(100 days)
No
The 510(k) summary describes a physical mouth guard with no mention of AI or ML technology.
No
The device primarily acts as a physical barrier to prevent damage from grinding and clenching, rather than actively treating a medical condition or disease. Its function is protective, not therapeutic.
No
The device description states its use is for "protection of teeth and restorations against grinding and clenching" and as "a barrier between teeth for nighttime teeth grinding," indicating a preventative or protective function, not a diagnostic one.
No
The device description clearly states it is a "mouth guard used as a barrier between teeth," indicating a physical, hardware-based device.
Based on the provided information, the LIJIA Night Guard is not an IVD (In Vitro Diagnostic).
Here's why:
- IVDs are used to examine specimens from the human body. The LIJIA Night Guard is a physical device worn in the mouth.
- IVDs are used to provide information about a physiological state, health, or disease. The LIJIA Night Guard is a protective barrier to prevent physical damage from grinding and clenching. It doesn't diagnose or provide information about a medical condition.
- The intended use clearly states protection of teeth and restorations. This is a mechanical function, not a diagnostic one.
The device description and intended use align with a Class II medical device (as indicated by the predicate and reference devices which are also mouth guards), but not an IVD.
N/A
Intended Use / Indications for Use
The LIJIA Night Guard is indicated for protection of teeth and restorations against grinding and clenching.
Product codes
MQC
Device Description
The LIJIA Night Guard is a mouth guard used as a barrier between teeth for nighttime teeth grinding by creating physical separation between upper and lower tooth surfaces preventing tooth damage caused by bruxism (e.g., grinding and clenching).
Mentions image processing
Not Found
Mentions AI, DNN, or ML
Not Found
Input Imaging Modality
Not Found
Anatomical Site
Worn on maxillary or mandibular teeth
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
Non-Clinical Performance Testing: The use of thermoplastic materials for Night Guards has been well documented in scientific literature. However, durability testing was completed on these night guards. An internal manufacturing validation was performed to test the dimensional accuracy of the manufacturing process for the Night Guards.
Clinical Performance Testing: The technological characteristics, indications for use, material, and manufacturing and processes are the same or similar to the predicate device and therefore, no clinical studies were deemed necessary to demonstrate the safety and effectiveness of the subject device.
Key Metrics
Not Found
Predicate Device(s)
Reference Device(s)
Predetermined Change Control Plan (PCCP) - All Relevant Information
Not Found
N/A
0
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August 22, 2024
Lijia LLC % Jennifer Day Regulatory Correspondent Prime Path Medtech 1321 Upland Dr Suite 6792 Houston, Texas 77043
Re: K241369
Trade/Device Name: LIJIA Night Guard Regulatory Class: Unclassified Product Code: MQC Dated: May 14, 2024 Received: May 14, 2024
Dear Jennifer Day:
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" (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).
1
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 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,
Bobak Shirmohammadi -S
For Michael E. Adjodha, M. ChE., RAC, CQIA Assistant Director DHT1B: Division of Dental and ENT Devices OHT1: Office of Ophthalmic, Anesthesia, Respiratory, ENT, and Dental Devices Office of Product Evaluation and Quality
2
Enclosure
3
Indications for Use
Form Approved: OMB No. 0910-0120 Expiration Date: 07/31/2026 See PRA Statement below.
Submission Number (if known)
Device Name
LIJIA Night Guard
Indications for Use (Describe)
The LIJIA Night Guard is indicated for protection of teeth and restorations against grinding and clenching.
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)
CONTINUE ON A SEPARATE PAGE IF NEEDED.
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DO NOT SEND YOUR COMPLETED FORM TO THE PRA STAFF EMAIL ADDRESS BELOW.
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4
510(k) Summary
A summary of 510(k) safety and effectiveness information in accordance with the requirements of 21 CFR 807.92.
| Submitter: | LIJIA, LLC |
|---|---|
| Company Contact Person: | Ben Li |
| Address: | 1520 Brookhollow Dr, Santa Ana, CA 92705 |
| Phone: | 310-866-0323 |
| Email: | b.jaminli@gmail.com |
| Submission Correspondent: | Jennifer Day, Regulatory Affairs Consultant |
| Address: | 1321 Upland Dr. Suite 6792 |
| Houston, TX 77043 | |
| Phone: | 314-809-1919 |
| Email: | jday@primepathmedtech.com |
| Date Prepared: | 5/9/2024 |
| Proprietary Name: | LIJIA Night Guard |
| Common Name: | Mouth Guard |
| Product Code: | MQC |
| Device Classification: | Unclassified |
| Predicate Device: | JS Dental Lab Mouth Guard |
| Reference Device: | FBCC Night Guard |
Device Description:
The LIJIA Night Guard is a mouth guard used as a barrier between teeth for nighttime teeth grinding by creating physical separation between upper and lower tooth surfaces preventing tooth damage caused by bruxism (e.g., grinding and clenching).
Indications for Use:
The LIJIA Night Guard is indicated for protection of teeth and restorations against grinding and clenching.
5
Comparison to Predicate Devices:
| Table 1. Predicate and Reference Device Comparison | ||
|---|---|---|
| Specification | Subject Device:
LIJIA Night Guard | Predicate Device:
JS Dental Lab Mouth Guard
(K210011) | Reference Device:
FBCC Night Guard
(K221369) | Comparison
Result |
|-------------------------|-------------------------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------------------------------------------|----------------------|
| Product Code | MQC | MQC | OBR | Same |
| Classification
Panel | Dental | Dental | Dental | Same |
| Device Class | Unclassified | Unclassified | Unclassified | Same |
| OTC or Rx | Rx | Rx | OTC | Same |
| Anatomical
Sites | Worn on maxillary
or mandibular
teeth | Worn on maxillary or
mandibular teeth | Worn on maxillary
or mandibular
teeth | Same |
| Sterile | Non-Sterile | Non-sterile | Non-Sterile | Same |
| Patient
Removable? | Yes | Yes | Yes | Same |
| Indication for
Use | The LIJIA Night
Guard is indicated
for protection of
teeth and
restorations
against grinding
and clenching. | The Subject Device (The JS
Dental Mouth Guard) is
intended for protection
against bruxism and teeth
grinding. They create a
barrier between the upper
and lower dentition to
protect the patient's
overall occlusion. | The FBCC Night
Guard is indicated
for protection of
teeth and
restorations
against grinding
and clenching. | Same as
reference |
Indications for Use:
The indication for use is very similar to the predicate device, the JS Dental Lab Mouth Guard, and the same as the the reference device, the FBCC Night Guard. All of the devices are indicated for the protection of teeth against grinding and clenching.
Technological Features:
The LIJIA Night Guard uses the same mechanism of action as the predicate product and reference product. It is intended to be worn on the teeth to protect teeth against grinding and clenching and to mitigate the pains associated with temporomandibular disorders.
6
Non-Clinical Performance Testing
The use of thermoplastic materials for Night Guards has been well documented in scientific literature. However, durability testing was completed on these night guards.
An internal manufacturing validation was performed to test the dimensional accuracy of the manufacturing process for the Night Guards.
Clinical Performance Testing
The technological characteristics, indications for use, material, and manufacturing and processes are the same or similar to the predicate device and therefore, no clinical studies were deemed necessary to demonstrate the safety and effectiveness of the subject device.
Conclusion
Based on the similarities in indications for use, technological characteristics, and non-clinical performance testing the Night Guards are substantially equivalent to the predicate device.