K Number
K232735
Device Name
EMA 3D
Date Cleared
2024-05-03

(239 days)

Product Code
Regulation Number
872.5570
Panel
Dental
Reference & Predicate Devices
Predicate For
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The EMA 3D is a removable medical device that is fitted in the patient's mouth and is intended to reduce or alleviate snoring and mild to moderate obstructive sleep apnea (OSA) in adults.

Device Description

The EMA 3D device is a simple hardware device. It is an oral appliance and will be manufactured by a dental laboratory to and on the order of a dentist, physician or licensed practitioner. Each appliance is customized for patients. The EMA 3D device is intra-oral device used for treating snoring and mild to moderate Obstructive Sleep Apnea (OSA). It has a patented button hook design with variable elastic band for optimum titration with bitewing if needed. The device consists of two custom fitted trays which fit over the upper and lower dentition of a patient. The trays are standard biocompatible trays that do not reposition teeth. Each tray holds the teeth in their present location not allowing tooth movement. The devices function as mandibular repositioners, which act to increase the patient's pharyngeal space by reducing obstructions of the airway during sleep and improve their ability to exchange air. There are four button hooks utilized on the EMA 3D device (two hooks per tray, two trays top and bottom. The hooks must be placed at a distance of 21mm apart from the top tray hook to the bottom tray hook center to center. Though there is no requirement except the opitimum location for hook placement between the top and bottom trays is on the upper bicuspid and the lower first molar. Button hooks and bite blocks for the EMA 3D utilize standard dimensions. These button hooks serve as fastening anchors for Elastic Straps that come in four different color coded strengths: White-Soft, Yellow-Medium, Blue-Firm and Clear- Extra Firm. These straps also come in 9 different lengths such that the Dental Professional can ensure the patient specific correct amount of mandibular advancement the lengths are as follows: 21mm, 20mm, 19mm, 18mm, 17mm, 16mm, 15mm, 14mm, 13mm.

AI/ML Overview

Based on the provided text, the device in question is the EMA 3D, an intraoral device for snoring and mild to moderate obstructive sleep apnea (OSA) in adults. The substance of the application is a 510(k) premarket notification, which seeks to demonstrate substantial equivalence to legally marketed predicate devices, not to prove clinical efficacy through a comparative effectiveness study or standalone algorithm performance. Therefore, the information provided focuses on non-clinical performance data and comparison to predicates rather than a clinical study with human readers or AI.

Here's a breakdown of the requested information based on the document:

1. A table of acceptance criteria and the reported device performance

The document does not explicitly present acceptance criteria in a table format with specific quantitative thresholds for "Pass" or "Fail" for all tests. Instead, it states that "All testing was considered successful and met identified acceptance criteria" and "The EMA 3D passed all the testing in accordance with internal requirements, applied national standards, and applied international standards." The performance data is primarily qualitative and comparative to predicate devices concerning materials, design, and functionality.

Acceptance Criteria CategoryReported Device Performance (Summary)
Mechanical/Physical Properties
Strength Flexural Testing (ISO 20795-2 & ASTM D790-17 as applied to reference materials)Passed; confirmed material properties of Keystone KeySplint Soft/Hard (used for EMA 3D trays).
Biocompatibility
ISO 10993-1 (Biological Evaluation of Medical Devices)Assessed; all components evaluated for biological safety.
ISO 10993-5 (Cytotoxicity)Passed.
ISO 10993-10 (Irritation & Skin Sensitization)Passed.
Risk Management (ISO 14971)
Acceptance of outcomes of risks within the context of ISO 14971 and mitigation to the lowest form.All potential risks considered acceptable and mitigated to the lowest form.
Overall Design & Performance
Meeting overall design, biocompatibility, and performance testing requirements; output meets design inputs/specifications.Met all requirements, confirming substantial equivalence to Primary and Secondary Predicate devices. Performance commensurate with indications for use.

2. Sample size used for the test set and the data provenance (e.g. country of origin of the data, retrospective or prospective)

The document refers to "testing" of the device components and materials. It does not specify sample sizes for these tests in terms of number of devices or patients. The data provenance is also not explicitly stated in terms of country of origin or retrospective/prospective nature. The tests mentioned are laboratory-based material and component performance tests, not clinical studies on patient populations.

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts (e.g. radiologist with 10 years of experience)

This information is not applicable and not provided. The "ground truth" concept usually applies to clinical efficacy or diagnostic accuracy studies (e.g., for AI/image analysis devices). For a hardware device seeking 510(k) clearance based on substantial equivalence, the "ground truth" refers to the adherence to engineering standards and biocompatibility requirements rather than clinical consensus.

4. Adjudication method (e.g. 2+1, 3+1, none) for the test set

This information is not applicable and not provided. Adjudication methods are relevant for studies involving human interpretation or clinical outcomes, which is not the primary focus of this 510(k) submission as described.

5. If a multi reader multi case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance

There is no mention of a multi-reader multi-case (MRMC) comparative effectiveness study or AI assistance. This device is a physical intraoral appliance, not an AI or imaging device where such a study would be relevant.

6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done

There is no mention of a standalone algorithm performance. This is a physical medical device.

7. The type of ground truth used (expert consensus, pathology, outcomes data, etc)

For this device, the "ground truth" is established through adherence to recognized material and performance standards (e.g., ISO, ASTM for mechanical properties; ISO 10993 for biocompatibility) and demonstrable equivalence to predicate devices in terms of indications for use, technological characteristics, and safety profiles. It is not based on direct clinical outcomes data from new patient studies for this 510(k) submission.

8. The sample size for the training set

This information is not applicable and not provided. This is not a machine learning or AI device that would require a "training set."

9. How the ground truth for the training set was established

This information is not applicable and not provided. There is no training set for this type of device.

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Image /page/0/Picture/0 description: The image shows 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 consists of the letters "FDA" in a blue square, followed by the words "U.S. FOOD & DRUG" in blue, with the word "ADMINISTRATION" underneath.

May 3, 2024

EMA Sleep Incorporated % Cheryl Fisher Principal Consultant FisherMed Consulting LLC 820 Civic Center Drive Santa Clara, California 95050

Re: K232735

Trade/Device Name: EMA 3D Regulation Number: 21 CFR 872.5570 Regulation Name: Intraoral Devices For Snoring And Intraoral Devices For Snoring And Obstructive Sleep Apnea Regulatory Class: Class II Product Code: LRK. LOZ Dated: February 5, 2024 Received: February 5, 2024

Dear Cheryl Fisher:

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 (the 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 available 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.

Additional information about changes that may require a new premarket notification are provided in the FDA guidance documents entitled "Deciding When to Submit a 510(k) for a Change to an Existing Device"

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(https://www.fda.gov/media/99812/download) and "Deciding When to Submit a 510(k) for a Software Change to an Existing Device" (https://www.fda.gov/media/99785/download).

Your device is also subject to, among other requirements, the Quality System (QS) regulation (21 CFR Part 820), which includes, but is not limited to, 21 CFR 820.30. Design controls; 21 CFR 820.90. Nonconforming product; and 21 CFR 820.100, Corrective and preventive action. Please note that regardless of whether a change requires premarket review. the OS regulation requires device manufacturers to review and approve changes to device design and production (21 CFR 820.30 and 21 CFR 820.70) and document changes and approvals in the device master record (21 CFR 820.181).

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 Part 803) for devices or postmarketing safety reporting (21 CFR Part 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 Part 4, Subpart A) for combination products; and, if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR Parts 1000-1050.

Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 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.

Bobak Shirmohammadi -S

For Michael E. Adjodha, M.ChE., RAC, CQIA Assistant Director DHT1B: Division of Dental and

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ENT Devices OHT1: Office of Ophthalmic, Anesthesia, Respiratory, ENT and Dental Devices Office of Product Evaluation and Quality Center for Devices and Radiological Health

Enclosure

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Indications for Use

Submission Number (if known)

K232735

Device Name

EMA 3D (EMA 3D)

Indications for Use (Describe)

The EMA 3D is a removable medical device that is fitted in the patient's mouth and is intended to reduce or alleviate snoring and mild to moderate obstructive sleep apnea (OSA) in adults.

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

EMA 3D

K232735

1. Submission Sponsor

EMA Sleep Incorporated

27005 Masters Parkway

Spicewood, TX

78669

United States

Contact: Joseph Frantz

Title: President

2. Submission Correspondent

FisherMed Consulting, LLC

820 Civic Center Drive

Santa Clara, CA 95050

Office Phone: (408) 410-5920

Contact: Cheryl Fisher

Title: Principal Consultant, RA/QA

3. Date Prepared

4/30/24

4. Device Identification

Trade/Proprietary Name:EMA 3D
Common/Usual Name:Intraoral Devices for Snoring and / or Obstructive Sleep Apnea
Classification Name:Intraoral Devices for Snoring and / or Obstructive Sleep Apnea
Regulation Number:872.5570

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Product Code: LRK, Device, Anti Snoring- Intraoral devices for snoring and intraoral devices for snoring and obstructive sleep apnea.

LQZ, Device, Jaw Repositioning- Intraoral devices for snoring and intraoral devices for snoring and obstructive sleep apnea

Device Class: Class II

Classification Panel: Dental

5. Legally Marketed Predicate Device(s)

Primary Predicate K203606 Serena Sleep Elastic Mandibular Advancement

Secondary Predicate K971794 Elastic Mandibular Advancement

Reference Devices K183598 KeySplint Soft K203000 KeySplint Hard

6. Indication for Use Statement

The EMA 3D is a removable medical device that is fitted in the patient's mouth and is intended to reduce or alleviate snoring and mild to moderate obstructive sleep apnea (OSA) in adults.

7. Device Description

The EMA 3D device is a simple hardware device. It is an oral appliance and will be manufactured by a dental laboratory to and on the order of a dentist, physician or licensed practitioner. Each appliance is customized for patients.

The EMA 3D device is intra-oral device used for treating snoring and mild to moderate Obstructive Sleep Apnea (OSA). It has a patented button hook design with variable elastic band for optimum titration with bitewing if needed. The device consists of two custom fitted trays which fit over the upper and lower dentition of a patient. The trays are standard biocompatible trays that do not reposition teeth. Each tray holds the teeth in their present location not allowing tooth movement. The devices function as mandibular repositioners, which act to increase the patient's pharyngeal space by reducing obstructions of the airway during sleep and improve their ability to exchange air.

There are four button hooks utilized on the EMA 3D device (two hooks per tray, two trays top and bottom. The hooks must be placed at a distance of 21mm apart from the top tray hook to the bottom tray hook center to center. Though there is no requirement except the opitimum location for hook placement between the top and bottom trays is on the upper bicuspid and the lower first molar.

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lt is important to note the hooks are made of the same material as the trays and are integrated as a part of the fabrication process.

Button hooks and bite blocks for the EMA 3D utilize standard dimensions.

These button hooks serve as fastening anchors for Elastic Straps that come in four different color coded strengths:

    1. White-Soft
    1. Yellow-Medium
    1. Blue-Firm and
    1. Clear- Extra Firm

These straps also come in 9 different lengths such that the Dental Professional can ensure the patient specific correct amount of mandibular advancement the lengths are as follows:

    1. 21mm
    1. 20mm
    1. 19mm
    1. 18mm
    1. 17mm
    1. 16mm
    1. 15mm
    1. 14mm
    1. 13mm

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8. Substantial Equivalence Discussion

The following table compares the EMA 3D to the Secondary Predicate and reference device(s) and Primary Predicate with respect to indications for use, principles of operation, technological characteristics, and performance testing. The comparison of the devices provides more detailed information regarding the determination of substantial equivalence. The subject device does not raise any new issues of safety or effectiveness based on the similarities to the Secondary Predicate device.

9. FeatureEMA 3DSecondaryPredicateElastic MandibularAdvancementReference Device 1KeySplint SoftReference Device 2KeySplint HardPrimary PredicateSerena Sleep ElasticMandibularAdvancementComparison
510 (k) NumberK232735K971794K183598K203000K203606Same method
ManufacturerEMAIncorporatedDonald Frantz, DDS(Patent Holder ofEMA system)MeyersonKeystone IndustriesKeystone IndustriesSerena Sleep SolutionsNA
Primary Device Similarities to support Substantial Equivalence
Classification #872-5570872-5570UnclassifiedUnclassified872-5570Same
Product CodePrimary LRKPrimary LRKPrimary MQCSecondary KMYPrimary MQCSecondary KMY/EBIPrimary LRKSame

Table 5A – Comparison of Characteristics

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IntendedUseAdults, TransitionalAdolescent (A&B),Adults, TransitionalAdolescent (A&B),and AdolescentNot definedNot definedAdults and TransitionalAdolescent (A&B)Same as PrimaryPredicateMode of ActionThesedevicesfunctionasamandibularrepositioner, whichacts to increase thepatient'spharyngeal space,byreducingobstructions of theairwayandimprovingtheirability to exchangeair during sleep.Thesedevicesfunctionasamandibularrepositioner, whichacts to increase thepatient'spharyngeal space,byreducingobstructions of theairwayandimprovingtheirability to exchangeair during sleep.Not ApplicableThis is a dental resinthe mode of action isdetermined bythetype of device thematerial is fabricatedto beNot ApplicableThis is a dental resinthe mode of action isdetermined bythetype of device thematerial is fabricatedto beMandibularadvancementachieved through thetwin-matedpositioning posts buildinto the upper andlower traysMember of thePrimary Predicatefamily.Same mode ofaction for boththePrimaryPredicateDeviceandSecondaryPredicateReferencedevices 1 and 2are the dentalresins used tomake the EMA 3Dtrays
populationCurrent Market Usage:Adults,TransitionalAdolescent (A&B), andAdolescentCurrent Market usage:Adults,TransitionalAdolescent (A&B), andAdolescentSimilartoSecondaryPredicate .Referencedevices 1 and 2are dental resinsthe EMA 3D ismadeoftherefore theintendedpopulationincludes adultsand transitionalAdolescent (A&B)but is also used inAdolecents forthe use ofretainers made ofthe resinsFunctionalityConsistsofanupper and lowerappliance that are2separateappliancesthatworkinconjunctionwitheach other – via anembedded buttonhook and variableConsistsofanupper and lowerappliance that are 2separateappliancesthatwork in conjunctionwith each other -via a an embeddedbutton hook andvariable size andNot ApplicableThis is the dental resinused to fabricate thetrays for the EMA 3DdeviceNot ApplicableThis is the dental resinused to fabricate thetrays for the EMA 3DdeviceConsists of an upperand lower appliancethat are 2 separateappliances that workin conjunction witheach other -via a anembeddedbuttonhook and variable sizeand strength elasticbands that allows theFunctionality isthe same for theEMA 3D, itsPrimary Predicatespecifically theSerena SleepSolutions ElasticFamily memberof the Primarypredicate and its
Indications foruseThe EMA 3D is aremovable medicaldevice that is fittedin the patient'smouth and isintended to reduceor alleviate snoringTreatment of nasalrespiratorydysfunction ofobstructive sleepapnea and snoringin those patientswhereTheKeyPrint®KeySplint Soft™device is indicated forthe fabrication oforthodontic and dentalappliancesTheKeyPrint"KeySplint HardTMdevice is indicated forthe fabrication oforthodontic anddental appliances suchas mouthguards.The Serena SleepAppliance is aremovable medicaldevice that is fitted inthe patient's mouthSame as PrimaryPredicate SerenaSleep EMASimilar toSecondary
and mild tomoderateobstructive sleepapnea (OSA) inadults.repositioning of themandible canincrease thepatients air space.such as mouthguards,nightguards, splintsand repositionersnightguards,splints andrepositionersretainers.and is intended toreduce oralleviate snoring andmild to moderateobstructive sleepapnea (OSA) in adults.Predicate devicethe original EMAReferencedevices 1 and 2are the resinsused by the EMASleep Inc. tomake the traysused in the EMA3D therefore theindications foruse are not thesame
TargetPopulationAdults diagnosedwith mild tomoderate sleepapneaAdults diagnosedwith mild tomoderate sleepapneaPatients diagnosedwith the need fordental appliances formultiple conditionsPatients diagnosedwith a need for dentalappliances for multipleconditionsAdults diagnosed withmild to moderatesleep apneaobstructive sleepapnea (OSA) in adultsSame as PrimaryPredicate andSecondaryPredicate
Single or FamilysubmissionSingleSingleSingleSingleFamilySame as SecondaryPredicate andreference devices1 and 2.

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size and strengthstrength elasticdental professional toSecondary
elastic bands thatbands that allowsproperly adjust thePredicate .
allows the dentalthe dentaldevices to patient
professional toprofessional todentition and
properly adjust theproperly adjust thephysiological need
devices to patientdevices to patientultimately reducing
dentition anddentition andpharyngeal
physiological needphysiological needobstruction through
ultimately reducingultimately reducingmandibular
pharyngealpharyngealadvancement
obstructionobstruction
throughthrough
mandibularmandibular
advancementadvancement
Tray MaterialKeystoneEMASameSameSerena SolutionsSleep Similar in
KeySplint Hard FDA(K203000)PETGThis is the dental resinThis is the dental resinNylon 12strength andbiocompatibility
KeySplint Soft FDA(K183593)used to fabricate thetrays for the EMA 3Ddeviceused to fabricate thetrays for the EMA 3Ddeviceand performanceaspects of boththe
PrimaryPredicatedevice and
SecondaryPredicatedifferent material
The EMA 3Dutilizes tray
material of thefabricated dentalresins identifiedas Referencedevices 1 and 2
MaterialConnectingMechanismThermoplasticElastomer (TPE)and colorant forWhite, Yellow andBlue Elastic StrapsNo colorantutilized ClearElastic strapsThermoplasticElastomer (TPE)and colorant forWhite, Yellow andBlue Elastic StrapsNo colorant utilizedfor Clear ElasticstrapsNot ApplicableThis is the dental resinused to fabricate thetrays for the EMA 3DdeviceNot ApplicableThis is the dental resinused to fabricate thetrays for the EMA 3DdeviceThermoplasticElastomer (TPE) andcolorant for White,Yellow and Blue ElasticStrapsNo colorant utilized forClear Elastic strapsSame
ConnectingMechanismButton hooksystem with ElasticStrapsButton hooksystem with ElasticStrapsNot ApplicableThis is the dental resinused to fabricate thetrays for the EMA 3DdeviceNot ApplicableThis is the dental resinused to fabricate thetrays for the EMA 3DdeviceButton hook systemwith Elastic StrapsSame
Range andPrecision ofadjustmentFront to back +/-1mmFront to back +/-1mmNot ApplicableThis is the dental resinused to fabricate thetrays for the EMA 3DdeviceNot ApplicableThis is the dental resinused to fabricate thetrays for the EMA 3DdeviceFront to back +/- 1mmSame

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trays for the EMA 3Ddevice
MaximumMandibularAdvancement14 mm14 mmNot ApplicableNot Applicable14mmSame as PrimaryPredicate Deviceand SecondaryPredicate
Mode of CareAdjustable byDentist orPhysician duringthe duration of useAdjustable byDentist or Physicianduring the durationof useNot ApplicableThis is the dental resinused to fabricate thetrays for the EMA 3DdeviceNot ApplicableThis is the dental resinused to fabricate thetrays for the EMA 3DdeviceAdjustable by Dentistor Physician during theduration of useSame
UsageRemovable andReusable by thesame patient.Night Time UsageOnlyRemovable andReusable by thesame patient.Night Time UsageOnlyIn fabricated formRemovable andReusable by the samepatient.Night Time Usage OnlyIn fabricated formRemovable andReusable by the samepatient.Night Time Usage OnlyRemovable andReusable by the samepatient.Night Time Usage OnlySame
SterilityNon-sterile devicecleaned betweenNon-sterile devicecleaned betweenNot ApplicableNot ApplicableNon-sterile devicecleaned between usesNon-sterile devicecleaned
uses by the patientfollowinginstructionsprovided by itsmanufactureruses by the patientfollowinginstructionsprovided by itsmanufacturerThis is the dental resinused to fabricate thetrays for the EMA 3DdeviceEMA 3D device is Non-sterile device cleanedbetween uses by thepatient following theinstructions for useprovided by thefabricated devicemanufacturerThis is the dental resinused to fabricate thetrays for the EMA 3DdeviceEMA 3D device is Non-sterile device cleanedbetween uses by thepatient following theinstructions for useprovided by thefabricated devicemanufacturerby the patientfollowing instructionsprovided by itsmanufacturerbetween uses bythe patientfollowinginstructionsprovided by itsmanufacturer
BiocompatibleYesYesYesYesYesSame
OTC or RxRxRxRxRxRxSame
Device Technological Differences Difference
Tray MaterialsEMA-3D- KeySplintHard(K203000)KeySplint Soft(K183593)EMA Custom-PETGThis is the dental resinused to fabricate thetrays for the EMA 3DdeviceThis is the dental resinused to fabricate thetrays for the EMA 3DdeviceSerena Sleep SolutionsNylon 12PETG/TPU, EVAPETG/TPE, Nylon,KeystoneKeySplintmaterials havedifferent physica

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properties. Each
material utilized
has a long and
successful history
of use in the
orthodontic and
oral appliance
devices.
They are
biocompatible,
durable and have
sufficient
strength to
perform the
intended
functions of the
device in
accordance with
each patients
specific clinical
needs. Therefore
there are no
additional risks
incurred by the
patient

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Fabrication3D PrintedThermoformed3D Printed3D PrintedLaser SinteringThe different fabrications utilized are all commonly used in the dental industry for dental and orthodontic appliances they are all capable of creating product that meets specified requirements with no additional risks to the patient.

The EMA 3D device shares the same or similar indications for use, device operation, overall technical and therefore is substantially equivalent to the Primary Predicate device(s). The EMA 3D is similar in design and function to the Primary and Secondary Predicate devices for the modes of operation and use.

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Performance Testing Summary

The EMA Sleep Incorporated utilized risk management techniques identified in ISO 14971 Application of Risk Management to medical devices.

Standard Physical Properties testing was completed on the EMA 3D device components using accepted standards including:

Strength Flexural Testing:

#Standard
1ISO 20795-2 Ultimate Flexural Strength, Flexural Modulus, Sorption, Solubility, Free MonomerExtraction, as applied by Keystone industries in the KeySplint Soft Material
2ASTM, D790-17, Standard Test Methods for Flexure Properties of Unreinforced Plastics andElectrical Insulating Materials, 2016 as applied by the Keystone Industries in KeySplint HardMaterial

Additionally, Biocompatibility testing was completed on the individual components of this device in accordance with the recommendations of ISO, 10993-1, Biological Evaluation of Medical Devices, 06/30/2010, for this type of device.

Internal verification and validation testing confirms that product specifications are met which are equivalent in design and technological characteristics as the Primary and Secondary Predicate devices

All testing was considered successful and met identified acceptance criteria. Results demonstrate performance commensurate with the indications for use, in the intended use environment and supports the claims of substantial equivalence to the Primary and Secondary Predicate devices.

Comparison Discussion:

The differences between the EMA 3D and its predicate and reference devices are not significant and do not affect the substantial equivalence of the device. Most of the differences documented between the EMA 3D and its predicate and reference device(s), primarily the predicate devices are related to fabrication method and materials which have similar strengths and technical characteristics that satisfy the intended use of the devices cleared for similar indications for use. The reference devices 1 and 2 that are resins are the same resins used to fabricate the EMA 3D device.

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The EMA 3D device has similar intended uses and technological characteristics as compared to the predicate device and reference device(s) and therefore are substantially equivalent to the predicate and reference device(s).

10. Non-Clinical Performance Data

As part of demonstrating the substantial equivalence of the EMA 3D to the Secondary Predicate/reference devices that are subject to this 510(k) submission, EMA Sleep Incorporated utilized Elastic straps that have been previously cleared by the FDA under K97194 and utilized FDA cleared materials under K203000 and K183598 that have undergone the following performance testing:

Strength and Flexural testing:

#Standard
1ISO 20795-2 Ultimate Flexural Strength, Flexural Modulus, Sorption, Solubility, Free MonomerExtraction
2ASTM, D790-17, Standard Test Methods for Flexure Properties of Unreinforced Plastics andElectrical Insulating Materials, 2016

The EMA 3D passed all the testing in accordance with internal requirements, applied national standards, and applied international standards shown below to support substantial equivalence of the subject device:

Biocompatibility - The biological safety of the components of the EMA 3D were evaluated in accordance with ISO 10993-1 and guidance document entitled Use of International ISO-10993-1,"Biological Evaluation of Medical Devices: Part 1: Evaluation and Testing within a Risk Management Process". Under this, for the stated indications for use, each component of the device's biological safety was evaluated for in vitro cytotoxicity, skin sensitization, and irritation, and mutagenicity and chemical characterization.

  • . Biocompatibility testing per ISO 10993-1 Biological Evaluation of Medical Devices: Part 1: Evaluation and Testing within a Risk Management Process: Assessed
  • Biocompatibility testing per ISO 10993-5 Cytotoxicity: Passed
  • . Biocompatibility testing per ISO 10993-10 Test for irritation and Skin Sensitization Passed

Risk Analysis - Formal Risk Assessment of the EMA 3D was performed in accordance with ISO 14971. With respect to perceivable conditions in which the device would be subjected to a worst-case environmental or human error scenario, EMA Sleep Incorporated believes the outcomes of these risks

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are considered acceptable within the context of ISO 14971, and that all potential risks have been mitigated to the lowest form.

11. Performance Testing Summary

As part of demonstrating the substantial equivalence of the EMA 3D and in showing substantial equivalence to the Secondary Predicate devices that are subject to this 510(k) submission, EMA Sleep Incorporated completed a number of tests. The EMA 3D met all the requirements for overall design, biocompatibility, and performance testing confirming that the output meets the design inputs and specifications. The EMA 3D passed all required testing stated above as shown by the acceptable results obtained.

The EMA 3D complies with the applicable voluntary standards for biocompatibility per materials used. The device passed all the testing in accordance with national standards relative to their intended use.

12. Statement of Substantial Equivalence

lt has been shown in this 510(k) submission that the differences between the EMA 3D and the Primary Predicate or Secondary Predicate device do not raise any different questions regarding its safety and effectiveness. The performance testing provided demonstrates that the subject device(s) are substantially equivalent to the Primary and Secondary Predicate device and reference devices. The EMA Sleep Incorporated , EMA 3D as designed and manufactured, are determined to be substantially equivalent to the Primary and Secondary Predicate devices and reference device(s).

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§ 872.5570 Intraoral devices for snoring and intraoral devices for snoring and obstructive sleep apnea.

(a)
Identification. Intraoral devices for snoring and intraoral devices for snoring and obstructive sleep apnea are devices that are worn during sleep to reduce the incidence of snoring and to treat obstructive sleep apnea. The devices are designed to increase the patency of the airway and to decrease air turbulence and airway obstruction. The classification includes palatal lifting devices, tongue retaining devices, and mandibular repositioning devices.(b)
Classification. Class II (special controls). The special control for these devices is the FDA guidance document entitled “Class II Special Controls Guidance Document: Intraoral Devices for Snoring and/or Obstructive Sleep Apnea; Guidance for Industry and FDA.”