K Number
K240511
Device Name
Dentis s-Clean SQ-SL Fixture
Manufacturer
Date Cleared
2024-05-20

(88 days)

Product Code
Regulation Number
872.3640
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
Dentis s-Clean SQ-SL Fixture 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 SQ-SL Fixture is two type as Mini and Regular according to the connection. Dentis s-Clean SQ-SL Fixture is a thread type implant made of Pure titanium according to ASTM F67 which will be placed in the alveolar bone to replace the function of the missing tooth. This device has connection between the upper prosthesis and the internal Hex. The surface of fixture is treated with SLA (Sandblasted with Large-grit and Acid-etching). The dimensions of fixtures are as following: | No. | Device Name | Dimension Ranges | |-----|----------------------------|------------------------------------------| | 1 | s-Clean SQ-SL Fixture | Ø4.35, 4.8 and 5.2 (D) X 15.5 and 17.5mm | | 2 | s-Clean SQ-SL Fixture Mini | Ø3.7 and 4.1 (D) X 15.5 and 17.5 | Tolerance of dimension shall be within ± 1% range. s-Clean SQ-SL Fixture is compatible with devices in K192688 and K210134 as below: | 510(K) | Abutment Name | Diameter(Ø) | Angulation | Length(mm) | |---------|---------------------------------------------------|---------------------------|------------|---------------------| | K192688 | s-Clean Cover Screw | Ø3.6mm | 0 | 5.9mm | | K192688 | s-Clen (TiN Half Coating)<br>Sole Abutment S-Line | Ø4.5, 5.5, 6.5 and<br>7.5 | 0 | 11.6, 12.6 and 13.6 | | K210134 | s-Celan (TiN Half Coating)<br>Angled Abutment | Ø4.5 | 15 | 12.6 | s-Clean SO-SL Fixture Mini is compatible with devices in K210080 as below: | 510(K) | Abutment Name | Diameter(Ø) | Angulation | Length(mm) | |---------|----------------------------------------------------|-------------------|------------|---------------------------------------------------------------------------------------------------------------------------| | K210080 | s-Clean Cover Screw Mini | Ø3.2mm | 0 | 5.0mm | | K2100080 | s-Clean Healing Abutment S-<br>Line Mini | Ø4.3, 4.8 and 5.8 | 0 | 7.61, 8.61, 9.61, 10.61, 11.61,<br>12.61 and 14.61 | | K210080 | s-Celan (TiN Half Coating)<br>Sole Abutment Mini | Ø4.5 and 5.5 | 0 | 11.01, 12.01, 12.51, 13.01,<br>13.521, 14.01, 14.51, 15.01,<br>15.51, 16.01 and 17.01 | | K210080 | s-Celan (TiN Half Coating)<br>Couple Abutment Mini | Ø4.0, 4.5 and 5.5 | 0 | 8.35, 8.6, 9.35, 9.6, 9.85, 10.1,<br>10.35, 10.6, 11.1, 11.35, 11.6,<br>12.1, 12.85, 13.1, 13.35, 13.6,<br>14.35 and 14.6 | | K210080 | s-Celan (TiN Half Coating)<br>Angled Abutment Mini | Ø4.0 and 4.5 | 15 | 12.09, 12.34, 12.51 and 12.76 | Denis s-Clean SQ-SL Fixture is provided sterilized. Dentis s-Clean SQ-SL Fixture is packaged with Cover screw that was cleared in FDA as K192688 and K210080.
More Information

No
The device description and performance studies focus on the physical properties, materials, and mechanical testing of a dental implant fixture. There is no mention of software, algorithms, or data processing that would indicate the use of AI/ML.

Yes
The device is a dental implant intended to replace missing teeth, which falls under the definition of a therapeutic device as it treats a medical condition (edentulism).

No

Explanation: The device is described as a dental implant (fixture) intended to replace missing teeth, which is a therapeutic function, not a diagnostic one. Its purpose is to support restorations, not to diagnose a condition.

No

The device description clearly states it is a thread type implant made of Pure titanium, which is a physical hardware component. The summary also details physical dimensions and compatibility with other hardware components like abutments and cover screws.

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

Here's why:

  • Intended Use: The intended use clearly states that the device is a dental implant system used to replace missing teeth in the jawbone. This is a surgical device intended for implantation in the human body.
  • Device Description: The description details the physical characteristics, material (titanium), dimensions, and surface treatment of the implant fixture. It also mentions compatibility with other dental components like abutments and cover screws.
  • IVD Definition: An In Vitro Diagnostic device is defined as a medical device that is used to perform tests on samples taken from the human body, such as blood, urine, or tissue, to detect diseases, conditions, or infections.

This device does not perform any tests on samples taken from the body. It is a physical implant placed within the body.

N/A

Intended Use / Indications for Use

Dentis s-Clean SQ-SL Fixture 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 (comma separated list FDA assigned to the subject device)

DZE

Device Description

Dentis s-Clean SQ-SL Fixture is two type as Mini and Regular according to the connection. Dentis s-Clean SQ-SL Fixture is a thread type implant made of Pure titanium according to ASTM F67 which will be placed in the alveolar bone to replace the function of the missing tooth. This device has connection between the upper prosthesis and the internal Hex.
The surface of fixture is treated with SLA (Sandblasted with Large-grit and Acid-etching).
The dimensions of fixtures are as following:

No. Device NameDimension Ranges
1 s-Clean SQ-SL FixtureØ4.35, 4.8 and 5.2 (D) X 15.5 and 17.5mm
2 s-Clean SQ-SL Fixture MiniØ3.7 and 4.1 (D) X 15.5 and 17.5

Tolerance of dimension shall be within ± 1% range.
s-Clean SQ-SL Fixture is compatible with devices in K192688 and K210134 as below:

510(K)Abutment NameDiameter(Ø)AngulationLength(mm)
K192688s-Clean Cover ScrewØ3.6mm05.9mm
K192688s-Clen (TiN Half Coating) Sole Abutment S-LineØ4.5, 5.5, 6.5 and 7.5011.6, 12.6 and 13.6
K210134s-Celan (TiN Half Coating) Angled AbutmentØ4.51512.6

s-Clean SO-SL Fixture Mini is compatible with devices in K210080 as below:

510(K)Abutment NameDiameter(Ø)AngulationLength(mm)
K210080s-Clean Cover Screw MiniØ3.2mm05.0mm
K210080s-Clean Healing Abutment S- Line MiniØ4.3, 4.8 and 5.807.61, 8.61, 9.61, 10.61, 11.61, 12.61 and 14.61
K210080s-Celan (TiN Half Coating) Sole Abutment MiniØ4.5 and 5.5011.01, 12.01, 12.51, 13.01, 13.521, 14.01, 14.51, 15.01, 15.51, 16.01 and 17.01
K210080s-Celan (TiN Half Coating) Couple Abutment MiniØ4.0, 4.5 and 5.508.35, 8.6, 9.35, 9.6, 9.85, 10.1, 10.35, 10.6, 11.1, 11.35, 11.6, 12.1, 12.85, 13.1, 13.35, 13.6, 14.35 and 14.6
K210080s-Celan (TiN Half Coating) Angled Abutment MiniØ4.0 and 4.51512.09, 12.34, 12.51 and 12.76

Denis s-Clean SQ-SL Fixture is provided sterilized.
Dentis s-Clean SQ-SL Fixture is packaged with Cover screw that was cleared in FDA as K192688 and K210080.

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 on Fixtures according to ISO 11137-1,2,3 referenced in K192688
  • Shelf-Life Test on Fixtures according to ASTM F1980 referenced in K153639
  • Biocompatibility testing on fixtures according to ISO 10993-1:2009, ISO 10993-3:2014, ISO 10993-5:2009, ISO 10993-6:2007, ISO 10993-10:2010 and ISO 10993-11:2006 referenced in K153639
  • Bacterial Endotoxin Test Report on Fixtures according to ANSI/AAMI ST72:2011, USP , and USP referenced in K192688

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

MR Environment Condition:
Non-clinical worst-case MRI review was performed to evaluate the metallic. Dentis s-Clean SQ-SL Fixture in the MRI environment using scientific rationale and published literature (e.g., Woods, Terry 0., Jana G. Delfino, and Sunder Rajan. 'Assessment of Magnetically Induced Displacement Force and Torque on Metal Alloys Used in Medical Devices." Journal of Testing and Evaluation 49.2 (2019): 783-795)., based on the entire system including all variations (all compatible implant bodied, dental abutments and, fixation screws) and material composition. Rationale addressed parameters per the FDA Guidance "Testing and Labeling Medical Devices for Safety in the Magnetic Resonance (MR) Environment," including magnetically induced displacement force and torque.

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

Not Found

Predicate Device(s): If the device was cleared using the 510(k) pathway, identify the Predicate Device(s) K/DEN number used to claim substantial equivalence and list them here in a comma separated list exactly as they appear in the text. List the primary predicate first in the list.

K192688

Reference Device(s): Identify the Reference Device(s) K/DEN number and list them here in a comma separated list exactly as they appear in the text.

K140934, K153639, K202773, K210080, K210134, K222778

Predetermined Change Control Plan (PCCP) - All Relevant Information for the subject device only (e.g. presence / absence, what scope was granted / cleared under the PCCP, any restrictions, etc).

Not Found

§ 872.3640 Endosseous dental implant.

(a)
Identification. An endosseous dental implant is a prescription device made of a material such as titanium or titanium alloy that is intended to be surgically placed in the bone of the upper or lower jaw arches to provide support for prosthetic devices, such as artificial teeth, in order to restore a patient's chewing function.(b)
Classification. (1) Class II (special controls). The device is classified as class II if it is a root-form endosseous dental implant. The root-form endosseous dental implant is characterized by four geometrically distinct types: Basket, screw, solid cylinder, and hollow cylinder. The guidance document entitled “Class II Special Controls Guidance Document: Root-Form Endosseous Dental Implants and Endosseous Dental Implant Abutments” will serve as the special control. (See § 872.1(e) for the availability of this guidance document.)(2)
Classification. Class II (special controls). The device is classified as class II if it is a blade-form endosseous dental implant. The special controls for this device are:(i) The design characteristics of the device must ensure that the geometry and material composition are consistent with the intended use;
(ii) Mechanical performance (fatigue) testing under simulated physiological conditions to demonstrate maximum load (endurance limit) when the device is subjected to compressive and shear loads;
(iii) Corrosion testing under simulated physiological conditions to demonstrate corrosion potential of each metal or alloy, couple potential for an assembled dissimilar metal implant system, and corrosion rate for an assembled dissimilar metal implant system;
(iv) The device must be demonstrated to be biocompatible;
(v) Sterility testing must demonstrate the sterility of the device;
(vi) Performance testing to evaluate the compatibility of the device in a magnetic resonance (MR) environment;
(vii) Labeling must include a clear description of the technological features, how the device should be used in patients, detailed surgical protocol and restoration procedures, relevant precautions and warnings based on the clinical use of the device, and qualifications and training requirements for device users including technicians and clinicians;
(viii) Patient labeling must contain a description of how the device works, how the device is placed, how the patient needs to care for the implant, possible adverse events and how to report any complications; and
(ix) Documented clinical experience must demonstrate safe and effective use and capture any adverse events observed during clinical use.

0

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May 20, 2024

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

Re: K240511

Trade/Device Name: Dentis s-Clean SO-SL Fixture Regulation Number: 21 CFR 872.3640 Regulation Name: Endosseous Dental Implant Regulatory Class: Class II Product Code: DZE Dated: February 21, 2024 Received: February 22, 2024

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 (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"

1

(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.

Sherrill Lathrop Blitzer

for Andrew Steen Assistant Director DHT1B: Division of Dental and ENT Devices

2

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

Enclosure

3

Indications for Use

Submission Number (if known)

K240511

Device Name

Dentis s-Clean SQ-SL Fixture

Indications for Use (Describe)

Dentis s-Clean SQ-SL Fixture 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.

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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4

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

Device Information

  • Trade Name: Dentis s-Clean SQ-SL Fixture
  • Common Name: implant, endosseous, root-form
  • Classification Name: Endosseous dental implant
  • Product Code: DZE ●
  • Panel: Dental ●
  • Regulation Number: 872.3640
  • Device Class: Class II
  • Date Prepared: 05/16/2024

Predicate Devices:

Primary and Reference Device

  • K192688, s-Clean SQ-SL Implant System Regular by Dentis Co., Ltd. .
    Reference Device

  • K140934, HIOSSEN Implant System manufactured by HIOSSEN, Incorporated

  • K153639, OneO-SL s-Clean Implant System by Dentis Co., Ltd. ●

  • K202773, S-Clean SQ-SL Implant System Mini by Dentis Co., Ltd.

  • K210080, Dentis s-Clean s-Line Mini by Dentis Co., Ltd. ●

  • K210134, Dentis s-Clean s-Line by Dentis Co., Ltd.

  • K222778, Osstem Implant System by Osstem Implant Co., Ltd. ●

Indications for Use:

Dentis s-Clean SQ-SL Fixture 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.

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

5

Device Description:

Dentis s-Clean SQ-SL Fixture is two type as Mini and Regular according to the connection. Dentis s-Clean SQ-SL Fixture is a thread type implant made of Pure titanium according to ASTM F67 which will be placed in the alveolar bone to replace the function of the missing tooth. This device has connection between the upper prosthesis and the internal Hex.

The surface of fixture is treated with SLA (Sandblasted with Large-grit and Acid-etching).

The dimensions of fixtures are as following:

No.Device NameDimension Ranges
1s-Clean SQ-SL FixtureØ4.35, 4.8 and 5.2 (D) X 15.5 and 17.5mm
2s-Clean SQ-SL Fixture MiniØ3.7 and 4.1 (D) X 15.5 and 17.5

Tolerance of dimension shall be within ± 1% range.

s-Clean SQ-SL Fixture is compatible with devices in K192688 and K210134 as below:

510(K)Abutment NameDiameter(Ø)AngulationLength(mm)
K192688s-Clean Cover ScrewØ3.6mm05.9mm
K192688s-Clen (TiN Half Coating)
Sole Abutment S-LineØ4.5, 5.5, 6.5 and
7.5011.6, 12.6 and 13.6
K210134s-Celan (TiN Half Coating)
Angled AbutmentØ4.51512.6

s-Clean SO-SL Fixture Mini is compatible with devices in K210080 as below:

510(K)Abutment NameDiameter(Ø)AngulationLength(mm)
K210080s-Clean Cover Screw MiniØ3.2mm05.0mm
K210080s-Clean Healing Abutment S-
Line MiniØ4.3, 4.8 and 5.807.61, 8.61, 9.61, 10.61, 11.61,
12.61 and 14.61
K210080s-Celan (TiN Half Coating)
Sole Abutment MiniØ4.5 and 5.5011.01, 12.01, 12.51, 13.01,
13.521, 14.01, 14.51, 15.01,
15.51, 16.01 and 17.01
K210080s-Celan (TiN Half Coating)
Couple Abutment MiniØ4.0, 4.5 and 5.508.35, 8.6, 9.35, 9.6, 9.85, 10.1,
10.35, 10.6, 11.1, 11.35, 11.6,
12.1, 12.85, 13.1, 13.35, 13.6,
14.35 and 14.6
K210080s-Celan (TiN Half Coating)
Angled Abutment MiniØ4.0 and 4.51512.09, 12.34, 12.51 and 12.76

Denis s-Clean SQ-SL Fixture is provided sterilized.

Dentis s-Clean SQ-SL Fixture is packaged with Cover screw that was cleared in FDA as K192688 and K210080.

Materials:

  • Dentis s-Clean SQ-SL Fixture is fabricated from Pure titanium of ASTM F67 .

6

Summaries of Technological Characteristics & Substantial Equivalence Discussion

s-Clean SQ-SL Fixture

Subject DevicePrimary PredicateReference DevicePredicate Device
K240511K192688K140934K222778
ManufacturerDentis Co., LtdDentis Co., LtdHIOSSEN Inc.Osstem Implant CO.,
Ltd.
Trade NameDentis s-Clean SQ-
SL Fixtures-Clean SQ-SL Implant
System RegularHIOSSEN
IMPLANT SYSTEMOsstem Implant
System
Product
Names-Clean SQ-SL
Fixtures-Clean SQ-SL FixtureETII SA FixtureTSIV SA Implant
Design
Indications
for UseDentis s-Clean SQ-SL
Fixture 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.s-Clean SQ-SL Implant
System Regular 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 and not
dedicated for immediate
loading. This system is
intended for delayed
loading.The HIOSSEN Implant
System is indicated for
use in partially or fully
edentulous mandibles
and maxillae, in support
of single or multipleunit
restorations including;
cemented retained,
screw retained, or
overdenture
restorations, and final or
temporary abutment
support for fixed
bridgework. It is
intended for delayed
loading. ETIII SA
Ultra-Wide Fixture is
intended to be used in
the molar region.The Osstem Implant
System is indicated for
use in partially or fully
edentulous mandibles
and maxillae, in support
of single or multiple-
units restorations
including; cemented
retained, screw retained,
or overdenture
restorations, and final or
temporary abutment
support for fixed
bridgework. It is
intended for delayed
loading. Ultra wide
Implant system is
intended to be used in
the molar region.
Products with diameter
or less than 3.25mm
should be used
exclusively for the
lateral incisor in the
maxilla and a central or
lateral incisor in the
mandible.
Diameter and
LengthØ4.35 x 15.5,
17.5mm
Ø4.8 x 15.5, 17.5mm
Ø5.2 x 15.5, 17.5mmØ4.1 x 7, 7.5, 9.5, 11.5,
13.5mm
Ø4.35 x 7, 7.5, 9.5,
11.5, 13.5mm
Ø4.8 x 7, 7.5, 9.5, 11.5,
13.5mm
Ø5.8 x 7, 7.5, 9.5,
11.5mm
Ø6.8 x 7, 7.5, 9.5,
11.5mm
Ø7.8 x 7, 7.5, 9.5,
11.5mmØ3.5 x 8.7, 10.2,11.7,
13.2, 15.2, 18.2mm
Ø4.2 x 7.2, 8.7, 10.2,
11.7, 13.2, 15.2,
18.2mm
Ø4.45 x 7.2, 8.7,10.2,
11.7, 13.2, 15.2mm
Ø5.0x 6.2mm
Ø4.9 x 7.2, 8.7, 10.2,
11.7, 13.2, 15.2mmØ4.4 x 18mm
Ø4.8 x 18mm
Ø5.25 x 18mm
Surface
TreatmentSLASASA
MaterialCP Titanium Gr4
(ASTM F67)CP Titanium Gr4
(ASTM F67)CP Titanium Gr4
(ASTM F67)CP Titanium Gr4
(ASTM F67)
SterilizationGamma IrradiationGamma IrradiationGamma IrradiationGamma Irradiation
Shelf Life8years8years8years8years
ComparisonThe Subject Device and primary device, K192688 have same characteristics such as indications
for Use, design, surface treatment, material, sterilization, and shelf life. The difference between
subject device and primary predicate is dimension. The subject device has longer lengths fixtures,
such as 15.5 and 17.5mm. To support this difference, K140934 and K222778 were added
because the dimension combination of two devices covers all range of the subject device's
dimensions.

7

s-Clean SQ-SL Fixture Mini

Subject DeviceReference DeviceReference Device
K numberK240511K202773K140934
ManufacturerDentis Co., LtdDentis Co., LtdHIOSSEN Inc.
Trade NameDentis s-Clean SQ-SL
Fixtures-Clean SQ-SL Implant
System MiniOsstem Implant System
Product Names-Clean SQ-SL Minis-Clean SQ-SL Mini FixtureETII SA Fixture
DesignImage: Dentis s-Clean SQ-SL FixtureImage: s-Clean SQ-SL Implant System MiniImage: ETII SA Fixture
Indications for
UseDentis s-Clean SQ-SL Fixture
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.s-Clean SQ-SL Implant System
Mini 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.The HIOSSEN Implant System is
indicated for use in partially or fully
edentulous mandibles and maxillae,
in support of single or multipleunit
restorations including; cemented
retained, screw retained, or
overdenture restorations, and final or
temporary abutment support for fixed
bridgework. It is intended for delayed
loading. ETIII SA Ultra-Wide Fixture
is intended to be used in the molar
region.
Diameter and
Length$Ø3.7 x 15.5, 17.5mm$
$Ø4.17 x 15.5, 17.5mm$$Ø3.7 x 7.5, 9.5, 11.5, 13.5mm$
$Ø4.1 x 7.5, 9.5, 11.5, 13.5mm$$Ø3.5 x 8.7, 10.2, 11.7, 13.2, 15.2,$
$18.2mm$
$Ø4.2 x 7.2, 8.7, 10.2, 11.7, 13.2,$
$15.2, 18.2$
$Ø4.45 x 7.2, 8.7, 10.2, 11.7, 13.2,$
$15.2mm$
$Ø5.0x 6.2mm$
$Ø4.9 x 7.2, 8.7, 10.2, 11.7, 13.2,$
$15.2mm$
Surface
TreatmentSLASLASA
MaterialCP Titanium Gr4 (ASTM
F67)CP Titanium Gr4 (ASTM
F67)CP Titanium Gr4 (ASTM F67)
SterilizationGamma IrradiationGamma IrradiationGamma Irradiation
Shelf Life8years8years8years
ComparisonThe Subject Device and reference device, K202773 have same characteristics such as indications
for Use, design (dual screw joint), surface treatment, material, sterilization, and shelf life. The
difference between the two devices is dimension. To support this difference, K140934 was added
because the dimension combination of K140934 covers all range of the subject device's
dimensions.

8

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 on Fixtures according to ISO 11137-1,2,3 referenced in K192688

  • . Shelf-Life Test on Fixtures according to ASTM F1980 referenced in K153639

  • . Biocompatibility testing on fixtures according to ISO 10993-1:2009, ISO 10993-3:2014, ISO 10993-5:2009, ISO 10993-6:2007, ISO 10993-10:2010 and ISO 10993-11:2006 referenced in K153639

  • . Bacterial Endotoxin Test Report on Fixtures according to ANSI/AAMI ST72:2011, USP , and USP referenced in K192688

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

Non-clinical test data was conducted in accordance with FDA Guidance "Class II Special Controls Guidance Document: Root-form Endosseous Dental Implants and Endosseous Dental Implant Abutments". Clinical testing was not necessary to establish substantial equivalency of the device.

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

MR Environment Condition

Non-clinical worst-case MRI review was performed to evaluate the metallic. Dentis s-Clean SQ-SL Fixture in the MRI environment using scientific rationale and published literature (e.g., Woods, Terry 0., Jana G. Delfino, and Sunder Rajan. 'Assessment of Magnetically Induced Displacement Force and Torque on Metal Alloys Used in Medical Devices." Journal of Testing and Evaluation 49.2 (2019): 783-795)., based on the entire system including all variations (all compatible implant bodied, dental abutments and, fixation screws) and material composition. Rationale addressed parameters per the FDA Guidance "Testing and Labeling Medical Devices for Safety in the Magnetic Resonance (MR) Environment," including magnetically induced displacement force and torque.

Conclusion

Dentis s-Clean SO-SL Fixture 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, Dentis s-Clean SQ-SL Fixture and its predicates are substantially equivalent.