K Number
K981869
Device Name
PRO-FLEX DISPOSABLE PROPHY ANGLE
Date Cleared
1998-08-11

(75 days)

Product Code
Regulation Number
872.4200
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
For one time use as part of a professionally administered prophylaxis treatment, to clean and polish teeth.
Device Description
The device is a disposable dental prophylaxis angle which consists of a plastic body integrally formed with a drive mechanism, and a rubber cup that attaches to a retention knob or stud on the angle. The prophy angle has a slot for connecting the angle to a dental handpiece, which powers the prophy angle. The drive shaft of the prophy angle allows the rubber prophy cup to rotate.
More Information

Not Found

No
The device description and intended use describe a purely mechanical dental tool with no mention of software, data processing, or any AI/ML related terms.

No
The device is described as cleaning and polishing teeth as part of a prophylaxis treatment, and its function is mechanical rotation for cleaning, not directly treating a disease or therapeutic condition.

No
The intended use of the device is to "clean and polish teeth" as part of a "prophylaxis treatment," which is a treatment rather than a diagnostic process. The device description also focuses on its mechanical function for cleaning, not for identifying a condition or disease.

No

The device description clearly states it is a disposable dental prophylaxis angle made of plastic with a drive mechanism and rubber cup, which are physical components, not software.

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

Here's why:

  • Intended Use: The intended use is "to clean and polish teeth" as part of a prophylaxis treatment. This is a physical, mechanical action performed directly on the patient's teeth.
  • Device Description: The device is a "disposable dental prophylaxis angle" with a rubber cup that rotates to clean and polish. This describes a physical tool used for a dental procedure.
  • Lack of IVD Characteristics: IVD devices are used to examine specimens (like blood, urine, tissue) taken from the human body to provide information about a physiological state, health, disease, or congenital abnormality. This device does not involve the examination of any such specimens.

The device is a dental tool used for a direct treatment procedure, not for diagnostic testing of biological samples.

N/A

Intended Use / Indications for Use

For one time use as part of a professionally administered prophylaxis treatment, to clean and polish teeth.

Product codes

EFB

Device Description

The device is a disposable dental prophylaxis angle which consists of a plastic body integrally formed with a drive mechanism, and a rubber cup that attaches to a retention knob or stud on the angle. The prophy angle has a slot for connecting the angle to a dental handpiece, which powers the prophy angle. The drive shaft of the prophy angle allows the rubber prophy cup to rotate.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

teeth

Indicated Patient Age Range

Not Found

Intended User / Care Setting

dental professionals

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)

K981869

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 872.4200 Dental handpiece and accessories.

(a)
Identification. A dental handpiece and accessories is an AC-powered, water-powered, air-powered, or belt-driven, hand-held device that may include a foot controller for regulation of speed and direction of rotation or a contra-angle attachment for difficult to reach areas intended to prepare dental cavities for restorations, such as fillings, and for cleaning teeth.(b)
Classification. Class I.

0

Ka81869

SUMMARY OF SAFETY AND EFFECTIVENESS -

1. Name and Address

This Summary of Safety and Effectiveness is being submitted by Professional Dental Manufacturing, Inc., 633 Lawrence Street, Batesville, Arkansas 72501. The telephone number is 870-698-2300.

2. Name of the Device

The device is generally known as a dental prophylaxis angle.

3. Identification of Predicate Device(s)

Dentsply's NUPRO® Disposable Prophy Angle.

4. Description of the Device

The device is a disposable dental prophylaxis angle which consists of a plastic body integrally formed with a drive mechanism, and a rubber cup that attaches to a retention knob or stud on the angle. The prophy angle has a slot for connecting the angle to a dental handpiece, which powers the prophy angle. The drive shaft of the prophy angle allows the rubber prophy cup to rotate.

5. Intended Use of the Device

Professional Dental Manufacturing, Inc.'s Pro-Flex™ Disposable Prophy Angle is intended for one time use by dental professionals during general prophylaxis. Pro-Flex™ is used to clean and polish teeth by application of a prophy angle with a rotating rubber cup, combined with a cleaning and polishing paste or powder, to the surfaces of teeth.

6. Comparison of Technological Characteristics

The differences in design between the Pro-Flex™ and the predicate device are very minor and do not impact the safety and effectiveness of the device in any significant way since the function and intended use are the same.

1

7. Safety

Professional Dental Manufacturing, Inc. reviewed the Medical Device Records (MDR) filed with CDRH during the period from 1992 through 1996 for information on prophy angles which may have caused a death or serious injury. Of the more than 200 MDRs filed, no serious injury events were reported. A single MDR indicated that a disposable prophy angle purportedly caused grooves or wearing away of enamel on the facial aspects of several teeth.

The other events reported were malfunctions falling into one of the following categories: the prophy angle stalled or locked up, the drive gears came apart, or the angle got hot. Several events reported that the rubber cup came off the prophy angle, occasionally in the patient's mouth, but no injuries were reported due to this or the other described malfunctions.

2

Image /page/2/Picture/1 description: The image is a seal for the Department of Health & Human Services - USA. The seal is circular and contains the words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter. In the center of the seal is a stylized image of a bird with three wing-like shapes.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

AUG | | | 1998

Bob Zahradnik, Ph.D. Professional Dental Manufacturing, Inc. 633 Lawrence Street Batesville, Arizona 72501

Re : K981869 Pro-Flex™ Disposable Prophy Angle Trade Name: Requlatory Class: I Product Code: EFB Dated: May 28, 1998 Received: May 28, 1998

Dear Dr. Zahradnik:

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 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). You may, therefore, market the device, subject to the general controls provisions of the Act. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions aqainst 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 requlations affecting your device can be found in the Code of Federal Requlations, Title 21, Parts 800 to 895. A substantially equivalent determination assumes compliance with the Current Good Manufacturing Practice requirements, as set forth in the Quality System Requlation (QS) for Medical Devices: General requlation (21 CFR Part 820) and that, through periodic QS inspections, the Food and Druq Administration (FDA) will verify such assumptions. Failure to comply with the GMP regulation 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

3

Page 2 - Dr. Zahradnik

through 542 of the Act for devices under the Electronic Product Radiation Control provisions, or other Federal laws or regulations.

This letter will allow you to begin 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 requlation (21 CFR Part 801 and additionally 809.10 for in vitro diagnostic devices), please contact the Office of Compliance at (301) 594-4692. 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"(21CFR 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 (301) 443-6597 or at its internet address

"http://www.fda.gov/cdrh/dsma/dsmamain.html".

Sincerely yours,

S. Dutram fr

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

Enclosure .... ..............

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510(k) Number (if known):
Device Name:Pro-Flex™ Disposable Prophy Angle
Indications For Use:For one time use as part of a professionally administered prophylaxis treatment, to clean and polish teeth.

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Concurrence of CDRH, Office of Device Evaluation (ODE)

(Division Sign-Off) Division of Dental, Infection Control, and General Hospital Devices
510(k) NumberK981869
Prescription UseOROver-the-Counter Use ______
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