K Number
K971513
Device Name
COMPOGLASS F
Date Cleared
1997-06-03

(36 days)

Product Code
Regulation Number
872.3690
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
- Restorations in deciduous teeth - Class V restorations (cervical caries, root erosion, wedge-shaped defects) - Class III restorations - Intermediate Class I and II restorations
Device Description
Not Found
More Information

Not Found

Not Found

No
The provided 510(k) summary contains no mention of AI, ML, image processing, or any other indicators typically associated with AI/ML medical devices. The intended uses listed are for traditional dental restorative procedures.

No
The device is used for dental restorations, which are procedures to repair damaged teeth. While these restore function and address health issues, the device itself is a restorative material used in a therapeutic procedure, not a therapeutic device that delivers therapy or treatment directly to a patient (like a drug-delivery device or a device for pain relief).

No
The provided 'Intended Use / Indications for Use' describes applications for dental fillings (restorations), which are therapeutic procedures, not diagnostic ones. There is no information suggesting the device identifies or detects diseases.

Unknown

The provided 510(k) summary is incomplete and lacks a device description, making it impossible to determine if the device is software-only. The intended use describes dental restorations, which typically involve physical materials and tools.

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

Here's why:

  • Intended Use: The intended uses listed (restorations in teeth) are procedures performed directly on a patient's body.
  • Lack of IVD Characteristics: There is no mention of analyzing samples taken from the body (like blood, urine, tissue) or providing diagnostic information based on such analysis.

IVDs are devices used to examine specimens derived from the human body to provide information for diagnostic, monitoring, or compatibility purposes. The described device's function is clearly related to dental restoration, which is a therapeutic procedure, not an in vitro diagnostic test.

N/A

Intended Use / Indications for Use

  • Restorations in deciduous teeth
  • Class V restorations (cervical caries, root erosion, wedge-shaped defects)
  • Class III restorations
  • Intermediate Class I and II restorations

Product codes

EBF

Device Description

Not Found

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Not Found

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)

Not Found

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.

Not Found

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.

Not Found

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

§ 872.3690 Tooth shade resin material.

(a)
Identification. Tooth shade resin material is a device composed of materials such as bisphenol-A glycidyl methacrylate (Bis-GMA) intended to restore carious lesions or structural defects in teeth.(b)
Classification. Class II.

0

Image /page/0/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a circular seal with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES USA" around the perimeter. Inside the circle is a stylized image of an eagle with three wavy lines extending from its body, representing the department's mission to protect the health of all Americans and provide essential human services.

Federal Aviation Administration

JUN - 3 1997

Food and Drug. Administration 9200 Corporate Boulevard Rockville MD 20850

Mr. Peter P. Mancuso 'Ouality Assurance/Requlatory Affairs Manager Ivoclar North America, Incorporated 175 Pineview Drive Amherst, New York 14228

K971513 Re : Compoglass F Trade Name: Requlatory Class: II Product Code: EBF Dated: April 18, 1997 April 28, 1997 Received:

Dear Mr. Mancuso:

We have reviewed your Section 510(k) notification of intent to market the device referenced above and we have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to 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). You may, therefore, market the device, subject to the general controls provisions The general controls provisions of the Act of the Act. include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration.

If your device is classified (see above) into either class II (Special Controls) or class III (Premarket Approval), it may be subject to such additional controls. Existing major regulations affecting your device can be found in the Code of Federal Requlations, Title 21, Parts 800 to 895. ਸ substantially equivalent determination assumes compliance with the Good Manufacturing Practice for Medical Devices: General (GMP) requlation (21 CFR Part 820) and that, through periodic GMP inspections, the Food and Drug Administration (FDA) will verify such assumptions. Failure to comply with the GMP requlation may result in regulatory action. In addition, FDA may publish further announcements concerning your device in the Federal Register. Please note: this response to your premarket notification submission does not affect any obligation you might have under sections 531 through 542 of the Act for devices under the Electronic Product Radiation Control provisions, or other Federal laws or regulations.

1

Page 2 - Mr. Mancuso

This letter will allow you to beqin marketing your device as described in your 510 (k) premarket notification. The FDA finding of substantial equivalence of your device to a legally marketed predicate device results in a classification for your device and thus, permits your device to proceed to the market.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801 and additionally 809.10 for in vitro diagnostic devices), please contact the Office of Compliance at (301) 594-4618. Additionally, for questions on the promotion and advertising of your device, please contact the Office of Compliance at (301) 594-4639. Also, please note the regulation entitled, "Misbranding by reference to
premarket notification" (21 CFR 807.97). Other general information on your responsibilities under the Act may be obtained from the Division of Small Manufacturers Assistance at its toll-free number (800) 638-2041 or at (301) 443-6597.

Sincerely yours,

Timothy H. White, chair

Time y A. Ulatowski Director Division of Dental, Infection Control and General Hospital Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

2

Page 1 of 1

510(k) Number (if known):

Compoglass F Device Name:

Indications For Use:

  • Restorations in deciduous teeth -
  • Class V restorations (cervical caries, root erosion, wedge-shaped defects) -
  • Class III restorations -
  • -Intermediate Class I and II restorations

(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)

Susan Rumm

(Division Sign-Off) Division of Dental, Infection Contr and General Hospital 510(k) Number

Prescription Use (Per 21 CFR 801 1109)

OR

Over-The-Counter Use No

(Optional Format 1-2-96)