K Number
K230126
Device Name
Dentis s-Clean Regular Abutment
Manufacturer
Date Cleared
2023-08-04

(199 days)

Product Code
Regulation Number
872.3630
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
Dentis s-Clean Regular Abutment 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 terminal or intermediate abutment support for fixed bridgework. This system is dedicated for one and two stage surgical procedures. This system is intended for delayed loading.
Device Description
Dentis s-Clean Regular Abutment is intended for use as an aid in prosthetic restoration. It consists of Abutments, components, and Abutment screws.
More Information

No
The summary describes a dental abutment and its components, focusing on mechanical and sterilization testing. There is no mention of AI, ML, image processing, or any software-driven analytical capabilities.

No
The device is described as an abutment intended for use in prosthetic restoration, which is a supportive component rather than a device that treats or cures a condition.

No

Explanation: The device is described as an abutment used in prosthetic restoration for single or multiple unit restorations, not for diagnosing medical conditions.

No

The device description explicitly states it consists of "Abutments, components, and Abutment screws," which are physical hardware components. The performance studies also detail testing on physical materials and sterilization processes for these components.

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

Here's why:

  • IVD Definition: In vitro diagnostics are tests performed on samples taken from the human body, such as blood, urine, or tissue, to detect diseases, conditions, or infections.
  • Device Description and Intended Use: The description and intended use clearly state that the Dentis s-Clean Regular Abutment is a physical component used in dental prosthetic restoration, specifically for supporting single or multiple unit restorations in the mouth. It is implanted into the jawbone.
  • Lack of Mention of Biological Samples or Testing: There is no mention of the device being used to analyze biological samples or perform any kind of diagnostic test. The performance studies focus on mechanical properties (fatigue), sterilization, shelf life, and biocompatibility, which are relevant to an implantable medical device, not an IVD.

Therefore, the Dentis s-Clean Regular Abutment is a medical device, but not an in vitro diagnostic device.

N/A

Intended Use / Indications for Use

Dentis s-Clean Regular Abutment 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 terminal or intermediate abutment support for fixed bridgework. This system is dedicated for one and two stage surgical procedures. This system is intended for delayed loading.

Product codes

NHA

Device Description

Dentis s-Clean Regular Abutment is intended for use as an aid in prosthetic restoration. It consists of Abutments, components, and Abutment screws.

Dentis s-Clean Regular Abutment is compatible with the fixtures below:

K numberDevice NameDimension Ranges
K192688s-Clean SQ-SL FixtureØ5.8, 6.8 and 7.8 (D) x 7.0, 7.5, 9.5, 11.4 and 1

Tolerance of dimension shall be within ± 1% range.

The dimensions of abutments are as following:

No.Device NameDimension RangesAngulation
1s-Clean Couple AbutmentØ4.5, 5.5 and 6.5 (D) x 7.3, 7.44, 7.8, 7.94, 8.3, 8.44, 8.8,
8.94, 9.8, 9.94, 10.8 10.94, 11.8 and 11.94mm (L)
2s-Clean Angled AbutmentØ4.5, 5.5 and 6.5 (D) x 9.4, 9.54, 10.4, 10.54, 12.4 and
12.54mm (L)15° and 25°
3s-Clean Temporary AbutmentØ4.5 and 5.5 (D) x 15.4 and 15.54mm (L)
4s-Clean MU Angled
AbutmentØ4.8 (D) x 6.1mm (L)17°
5s-Clean MU Healing CapØ5.8 and 6.8 (D) x 4.1mm (L)
6s-Clean Multi Use Coping
Healing CapØ5.2, 5.9 and 6.9 (D) x 6.1mm (L)
7O-Ring Abutment Retainer
CapØ5.15 (D) x 4.3mm (L)
8O-Ring Abutment O-RingØ4.4 and 4.6 (D) x 1.5mm (L)
9SAVE Wide CapØ6.0, 7.0 and 8.0 (D) x 7.7, 8.6 and 9.6mm (L)

The Abutments have below featured:

NameUsesSurfaceConnection
s-Clean Couple AbutmentThe Abutment is connected with fixture and it
supports prosthesis which restores tooth
function.Non
s-Clean Angled AbutmentNon
s-Clean Temporary AbutmentThis Abutment is used for fabricating
provisional restorationNonInternal Hex
2.5
s-Clean MU Angled AbutmentMU Abutment is useful for various angulation
implanted fixture and gingival angulation.
MU Angled Abutment is for multi-unit only.Non
s-Clean MU Healing CapThis Healing cap is used for protect the
abutment and reduce patient discomfort.NonScrew
retained
s-Clean Multi Use Coping Healing
CapNonN/A
O-Ring Abutment Retainer CapNonN/A
O-Ring Abutment O-RingThis O-Ring Abutment is used for overdentureNonN/A
SAVE Wide CapSAVE Wide Cap is intended for use as an aid in
prosthetic rehabilitation.NonScrew
retained

Tolerance of dimension for Abutments shall be within ± 1% range.

Dentis s-Clean Regular Abutment is provided non-sterilized. The SAVE Wide Cap is provided sterilized.

Materials:

  • s-Clean Couple Abutment, s-Clean Angled Abutment, s-Clean MU Angled Abutment, s-Clean MU ● Healing Cap and SAVE Wide Cap are fabricated from Ti-6A1-4V of ASTM F136
  • s-Clean Temporary Abutment and O-Ring Abutment Retainer Cap are fabricated from Pure Titanium . for ASTM F67
  • . s-Clean Temporary Abutment is fabricated form Polyetheretherketone for ASTM F2026
  • s-Clean Multi Use Coping Healing Cap is fabricated from Polyoxymethylene(POM) for ASTM F1855

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

partially or fully edentulous 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)

Non-Clinical Test Data:

  • Fatigue Testing under the worst-case scenario according to ISO 14801:2016
  • Sterilization Validation Test for SAVE Wide Cap according to ISO 11137-1.2,3
  • Shelf Life Test for SAVE Wide Cap according to ASTM F1980 referenced in K171027
  • End User Sterilization Validation Test Report for Abutments made with Ti-6Al-4V ELI according to ANSVAAMI ST79, ISO 17665-1,-2, ISO 11737-1,-2, and ISO 11138-1 referenced in K111364
  • End User Sterilization Validation Test Report for Abutments made with PEEK, POM and CP Titanium Grade 4 according to ANSI/AAMI ST79, ISO 17665-1,-2, ISO 11737-1,-2, and ISO 11138-1
  • Biocompatibility testing for subject Abutments according to ISO 10993-1:2009 referenced in K171027, K171694, and K222913

Key results:
The results of the above tests have met the criteria of the standards and demonstrated the substantial equivalence with the predicate device.
Gamma sterilization test was performed for our other device. Healing Abutment (DSHZ7890C) as test specimen and leveraged for the subject device because material, manufacturing process, sterilization and packaging of both products are exactly same.
The end user sterilization test was performed for the predicate device K171027 and reference device K111364 and leveraged for the subject device because the product category, material, manufacturing process, facility, and packaging of the both products are exactly same.
For other subject devices made with other materials as POM, PEEK and Pure Titanium Gr4, the end user sterilization validation reports are provided.
The Biocompatibility Test was conducted on the predicate device and leveraged for the subject device because both products are manufactured with same materials and manufacturing process. It demonstrates that the subject device is biocompatible and substantial equivalence with the predicate.
The non-clinical testing results demonstrate that the subject device is substantially equivalent to the predicate device.

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

Not Found

Predicate Device(s)

K171027

Reference Device(s)

K082843, K111364, K150344, K161689, K171694, K210134, K210826, K222913

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 872.3630 Endosseous dental implant abutment.

(a)
Identification. An endosseous dental implant abutment is a premanufactured prosthetic component directly connected to the endosseous dental implant and is intended for use as an aid in prosthetic rehabilitation.(b)
Classification. Class II (special controls). The guidance document entitled “Class II Special Controls Guidance Document: Root-Form Endosseous Dental Implants and Endosseous Dental Implant Abutments” will serve as the special control. (See § 872.1(e) for the availability of this guidance document.)

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Image /page/0/Picture/0 description: The image shows the logo of the U.S. Food and Drug Administration (FDA). The logo consists of two parts: the Department of Health & Human Services logo on the left and the FDA acronym followed by the full name of the agency on the right. The Department of Health & Human Services logo is a stylized depiction of an eagle. The FDA acronym and the agency's full name are in blue.

Dentis Co., Ltd % April Lee Consultant Withus Group Inc 106 Superior Irvine, California 92620

Re: K230126

Trade/Device Name: Dentis s-Clean Regular Abutment Regulation Number: 21 CFR 872.3630 Regulation Name: Endosseous Dental Implant Abutment Regulatory Class: Class II Product Code: NHA Dated: July 5, 2023 Received: July 6, 2023

Dear April 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.

1

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

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

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

Sincerely.

Andrew I. Steen -S

Andrew I. Steen Assistant Director DHT1B: Division of Dental and ENT Devices OHT1: Office of Ophthalmic, Anesthesia, Respiratory, ENT and Dental Devices Office of Product Evaluation and Ouality Center for Devices and Radiological Health

Enclosure

2

Indications for Use

510(k) Number (if known) K230126

Device Name Dentis s-Clean Regular Abutment

Indications for Use (Describe)

Dentis s-Clean Regular Abutment is indicated for use in partially or fully edentulous mandibles and maxillae, in support of single or multiple unit restorations including; cemented retained, or overdenture restorations, and terminal or intermediate abutment support for fixed bridgework. This system is dedicated for one and two stage surgical procedures. This system is intended for delayed loading.

Type of Use (Select one or both, as applicable)

☑ Prescription Use (Part 21 CFR 801 Subpart D)
☐ Over-The-Counter Use (21 CFR 801 Subpart C)

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510(K) Summary

Submitter

Dentis Co., Ltd. Gyu Ri Kim 99, Seongseoseo-ro, Dalseo-gu Daegu, 42718 Korea Email: kgr1026@dentis.co.kr Tel. +82-53-589-3541 Fax. +82-53-289-7922

Official Correspondent

Withus Group Inc. April Lee 106 Superior, Irvine. CA 92620 USA Email: withus6664@gmail.com Phone: 1-909-274-9971 Fax: 1-909-460-8122

Device Information

  • Trade Name: Dentis s-Clean Regular Abutment
  • Common Name: Dental Implant Abutment
  • Classification Name: Abutment, Implant, Dental, Endosseous ●
  • Product Code: NHA
  • Panel: Dental ●
  • Regulation Number: 872.3630
  • Device Class: Class II
  • Date Prepared: 08/04/2023

Predicate Devices:

The subject device is substantially equivalent to the following predicate devices:

Primary Predicate

  • K171027, Dentis Dental Implant System manufactured by Dentis Co., Ltd.

Reference devices

  • K082843, Dentis Dental Implant System manufactured by Dentis Co., Ltd
  • K111364, HAPTITE COATING IMPLANT SYSTEM by Dentis Co., Ltd.
  • K150344, Dentis Dental Implant System manufactured by Dentis Co., Ltd.
  • K161689, OSSTEM Implant System manufactured by Osstem Implant Co., Ltd ●
  • K171694, s-Clean TiN Coating Abutment manufactured by Dentis Co., Ltd.
  • K210134, Dentis s-Clean s-Line manufactured by Dentis Co., Ltd.
  • K210826, Healing Abutment, Cover Screw manufactured by Megagen Implant Co., Ltd. ●
  • . K222913, s-Clean Link Abutment by Dentis Co., Ltd.

Indication for Use:

Dentis s-Clean Regular Abutment 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 terminal or intermediate abutment support for fixed bridgework. This system is dedicated for one and two stage surgical procedures. This system is intended for delayed loading.

4

Device Description:

Dentis s-Clean Regular Abutment is intended for use as an aid in prosthetic restoration. It consists of Abutments, components, and Abutment screws.

Dentis s-Clean Regular Abutment is compatible with the fixtures below:

K numberDevice NameDimension Ranges
K192688s-Clean SQ-SL FixtureØ5.8, 6.8 and 7.8 (D) x 7.0, 7.5, 9.5, 11.4 and 1

Tolerance of dimension shall be within ± 1% range.

The dimensions of abutments are as following:

No.Device NameDimension RangesAngulation
1s-Clean Couple AbutmentØ4.5, 5.5 and 6.5 (D) x 7.3, 7.44, 7.8, 7.94, 8.3, 8.44, 8.8,
8.94, 9.8, 9.94, 10.8 10.94, 11.8 and 11.94mm (L)
2s-Clean Angled AbutmentØ4.5, 5.5 and 6.5 (D) x 9.4, 9.54, 10.4, 10.54, 12.4 and
12.54mm (L)15° and 25°
3s-Clean Temporary AbutmentØ4.5 and 5.5 (D) x 15.4 and 15.54mm (L)
4s-Clean MU Angled
AbutmentØ4.8 (D) x 6.1mm (L)17°
5s-Clean MU Healing CapØ5.8 and 6.8 (D) x 4.1mm (L)
6s-Clean Multi Use Coping
Healing CapØ5.2, 5.9 and 6.9 (D) x 6.1mm (L)
7O-Ring Abutment Retainer
CapØ5.15 (D) x 4.3mm (L)
8O-Ring Abutment O-RingØ4.4 and 4.6 (D) x 1.5mm (L)
9SAVE Wide CapØ6.0, 7.0 and 8.0 (D) x 7.7, 8.6 and 9.6mm (L)

The Abutments have below featured:

NameUsesSurfaceConnection
s-Clean Couple AbutmentThe Abutment is connected with fixture and it
supports prosthesis which restores tooth
function.Non
s-Clean Angled AbutmentNon
s-Clean Temporary AbutmentThis Abutment is used for fabricating
provisional restorationNonInternal Hex
2.5
s-Clean MU Angled AbutmentMU Abutment is useful for various angulation
implanted fixture and gingival angulation.
MU Angled Abutment is for multi-unit only.Non
s-Clean MU Healing CapThis Healing cap is used for protect the
abutment and reduce patient discomfort.NonScrew
retained
s-Clean Multi Use Coping Healing
CapNonN/A
O-Ring Abutment Retainer CapNonN/A
O-Ring Abutment O-RingThis O-Ring Abutment is used for overdentureNonN/A
SAVE Wide CapSAVE Wide Cap is intended for use as an aid in
prosthetic rehabilitation.NonScrew
retained

Tolerance of dimension for Abutments shall be within ± 1% range.

Dentis s-Clean Regular Abutment is provided non-sterilized. The SAVE Wide Cap is provided sterilized.

5

Materials:

  • s-Clean Couple Abutment, s-Clean Angled Abutment, s-Clean MU Angled Abutment, s-Clean MU ● Healing Cap and SAVE Wide Cap are fabricated from Ti-6A1-4V of ASTM F136
  • s-Clean Temporary Abutment and O-Ring Abutment Retainer Cap are fabricated from Pure Titanium . for ASTM F67
  • . s-Clean Temporary Abutment is fabricated form Polyetheretherketone for ASTM F2026
  • s-Clean Multi Use Coping Healing Cap is fabricated from Polyoxymethylene(POM) for ASTM F1855

Summaries of Technological Characteristics & Substantial Equivalence Discussion

Subject DevicePrimary Predicate
K numberK230126K171027
ManufacturerDentis Co., LtdDentis Co., Ltd
Trade NameDentis s-Clean Regular AbutmentDentis Dental Implant System
Product Names-Clean Couple Abutments-Clean Couple Abutment
DesignImage: s-Clean Couple Abutment designImage: s-Clean Couple Abutment design
DiameterØ4.5, 5.5 and 6.5Ø4.0, 4.5, 4.8, 5.5, 6.0 and Ø6.5
Gingival Height0.8, 1.3, 1.8, 2.3, 3.3, 4.3 and 5.3mm0.8, 1.3, 1.8, 2.3, 3.3, 4.3 and 5.3mm
Length7.3, 7.44, 7.8, 7.94, 8.3, 8.44, 8.8,
8.94, 9.8, 9.94, 10.8 10.94, 11.8 and
11.94mm7.3, 7.44, 7.8, 7.94, 8.3, 8.44, 8.8, 8.94, 9.3, 9.44,
9.8, 9.94, 10.3, 10.4, 10.44, 10.8, 10.9, 10.94,
11.3, 11.4, 11.44, 11.8, 11.9, 11.94, 12.3, 12.44,
12.8, 12.9, 12.94, 13.3, 13.44, 13.8, 13.9, 13.94,
14.8, 14.9 and 14.94mm
MaterialTi-6Al-4V ELI
(ASTM F136)Ti-6Al-4V ELI
(ASTM F136)
SterilizationEnd User Sterilization
ComparisonSubject Device and Primary Predicate(K171027) have same indications for use, similar
sizes such as diameters, gingival heights, and lengths, material, and sterilization method.
Both devices are substantial equivalent.

Dentis s-Clean Couple Abutment

s-Clean Angled Abutment

Subject DeviceReference Device
K numberK230126K082843
ManufacturerDentis Co., LtdDentis Co., Ltd
Trade NameDentis s-Clean Regular Abutments-Clean TiN Coating Abutment
Product Names-Clean Angled Abutments-Clean Angled Abutment
DesignImage: Subject Device DesignImage: Reference Device Design
DiameterØ4.5, 5.5 and Ø6.5Ø4.5, 5.0, 5.5 and Ø6.5
Gingival Height0.8, 1.8 and 3.8mm1.8 and 3.8mm
Length9.4, 9.54, 10.4, 10.54, 12.4 and
12.54mm10.54 and 12.54mm
Angulation15° and 25°15° and 25°
MaterialTi-6Al-4V ELI
(ASTM F136)Ti-6Al-4V ELI
(ASTM F136)
SterilizationEnd User SterilizationEnd User Sterilization

6

ComparisonSubject Device and Reference Device (K082843) have same indications for use, size as diameter, gingival height, angulation, material, and sterilization method. The lengths of the devices are different, but this difference is not an important factor for the device performance. Thus, both devices are substantial equivalent.
-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

s-Clean Temporary Abutment

Subject DevicePrimary Predicate
K numberK230126K171027
ManufacturerDentis Co., LtdDentis Co., Ltd
Trade NameDentis s-Clean Regular AbutmentDentis Dental Implant System
Product Names-Clean Temporary Abutments-Clean Temporary Abutment
DesignImage: Subject Device DesignsImage: Primary Predicate Designs
DiameterØ4.5 and Ø 5.5Ø4.5, 4.8, 5.5, 6.0 and Ø6.5
Length15.4 and 15.54mm13.4 and 13.54mm
MaterialPure Titanium Gr4 (ASFM F67) / PEEKPure Titanium Gr4 (ASFM F67) / PEEK
SterilizationEnd User SterilizationEnd User Sterilization
ComparisonSubject Device and Primary Predicate (K171027) have same indications for use, diameters, material, and sterilization method. Difference is only length, however, this difference is not importance factor for this product because this is used temporary. Both devices are substantial equivalent.

s-Clean MU Angled Abutment

Subject DeviceReference Device
K numberK230126K150344
ManufacturerDentis Co., LtdDentis Co., Ltd
Trade NameDentis s-Clean Regular AbutmentDentis Dental Implant System
Product Names-Clean MU Angled AbutmentMU Angled Abutment
DesignImage: Subject Device DesignImage: Reference Device Design
DiameterØ4.8Ø4.8
Length6.1mm6.08, 8.08, 6.69 and 8.69mm
Angulation17°17° and 30 °
MaterialTi-6Al-4V ELI (ASTM F136)Ti-6Al-4V ELI (ASTM F136)
SterilizationEnd User SterilizationEnd User Sterilization
ComparisonSubject Device and Reference Device (K150344) have same indications, diameter, length,
angulation, material, and sterilization method. Thus, both devices are substantial equivalent.

7

the control control control control control of the control of the control of the control of the control of the control of the control of the contribution of the control of th

s-Clean MU Healing Cap

Subject DeviceReference Device
K numberK230126K210134
ManufacturerDentis Co., LtdDentis Co., Ltd
Trade NameDentis s-Clean Regular AbutmentDentis s-Clean s-Line
Product Names-Clean MU Healing Caps-Clean MU Healing Cap
DesignImage: Subject Device DesignImage: Reference Device Design
Head Diameter$Ø$ 5.8 and 6.8$Ø$ 4.8
Length4.1mm4.1mm
MaterialTi-6Al-4V ELI (ASTM F136)Ti-6Al-4V ELI (ASTM F136)
SterilizationSteam sterilization by UserSteam sterilization by User
ComparisonSubject Device and Reference Device (K150344) have same indications for use and
material. The diameter and length are different but this difference is not an important factor
for the device performance. Thus, both devices are substantial equivalent.

s-Clean Multi Use Coping Healing Cap

Subject DeviceReference Device
K numberK230126K171694
ManufacturerDentis Co., LtdDentis Co., Ltd
Trade NameDentis s-Clean Regular Abutments-Clean TiN Coating Abutments
Product Names-Clean Multi Use Coping Healing CapSole Healing Cap
DesignImage: Subject Device DesignImage: Reference Device Design
Head Diameter$Ø$ 5.2, 5.9 and 6.9$Ø$ 4.6, 5.1, 5.9, 6.3, 6.8 and 6.9
Length6.1mm6.7, 7.5 and 9.0mm
MaterialPOMPOM
SterilizationEnd User SterilizationEnd User Sterilization
ComparisonSubject Device and Reference Device (K171694) have same indications for use and material. The diameter and length are different but this difference is not an important factor for the device performance. Thus, both devices are substantial equivalent.

O-Ring Abutment Retainer Cap

Subject DeviceReference Device
K numberK230126K161689
ManufacturerDentis Co., LtdOsstem Implant Co., Ltd
Trade NameDentis s-Clean Regular AbutmentOsstem Abutment System-Abutment
Product NameO-Ring Abutment Retainer CapO-ring Retainer Cap Set
DesignImage: Subject Device DesignImage: Reference Device Design
Head DiameterØ5.15Ø5.0
Length4.3mm3.9mm
MaterialPure Titanium Gr4 (ASTM F136)Titanium
SterilizationEnd User SterilizationEnd User Sterilization
ComparisonSubject Device and Reference Device (K161689) have same indications for use, similar
sizes and material. The diameter and length are slightly different, but this difference is not
an important factor for the device performance. Both devices are substantial equivalent.

8

Subject DeviceReference Device
K numberK230126K161689
ManufacturerDentis Co., LtdOsstem Implant Co., Ltd
Trade NameDentis s-Clean Regular AbutmentOsstem Abutment System-Abutment
Product NameO-Ring Abutment O-RingO-ring Retainer Cap Set
DesignImage: Red O-ringImage: Yellow O-ring
DiameterØ4.4 and 4.6Ø4.6
Length1.5mm1.5 mm
MaterialSiliconNBR(Acrylonitrile & Butadiene Polymer)
SterilizationEnd User SterilizationEnd User Sterilization
ComparisonThe Subject Device and Reference Device (K161689) have same indications for use,
length, and sterilization method. The diameter and material are different but both devices
are not patient contact, and it is not important factor to the device performance. The subject
device is substantial equivalent

O-Ring Abutment O-Ring

SAVE Wide Cap

Subject DeviceReference Device
K numberK230126K210826
ManufacturerDentis Co., LtdMegaGen Implant Co., Ltd.
Trade NameDentis s-Clean Regular AbutmentHealing Abutment, Cover Screw
Product NameSAVE Wide CapCover Screw
DesignImage: Subject Device DesignImage: Reference Device Design
DiameterØ6.0, 7.0 and 8.0Ø6.0
Length7.7, 8.6 and 9.6mm7.2~8.3mm
MaterialTi-6Al-4V ELI (ASTM F136)Ti-6Al-4V ELI (ASTM F136)
SterilizationGamma SterilizationGamma Sterilization
Shelf Life8years5years
ComparisonSubject Device and Reference Device (K210826) have same indications for use and
material. The diameter and length are different, but this difference is not important factors
for the device performance. Both devices are substantial equivalent

9

Non-Clinical Test Data

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:

  • Sterilization Validation Test for SAVE Wide Cap according to ISO 11137-1.2,3 .

  • . Shelf Life Test for SAVE Wide Cap according to ASTM F1980 referenced in K171027

  • . End User Sterilization Validation Test Report for Abutments made with Ti-6Al-4V ELI according to ANSVAAMI ST79, ISO 17665-1,-2, ISO 11737-1,-2, and ISO 11138-1 referenced in K111364

  • End User Sterilization Validation Test Report for Abutments made with PEEK, POM and CP Titanium Grade 4 according to ANSI/AAMI ST79, ISO 17665-1,-2, ISO 11737-1,-2, and ISO 11138-1

  • . Biocompatibility testing for subject Abutments according to ISO 10993-1:2009 referenced in K171027, K171694, and K222913

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

Gamma sterilization test was performed for our other device. Healing Abutment (DSHZ7890C) as test specimen and leveraged for the subject device because material, manufacturing process, sterilization and packaging of both products are exactly same.

The end user sterilization test was performed for the predicate device K171027 and reference device K111364 and leveraged for the subject device because the product category, material, manufacturing process, facility, and packaging of the both products are exactly same.

For other subject devices made with other materials as POM, PEEK and Pure Titanium Gr4, the end user sterilization validation reports are provided.

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

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

Conclusion

Dentis s-Clean Regular Abutment constitutes a substantially equivalent medical device, meeting all the declared requirements of its intended use. This system has the same intended use and fundamental scientific technology as its predicate devices. Therefore, s-Clean Regular Abutment and its predicates are substantially equivalent.