification Product Code NOF, regulation 872.3661.

This digital file is a series of CAD files (.stl) for building models that can be used to fabricate aligners. Commonly used standard dental software is used by dental professionals to virtually design a sequential aligner and generate an industry-standard "STL" 3D dataset which reflects the intended shape and contour. The design software used is 3Shape Ortho System™ by 3Shape A/S (K180941). The specialized orthodontic treatment planning software has a 510k clearance for the intended use under FDA Classification Product Code PNN, regulation 872.5470. This software is used for management of 3D scanned orthodontic models, orthodontic diagnosis by measuring, analyzing, inspecting and visualizing 3D scanned orthodontic models, virtual planning of orthodontic treatments by simulating tooth movements, and design of sequential aligners based on 3D scanned orthodontic models.

Once dental clinic manufacturing unit receive the data that *.stl CAD files of the treatment plan the 3D printer begins additive manufacturing. The dental clinician generates sequential 3D printed models replicating the approved treatment plan. The sequential aligner is 3D printed and cured in a post-cure unit. The fabricated aligners are cut to fit dentition, the cleaned and polished to remove rough edges by the dental clinician. The prescribing physician review and approves the sequential aligners are provides them to the patient the confirming fit and design.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

tooth / teeth / dentition

Indicated Patient Age Range

patients with permanent dentition (i.e., all second molars)

Intended User / Care Setting

professional dental work / dental clinician / dental professionals / dental clinic manufacturing unit

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)

Performance Data was provided including Manufacturing Validation and Performance Testing.
Manufacturing Validation: An independent 3rd party software and digital calipers were used to perform point-to-point and critical displacement measurement. All translational measurements were within 0.150 mm of the target input value, the predefined tolerance of the manufacturing process. There were no statistical differences in the difference in the intended and measured values observed from any of the groups. The test confirmed that the optimal output condition is to have the output angle at 30° and the output position centered. It was also confirmed that there was no problem with the number of effective outputs for repeated material output up to 7 times.
Performance Testing: Bench testing was performed to ensure the accuracy of the final product and to evaluate critical properties including Flexural Strength, Flexural Modulus, Water Solubility, Water absorption and etc. All met the requirements of ISO 20795-2:2013, Dentistry - Base Polymers -Part 2: Orthodontic base polymers. The results showed the subject device met testing criteria and was substantially equivalent to the predicate device in physical properties.

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

Manufacturing Validation:
Translational measurements: within 0.150 mm of the target input value.
Performance Testing (ISO 20795-2:2013 Compliance):
Surface characteristics: Sample surface is smooth, hard and glossy.
Shape capability: Sample edges are reproduced.
Colour: The color is expressed transparently without changing.
Freedom from porosity: There is no porosity.
Ultimate Flexural Strength (≥5 MPa): UNIZ Slash 2 Avg. 5.92 MPa, SprintRay PRO 95 Avg. 6.02 MPa.
Flexural modulus (≥50 MPa): UNIZ Slash 2 Avg. 69.10 MPa, SprintRay PRO 95 Avg. 72.38 MPa.
Solubility (≤5 µg/mm³): UNIZ Slash 2 Avg. 1.54 µg/mm³, SprintRay PRO 95 Avg. 1.56 µg/mm³.
Water sorption (≤32 µg/mm³): UNIZ Slash 2 Avg. 17.45 µg/mm³, SprintRay PRO 95 Avg. 17.03 µg/mm³.
Precision (less than 0.15): UNIZ Slash 2 0.079, 0.075, 0.069, 0.068, 0.071 mm; SprintRay PRO 95 0.063, 0.069, 0.065, 0.071, 0.059 mm.

Predicate Device(s)

K180107

Reference Device(s)

Dental LT Clear Resin (V2)/ Formlabs Inc.

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 872.5470 Orthodontic plastic bracket.

(a)
Identification. An orthodontic plastic bracket is a plastic device intended to be bonded to a tooth to apply pressure to a tooth from a flexible orthodontic wire to alter its position.(b)
Classification. Class II.

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.

November 3, 2022

Graphy Inc. % Dave Yungvirt CEO Third Party Review Group, LLC 25 Independence Blvd Warren, New Jersey 07059

Re: K223355

Trade/Device Name: Tera Harz Clear Regulation Number: 21 CFR 872.5470 Regulation Name: Orthodontic plastic bracket Regulatory Class: Class II Product Code: NXC Dated: October 30, 2022 Received: November 2, 2022

Dear Dave Yungvirt:

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 mediation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/medicaldevices/device-advice-comprehensive-regulatory-assistance) and CDRH Learn (https://www.fda.gov/training-and-continuing-education/cdrh-learn). Additionally, you may contact the Division of Industry and Consumer Education (DICE) to ask a question about a specific regulatory topic. See the DICE website (https://www.fda.gov/medical-device-advice-comprehensive-regulatoryassistance/contact-us-division-industry-and-consumer-education-dice) for more information or contact DICE by email (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100).

Sincerely.

Michael E. Adjodha, M.ChE. Assistant Director DHT1B: Division of Dental and ENT Devices OHT1: Office of Ophthalmic, Anesthesia, Respiratory, ENT and Dental Devices Office of Product Evaluation and Ouality Center for Devices and Radiological Health

Enclosure

2

DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration

Indications for Use

510(k) Number (if known) K-223355

Device Name TERA HARZ CLEAR

Indications for Use (Describe)

TERA HARZ CLEAR is intended for the treatment of tooth malocclusions in patients with permanent dentition (i.e., all second molars). Utilizing a series of increments, it sequentially positions teeth by way of continuous gentle force. TERA HARZ CLEAR is intended exclusively for professional dental work. Fabrication of aligner with TERA HARZ CLEAR requires an additive manufacturing system (AMS) that includes compatible with the following:

BrandType
Design:
Scanner3Shape A/STRIOS 3 Basic
Design software3Shape A/S3Shape Ortho System™
Printing:
3D PrinterUNIZSLASH 2
SprintRay Inc.SprintRay Pro 95
Post-Curing:
Post-cure unitCureMU102H
Type of Use (Select one or both, as applicable)
---------------------------------------------------

|X Prescription Use (Part 21 CFR 801 Subpart D)

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

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3

K223355

510(k) Summary For TERA HARZ CLEAR

l. SUBMISSION SPONSOR

Graphy Inc. #603, #617, Ace Gasan Forhu, 225, Gasan digital 1-ro, Geumcheon-gu, Seoul, Republic of Korea Office Phone: +82-2-864-3056 Fax: 82-2-864-3057 Contact Person: Mr. Moon Soo Park, Assistant Manager of RA Team

II. SUBMISSION CORRESPONDENT

SMB Korea #606, #607, 7, Boramae-ro 5ga-gil, Donjak-gu, Seoul, 07071, Republic of Korea Cell Phone: +82-10-2247-5579 Office Phone: +62-6241-9001 Kyung-hwan Kim, Representative Consultant, QA Contact: Email: info@smbkorea.com

III. DATE PREPARED

October 20, 2022

IV. DEVICE

Trade or Proprietary Name:TERA HARZ CLEAR
Common or Usual Name:Sequential Aligner
Classification Name:Orthodontic plastic bracket (872.5470)
Regulatory Class:II
Product Code:NXC
Classification Panel:Dental

V. PREDICATE DEVICE

Primary Predicate Device: K180107, Blue Sky Bio Aligner/ Blue Sky Bio LLC (Class II) Referencee Device Dental LT Clear Resin (V2)/ Formlabs Inc. (Class I)

DEVICE DESCRIPTION

TERA HARZ CLEAR is a series of clear aligners that are used to replace traditional

4

orthodontic wires and brackets for the alignment of maloccluded or misaligned teeth.

This series of aligner is intended for the treatment of tooth malocclusions in patients with permanent dentition (i.e., all second molars) by moves the teeth gently, and in small increments, from their original to their final treated position for improved dental alignment. This series of aligner is worn for approximately 1 week of 20 to 22 hours per day after (However, there are to be removed for eating and for cleaning) which it is replaced by the next stage aligners and are designed to be used in a sequence. This is repeated for duration as prescribed by the dental clinician.

TERA HARZ CLEAR is a light-cured, methacrylate-based resin commonly can used in additive manufacturing for the production of dental structures such as sequential aligners.

TERA HARZ CLEAR has stored in a black 1,000 g of HDPE bottle. It contains materials with colors of yellowish. This device is a liquid photo-curable material that is polymerized by UV laser at 405412 nm. It can be used to make a tooth model with a photo-curable polymer that is cured by ultraviolet light. The liquid UV curing resin is cured at a specific wavelength (395405 nm) by the photo-initiator contained in the resin. It is typically 100 um in thickness and is output at a resolution of 40 to 90 µm on the x, y axis, and it is possible to produce three-dimensional printed matter by curing lamination step by step a thickness of 100 um.

However, scanner, design software, 3D printer and post-cure unit are not included with the device.

These fabrications of TERA HARZ CLEAR are beginning with the dental clinician prescribing aligners to treat a patient's malocclusion, and decision to use methacrylatebased resins is made by the dental clinician. TERA HARZ CLEAR, an orthodontic appliance such as sequential aligner, is manufactured in a 3D printer that is compatible.

The dental clinician can generate a digital file by scanning the patient's mouth directly using listed with Intraoral scanner under FDA Classification Product Code NOF, regulation 872.3661.

This digital file is a series of CAD files (.stl) for building models that can be used to fabricate aligners. Commonly used standard dental software is used by dental professionals to virtually design a sequential aligner and generate an industry-standard "STL" 3D dataset which reflects the intended shape and contour. The design software used is 3Shape Ortho System™ by 3Shape A/S (K180941). The specialized orthodontic treatment planning software has a 510k clearance for the intended use under FDA

5

Classification Product Code PNN, regulation 872.5470. This software is used for management of 3D scanned orthodontic models, orthodontic diagnosis by measuring, analyzing, inspecting and visualizing 3D scanned orthodontic models, virtual planning of orthodontic treatments by simulating tooth movements, and design of sequential aligners based on 3D scanned orthodontic models.

Once dental clinic manufacturing unit receive the data that *.stl CAD files of the treatment plan the 3D printer begins additive manufacturing. The dental clinician generates sequential 3D printed models replicating the approved treatment plan. The sequential aligner is 3D printed and cured in a post-cure unit. The fabricated aligners are cut to fit dentition, the cleaned and polished to remove rough edges by the dental clinician. The prescribing physician review and approves the sequential aligners are provides them to the patient the confirming fit and design.

VI. INDICATION FOR USE

TERA HARZ CLEAR is intended for the treatment of tooth malocclusions in patients with permanent dentition (i.e., all second molars). Utilizing a series of incremental tooth movements, it sequentially positions teeth by way of continuous gentle force. TERA HARZ CLEAR is intended exclusively for professional dental work. Fabrication of aligner with TERA HARZ CLEAR requires an additive manufacturing system (AMS) that includes compatible with the following:

BrandType
Design:
Intraoral scanner3Shape A/STRIOS 3 Basic
Design software3Shape A/S3Shape Ortho System™™
Additive Manufacturing System:
3D PrinterUNIZSLASH 2
SprintRay Inc.SprintRay Pro 95
Post-Curing:
Post-cure unitCureMU102H

6

VII. COMPARISON OF TECHNOLOGICAL CHARACTERISTICS WITH THE PREDICATE DEVICE

The indications for use and mechanism of action of subject device is identical to the predicate device and supports a determination of substantial equivalence.

However, there is a main difference in the predicate device because the materials of use and the manufacturing process are differed.

So, Dental LT Clear Resin (V2) is selected as a reference device to support method of processing and raw material.

So that, TERA HARZ CLEAR performed testing as that of each predicate device. All test results of Flexural Strength, Flexural Modulus,Water Solubility, and Water Sorption was similar to that of the predicate device that meet the requirements of ISO 20795-2:2013. The performance characteristics of the TERA HARZ CLEAR are comparable to those of the predicate device for this particular indication and raise no new or different questions of safety and effectiveness. Therefore, the subject device and the predicate device are substantially equivalent in physical properties.

Any differences in technology characteristics are accompanied by information that demonstrated the device is as safe and as effective as the predicate device and do not raise different questions of safety and effectiveness than the predicate.

It was concluded, therefore, that the technological differences do not raise different questions of safety and effectiveness.

| | SUBJECT Device | Primary PREDICATE
Device (K180107) | REFERENCE Device | Significant Difference |
|-------------------------------|---------------------|---------------------------------------|------------------------------------------------|----------------------------------------------------------------|
| Manufacturer | Graphy Inc. | Blue Sky Bio LLC | Formlabs Inc. | - |
| Trade Name | TERA HARZ CLEAR | Blue Sky Bio Aligner | Dental LT Clear Resin
(V2) | - |
| Device Classification
Name | aligner, sequential | aligner, sequential | MAINTAINER, SPACE
PREFORMED,
ORTHODONTIC | - |
| Regulation Number | 21 CFR 872.5470 | 21 CFR 872.5470 | 21 CFR 872.5525 | Predicate device :
same
Reference device :
different |
| Product Code | NXC | NXC | DYT, KMY | Predicate device :
same
Reference device :
different. |
| Class | II | II | | Predicate device :
same
Reference device :
different. |

7

SUBJECT DevicePrimary PREDICATEREFERENCE DeviceSignificant Difference
Device (K180107)
ManufacturerGraphy Inc.Blue Sky Bio LLCFormlabs Inc.
Indications for UseTERA HARZ CLEAR is
intended for the
treatment of tooth
malocclusions in patients
with permanent dentition
(i.e., all second molars).
Utilizing a series of
incremental tooth
movements, it
sequentially positions
teeth by way of
continuous gentle force.
TERA HARZ CLEAR is
intended exclusively for
professional dental
work. Fabrication of
aligner with TERA HARZ
CLEAR requires an
additive manufacturing
system (AMS)
that
includes compatible with
the following:Blue Sky Bio Aligners
are a series of clear,
lightweight, plastic
appliances indicated for
the treatment of tooth
malocclusions in
patients with permanent
dentition
(i.e., all second molars).
Utilizing a series of
incremental tooth
movements, it
sequentially positions
teeth by way of
continuous gentle force.Dental LT Clear Resin
(V2) enables dental
practices and labs to
rapidly manufacture a
range of dental products
in-house, from
biocompatible surgical
guides and splints to
fixed prosthetic and
clear aligner models.Similarities: Indications
for use of the subject
device is slightly
different from the
predicate device in
phrase but fundamental
indication is the
identical. However, the
reference device is
different.
Mechanism of ActionOrthodontic tooth
movement occurs
through forces applied
to the teeth by the
appliance to the
dentition as each tooth
follows the programmed
displacement based on
a dental health
professional's
prescription.The mechanism of
action is similar to the
predicate devices and
supports a
determination of
substantial equivalence.
Orthodontic tooth
movement occurs
through forces applied
to the teeth by the
appliance to the
dentition as each tooth
follows the programmed
displacement based on a
dental health
professional's
prescriptionUnknownSimilarities:
Mechanism of action of
the subject device is
identical from the
predicate device.
however, reference
device is unknown.
SUBJECT DevicePrimary PREDICATE
Device (K180107)REFERENCE DeviceSignificant Difference
ManufacturerGraphy Inc.Blue Sky Bio LLCFormlabs Inc.
In Use DurationAligners are worn for approximately 1 week
of 20-22 hours of wear per day, after which itis
replaced by the next stage aligners. This is
repeated for duration as prescribed by the
dental clinician.UnknownUnknownDifference: Because the predicate device and
reference device are unknown, we concluded that the
predicate device and the subject device are different.
Materials of UseMethacrylate-based resinsEssix Thermoplastic resinsMethacrylate-based resinsDifference: The predicate device and subject device is
different. However reference device is similar in
Methacrylate-based resins.
so Dental LT Clear Resin(V2) is selected as a reference
device to support raw material.
Manufacturing
TechnologyAdditiveThermoformingAdditiveDifference: The predicate device and subject device is
different. since there are no products in the market that
have the same manufacturing process as our aligners,
Dental LT Clear Resin (V2) is selected as a reference
device to support manufacturing process.
SUBJECT DevicePrimary PREDICATE
Device (K180107)REFERENCE DeviceSignificant Difference
ManufacturerGraphy Inc.Blue Sky Bio LLCFormlabs Inc.
DesignImage: Subject Device DesignImage: Primary Predicate Device DesignImage: Reference Device DesignSimilarities: The arch
shape does not
introduce any
additional safety or
efficacy concerns.
Dimensions of the arch
form are in the same
range.
Performance TestingISO 20795-2:2013Does not apply.ISO and ASTMSimilarities: This does
not introduce
additional safety or
efficacy concerns
because subject device
and predicate device
meet some
requirements from ISO
20795-2:2013.
Surface characteristicsTesting of 5 samples,
same lot with 2 kind of
3d printer(UNIZ Slash2 ,
SprintRay pro95)
The surface of the
sample was smooth,
hard and glossy;The surface of the
sample was smooth,
hard and glossy.UnknownSimilarities:
The specifications of
predicate device are in
the same range. This
minor variance does not
introduce additional
safety or efficacy
concerns because both
devices meet
requirements from ISO
20795-2:2013.
SUBJECT DevicePrimary PREDICATEREFERENCE DeviceSignificant Difference
Device (K180107)
ManufacturerGraphy Inc.Blue Sky Bio LLCFormlabs Inc.-
Shape capabilityTesting of 5 samples,
same lot with 2 kinds of
3d printer (UNIZ Slash2 ,
SprintRay pro95)

Sample edges
were
reproduced; | Sample edges
were
reproduced. | Unknown | Similarities:
The specifications of
predicate device are in
the same range. This
minor variance does
not introduce
additional safety or
efficacy concerns
because both devices
meetrequirements
from ISO 20795-
2:2013. |
| Colour | Testing of 5 samples,
same lot with 2 kind of
3d printer (UNIZ Slash2 ,
SprintRay pro95)

The color was
expressed
transparently
without changing; | The color was
expressed
transparently
without changing. | Unknown | Similarities:
The specifications of
predicate device are in
the same range. This
minor variance does
not introduce
additional safety or
efficacy concerns
because both devices
meetrequirements
from ISO 20795-
2:2013. |

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9

10

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| | SUBJECT Device | Primary PREDICATE
Device (K180107) | REFERENCE Device | Significant Difference |
|----------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------|---------------------------------------|------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Manufacturer | Graphy Inc. | Blue Sky Bio LLC | Formlabs Inc. | – |
| Freedom from porosity | Testing of 5 samples,
same lot with 2 kind of
3d printer (UNIZ Slash2,
SprintRay pro95)

There is no porosity; | There is no porosity. | Unknown. | Similarities:
The specifications of
predicate device are in
the same range. This
minor variance does
not introduce
additional safety or
efficacy concerns
because both devices
meet requirements
from ISO 20795-
2:2013. |
| Ultimate Flexural Strength
(≥5 MPa) | Testing of 5 samples,
same lot with 2 kind of
3d printer (UNIZ Slash2,
SprintRay pro95)

Uniz
Avg. 5.91 MPa;

SprintRay pro 95
Avg. 6.04 MPa | Avg. 5.17 MPa | Unknown | Similarities:
The ultimate flexural
strength of subject
device is equivalent to
or better than the
predicate device
because the average
value of the subject
device' ultimate
flexural strength was
statistically significantly
higher than that of the
predicate device.
This minor variance
does not introduce
additionalsafety or
efficacy concerns
because both devices
meet requirements
from ISO 20795-
2:2013. |

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| | SUBJECT Device | Primary PREDICATE
Device (K180107) | REFERENCE Device | Significant Difference |
|-------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------|---------------------------------------|------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Manufacturer | Graphy Inc. | Blue Sky Bio LLC | Formlabs Inc. | – |
| Flexural modulus
(≥50 MPa) | Testing of 5 samples,
same lot with 2 3d
printer (UNIZSlash2,
SprintRay pro 95)
Uniz
Avg. 69.10 MPa;
SprintRay pro 95
Avg. 72.37 MPa | Avg. 56.26 MPa | Unknown | Similarities:
The ultimate flexural
strength of subject
device is equivalent to
or better than the
predicate because the
average value of the
subject device'
ultimate flexural
strength was
statistically significantly
higher than that of
the predicate device.
This minor variance
does not introduce
additional safety or
efficacy concerns
because both devices
meet requirements
from ISO 20795-2:2013. |

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| | SUBJECT Device | Primary PREDICATE
Device (K180107) | REFERENCE Device | Significant Difference |
|--------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------|---------------------------------------|------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Manufacturer | Graphy Inc. | Blue Sky Bio LLC | Formlabs Inc. | – |
| Solubility
(≤5 µg/mm3) | Testing of 5 samples,
same lot with 2 kind of
3d printer(UNIZ Slash2 ,
SprintRay pro95)
Uniz
Avg. 1.53 µg/mm3;
SprintRay pro 95
Avg. 1.55 µg/mm3 | Avg. 1.67 µg/mm3 | Unknown | Similarities:
The specifications of
predicate device are in
the same range.
This minor variance
does not introduce
additional safety or
efficacy concerns
because both devices
meet requirements
from ISO 20795-2:2013. |
| Water sorption
(≤32 µg/mm3) | Testing of 5 samples,
same lot with 2 kind of
3d printer(UNIZ Slash2 ,
SprintRay pro95)
Uniz
Avg. 17.44 µg/mm3;
SprintRay pro 95
Avg. 17.02 µg/mm3 | Avg. 17.51 µg/mm3 | Unknown | Similarities:
The specifications of
predicate device are in
the same range.
This minor variance
does not introduce
additional safety or
efficacy concerns
because both devices
meet requirements
from ISO 20795-2:2013. |

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| | SUBJECT Device | Primary PREDICATE
Device (K180107) | REFERENCE Device
(K203000) | Significant Difference |
|-------------------------------------------------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------|----------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Manufacturer | Graphy Inc. | Blue Sky Bio LLC | Formlabs Inc. | – |
| Appearance | Testing of 5 samples, same lot with 2 kind of 3d printer(UNIZ Slash2 , SprintRay pro95)
No evidence of foreign materials, contaminations,or any other defects that should be hazardous uponthe usage. | No evidence of foreign materials, contaminations, or any other defects that should be hazardous upon the usage. | Unknown | No difference. |
| Precision
(The standard deviation
is less than 0.150) | Testing of 5 samples, same lot with 2 kind of 3d printer(UNIZ Slash2 , SprintRay pro95)
Uniz
Avg.0.072/mm
SprintRay pro 95
Avg.0.065/mm | Avg. 0.122/mm | Unknown | Similarities:
The precision of subject device is equivalent to or better than the predicate device because the average value of the subject device' precision was statistically significantly lower than that of the predicate device. |
| Biocompatibility | Biocompatible according to ISO 10993-1 | The material used for the Blue Sky Bio aligners has a 510k clearance as an aligner material ,so no biocompatibility testing was performed. | Biocompatible according to ISO 10993-1 | No difference. |
| OTC or Rx | Rx | Rx | Rx | No difference. |
| Sterile | Not Applicable | Not Applicable | Not Applicable | No difference. |

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VIII. PERFORMANCE DATA

The following performance data were provided in support of the substantial equivalence determination.

Manufacturing Validation

A manufacturing validation was performed to demonstrate the manufacturing process for TERA HARZ CLEAR.

An independent 3rd party software and digital calipers were used to perform point-to- point and critical displacement measurement. All translational measurements were within 0.150 mm of the target input value, the predefined tolerance of the manufacturing process. There were no statistical differences in the difference in the intended and measured values observed from any of the groups. This test has met the pre-established acceptance criteria.

And the test also conducted studies on the effect of manufacturing validation and material reuse on the properties of the final finished device according to FDA's published guidance documents, "Technical Considerations for Additive Manufactured Medical Devices".

The TERA HARZ CLEAR were outputted by each different output condition and each flexural strength were measured and the evaluation criteria of the all the specimens were more than 50 MPa. The optimal output condition is that the output angle is 30°, and the output position is centered to confirming that the optimal condition is to be output.

In addition, it was confirmed that there was no problem in the number of effective outputs for repeated material output up to 7 times.

Performance Testing

Bench testing was performed to ensure the accuracy of the final product carried through the entire process from the initial intraoral scan through treatment planning and manufacturing process of the final finished aligner.

In addition, bench testing was conducted on both the subject device and the predicate device (Blue Sky Bio Aligner, K180107) to evaluate critical properties including Flexural Strength, Flexural Modulus, Water Solubility, Water absorption and etc. All met the requirements of ISO 20795-2:2013, Dentistry - Base Polymers -Part 2: Orthodontic base polymers.

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TERA HARZ CLEAR

| | Representative
sample | (Model/type TC-85DAC)
3D Printer | | Blue Sky Bio
Aligner | |
|----|-------------------------------------------|-------------------------------------------------------------------------|-------------------------------------------------------------------------|-------------------------------------------------------------------------|----------------------------------------------------------------|
| | Test Item | UNIZ Slash 2 | SprintRay
PRO 95 | Blue Sky Bio
Aligner | Test criteria |
| 1. | Surface
characteristics | Sample
surface is
smooth, hard
and glossy. | Sample
surface is
smooth, hard
and glossy. | Sample
surface is
smooth, hard
and glossy. | surface is smooth,
hard, and glossy |
| 2. | Shape
capability | Sample edges
are
reproduced. | Sample edges
are
reproduced. | Sample edges
are
reproduced. | edges are
reproduced |
| 3. | Colour | The color is
expressed
transparently
without
changing. | The color is
expressed
transparently
without
changing. | The color is
expressed
transparently
without
changing. | the color is
expressed
transparently
without changing |
| 4. | Freedom from
porosity | There is no
porosity. | There is no
porosity. | There is no
porosity. | there is no
porosity |
| 5. | Ultimate
Flexural
Strength
(MPa) | Avg. 5.92 | Avg. 6.02 | Avg. 5.17 | ≥5 MPa |
| 6. | Flexural modulus
(MPa) | Avg. 69.10 | Avg. 72.38 | Avg. 56.26 | ≥50 MPa |
| 7. | Solubility | Avg. 1.54 | Avg. 1.56 | Avg. 1.67 | ≤5 µg/mm³ |
| 8. | Water sorption
(≤32 µg/mm³) | Avg. 17.45 | Avg. 17.03 | Avg. 17.51 | ≤32 µg/mm³ |
| 9. | Precision | 1) 0.079/mm
2) 0.075/mm
3) 0.069/mm
4) 0.068/mm
5) 0.071/mm | 1) 0.063/mm
2) 0.069/mm
3) 0.065/mm
4) 0.071/mm
5) 0.059/mm | 1) 0.102/mm
2) 0.139/mm
3) 0.108/mm
4) 0.137/mm
5) 0.125/mm | less than 0.15 |

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As a result, TERA HARZ CLEAR tested with two types of 3D prints and predicate device met the tests criteria according to ISO 20795-2:2013, Dentistry – Base Polymers – Part 2: Orthodontic base polymers.

The result of the performance comparison test demonstrates that TERA HARZ CLEAR is substantially equivalent to the predicate device in physical properties. Both devices meet requirements of ISO 20795-2:2013.

Biocompatibility

A biocompatibility discussion was conducted. The TERA HARZ CLEAR uses the methacrylate-based resin, and this material has been tested and shown to be compliant with the following standards:

  • | EN ISO 7405:2018, Dentistry – Evaluation of biocompatibility of medical devices used in dentistry
  • -EN ISO 10993-1:2018, Biological evaluation of medical devices – Part 1: Evaluation and testing
  • -EN ISO 10993-3:2014, Biological evaluation of medical devices – Part 3: Tests for genotoxicity, carcinogenicity and reproductive toxicity
  • EN ISO 10993-5:2009, Biological evaluation of medical devices – Part 5: Tests for in vitro cytotoxicity
  • -EN ISO 10993-10:2013, Biological evaluation of medical devices – Part 10: Tests for irritation and skin sensitization
  • -EN ISO 10993-11:2018, Biological evaluation of medical devices – Part 11: Tests for systemic toxicity

IX. CLINICAL DATA

Clinical performance data was not provided for TERA HARZ CLEAR.

X. CONCLUSIONS

The TERA HARZ CLEAR is very similar to the predicate device and demonstrate substantial equivalence to predicate device K180107 in physical properties.

An analysis for subject device compared to the predicate device show TERA HARZ CLEAR and the Blue Sky Bio Aligner meet the requirements of Manufacturing Validation, all two devices share the same product code, meet the requirements, and all two are biocompatible.

In addition, an analysis for subject device compared to the predicate device show TERA HARZ CLEAR and the Blue Sky Bio Aligner meet the requirements of ISO 20795-2:2013, Dentistry – Base Polymers – Part 2: Orthodontic base polymers. All two devices meet or exceed the minimum strength requirements, and all two are biocompatible.

Any differences between subject device and the predicate device are material of use and method of processing. So reference device, which has same method of processing and is similar in material of use, is added to support material of use and method of processing.