K Number
K990040
Device Name
CLEARFIL SE BOND
Manufacturer
Date Cleared
1999-02-04

(29 days)

Product Code
Regulation Number
872.3200
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
CLEARFIL SE BOND is indicated for the following applications: 1) Direct filling restorations using light-curing composite or compomer 2) Cavity sealing as a pretreatment for indirect restorations 3) Treatment of hypersensitive and/or exposed root surfaces 4) Intraoral repairs of fractured facing crowns made of porcelain, hybrid ceramics and cured composite resin 5) Surface treatment of prosthetic appliances made of porcelain, hybrid ceramics and cured composite resin
Device Description
CLEARFIL SE BOND is classified into the resin tooth bonding agent, CFR 21 Section 872.3200, because it is a device composed of materials such as dimethacrylate monomers intended to painted on the interior of a prepared cavity of a tooth to improve retentive materials.
More Information

No
The document describes a dental bonding agent composed of chemical materials and does not mention any computational or data-driven processes indicative of AI/ML.

No

The device description indicates that it is a resin tooth bonding agent used to improve retentive materials for direct filling restorations, cavity sealing, and surface treatment, rather than directly treating a medical condition or disease.

No
The device, CLEARFIL SE BOND, is a resin tooth bonding agent used for direct filling restorations, cavity sealing, treating hypersensitive surfaces, and repairing fractured crowns. Its function is to improve the retention of dental materials. There is no indication that it diagnoses any condition; rather, it is used in the treatment and repair of dental issues.

No

The device description explicitly states it is "composed of materials such as dimethacrylate monomers," indicating it is a physical substance, not software.

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

Here's why:

  • Intended Use/Indications for Use: The listed applications are all related to dental procedures performed directly on a patient's tooth (direct fillings, cavity sealing, treating hypersensitivity, repairing crowns, surface treatment of prosthetic appliances). These are clinical applications, not diagnostic tests performed on samples outside the body.
  • Device Description: The description classifies it as a "resin tooth bonding agent" intended to be "painted on the interior of a prepared cavity of a tooth." This further reinforces its use in a clinical dental setting.
  • Lack of IVD Characteristics: There is no mention of analyzing biological samples (blood, urine, tissue, etc.), detecting specific analytes, or providing diagnostic information about a patient's health status.

IVD devices are used to examine specimens derived from the human body to provide information for diagnostic, monitoring, or compatibility purposes. This device does not fit that description.

N/A

Intended Use / Indications for Use

CLEARFIL SE BOND is indicated for the following applications:

  1. Direct filling restorations using light-curing composite or compomer
  2. Cavity sealing as a pretreatment for indirect restorations
  3. Treatment of hypersensitive and/or exposed root surfaces
  4. Intraoral repairs of fractured facing crowns made of porcelain, hybrid ceramics and cured composite resin
  5. Surface treatment of prosthetic appliances made of porcelain, hybrid ceramics and cured composite resin

Product codes

KLE

Device Description

CLEARFIL SE BOND is classified into the resin tooth bonding agent, CFR 21 Section 872.3200, because it is a device composed of materials such as dimethacrylate monomers intended to painted on the interior of a prepared cavity of a tooth to improve retentive materials.

CLEARFIL SE BOND consists of Primer, Bonding Agent, Etching Agent and accessories. These components are similar to those of the products in the paragraph 4 of this summary.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Tooth / prepared cavity of a tooth

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)

There is no ISO standard applicable to CLEARFIL SE BOND. The bond strengths to human enamel, numan dentife, precious mocal are performances are substantially equivalent to those of CLEARFIL LINER BOND 2V.

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

Not Found

Predicate Device(s)

K974486, K943170, K964525, K974390, K#unknown, K910860, K934690

Reference Device(s)

K943165

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 872.3200 Resin tooth bonding agent.

(a)
Identification. A resin tooth bonding agent is a device material, such as methylmethacrylate, intended to be painted on the interior of a prepared cavity of a tooth to improve retention of a restoration, such as a filling.(b)
Classification. Class II.

0

FEB 400000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000 ধ

K990040

(K943170)

(K943165)

KURAF

12-39, 1-Chome, Umeda, Kita-ku, Osaka 530-86 : +81-6-6348-2603 Phone Facsimile: +81-6-6348-2552

510(k) SUMMARY

1. Submitter

1) NameKURARAY CO., LTD.
2) Address1-12-39, Umeda, Kita-ku, Osaka 530-8611, Japan
3) Telephone81(Japan)-6-6348-2603
4) Facsimile81(Japan)-6-6348-2552
5) Contact personYoshinori Nagase
Dental Material Department
Medical Products Division
6) DateJanuary 6, 1999

2. Representing (Subsidiary of KURARAY CO., LTD.)

1) NameKURARAY AMERICA INC.
2) Address30th Fl. Metlife Building, 200 Park Avenue, New York,
NY 10166
3) Telephone(212)-986-2230
4) Facsimile(212)-867-3543
5) Contact personKoji Fujita
President

3. Name of Device

1) Proprietary NameCLEARFIL SE BOND
2) Classification NameResin tooth bonding agent (21CFR 872.3200)
3) Common/Usual NameResin-based dental adhesive system

র্ব-Predicate devices:

1. CLEARFIL LINER BOND 2V by KURARAY CO.,LTD.(K974486)
------------------------------------------------------------
  • CLEARFIL LINER BOND 2 by KURARAY CO.,LTD. 2.
    1. CLEARFIL PHOTO BOND by KURARAY CO.,LTD.
  • PRIME & BOND 2.1 MULTIPURPOSE DENTIN/ENAMEL (K964525) 4. BONDING AGENT WITH ACTIVATOR by DENTSPLY
  • GLUMA ONE BOND by HERAEUS KULZER, INC. (K974390) 5. (K#unknown) ONE STEP UNIVERSAL DENTAL ADHESIVE SYSTEM by BISCO, 6.
  • INC. (K910860) 7. ALL-BOND 2 by BISCO, INC.
  • (K934690) OPTIBOND by KERR MFG.CO 8.
    1. Description for the premarket notification

CLEARFIL SE BOND is classified into the resin tooth bonding agent, CFR 21 Section 872.3200, because it is a device composed of materials such as dimethacrylate monomers intended to painted on the interior of a prepared cavity of a tooth to improve retentive materials.

This product is similar and substantially equivalent in design, composition and function to the

1

similar products which are identified in the paragraph 4 of this summary; all of which are safe, effective and beneficial.

6. Statement of the intended use

Statement of the firended aso products.

1) Direct filling restorations using light-curing composite or compomer
a)CLEARFIL LINER BOND 2V by KURARAY CO., LTD.(K974486)
b)CLEARFIL LINER BOND 2 by KURARAY CO., LTD.(K943170)
c)PRIME & BOND 2.1 MULTIPURPOSE DENTIN/ENAMEL
BONDING AGENT WITH ACTIVATOR by DENTSPLY(K964525)
d)GLUMA ONE BOND by HERAEUS KULZER, INC.(K974390)
2) Cavity sealing as a pretreatment for indirect restorations
a)CLEARFIL LINER BOND 2V by KURARAY CO., LTD.(K974486)
b)ONE STEP UNIVERSAL DENTAL ADHESIVE SYSTEM by
BISCO, INC.(K#unknown)
c)ALL-BOND 2 by BISCO, INC.(K910860)
d)OPTIBOND by KERR MFG.CO(K934690)
3) Treatment of hypersensitive and/or exposed root surfaces
a)CLEARFIL LINER BOND 2V by KURARAY CO., LTD.(K974486)
b)CLEARFIL LINER BOND 2 by KURARAY CO., LTD.(K943170)
  • PRIME & BOND 2.1 MULTIPURPOSE DENTIN/ENAMEL (K964525) c) BONDING AGENT WITH ACTIVATOR by DENTSPLY
  • ONE STEP UNIVERSAL DENTAL ADHESIVE SYSTEM by (K#unknown) d) BISCO, INC.
  • Intraoral repairs of fractured facing crowns made of porcelain, hybrid ceramics or 4) composite resin using light-curing composite
a) CLEARFIL LINER BOND 2V by KURARAY CO., LTD.(K974486)
b) PRIME & BOND 2.1 MULTIPURPOSE DENTIN/ENAMEL
BONDING AGENT WITH ACTIVATOR by DENTSPLY(K964525)
    1. Surface treatment of prosthetic appliances made of porcelain, hybrid ceramics and cured composite resin
a) CLEARFIL LINER BOND 2V by KURARAY CO., LTD.(K974486)
b) CLEARFIL PHOTO BOND by KURARAY CO., LTD.(K943165)
    1. Statement of the technological characteristics and safety
      Buttems of the wonners great as a simplified system of CLEARFIL LINER BOND 2V permitted to be marketed (K974486). CLEARFIL SE BOND is substantially equivalent to those of products sold in the U.S. market in design, components and functions.
  • 7-1 Components
    CLEARFIL SE BOND consists of Primer, Bonding Agent, Etching Agent and accessories. These components are similar to those of the products in the paragraph 4 of this summary.

2

7-2 Performance

Periormance
There is no ISO standard applicable to CLEARFIL SE BOND. The bond strengths to human There Is no too standard appricable to cl and porcelain were evaluated in comparison with enamel, numan dentife, precious mocal are performances are substantially equivalent to those of CLEARFIL LINER BOND 2V.

7-3 Chemical ingredients and safety

The chemical ingredients and bacty The chemical ingredictive have been use an in ial y equivalent to the predicated devices.

  • CLEARFIL LINER BOND 2V by KURARAY CO., LTD. (K974486) a) (K983361) PANAVIA F by KURARAY CO., LTD. b)
  • (K982164) ESTENIA by KURARAY CO., LTD. c)

3

Image /page/3/Picture/2 description: The image is a black and white seal for the Department of Health & Human Services - USA. The seal is circular with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter. In the center of the seal is a stylized image of an eagle.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

FEB ! 4 1999

Kuraray Co., Ltd. C/O Mr. Koji Fujita President Kuraray America, Incorporated 30th FI Metlife Building 200 Park Avenue New York, New York 10166-3098

Re : K990040 CLEARFIL SE BOND Trade Name: Regulatory Class: II Product Code: KLE January 6, 1999 Dated: January 6, 1999 Received:

Dear Mr. Fujita:

We have reviewed your Section 510(k) notification of intent to we have reviewed your becoed above and we have determined the market the device refly 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 Commerce prior co nay ents, or to devices that have been Medical Device imendance with the provisions of the Federal Food, Drug, and Cosmetic Act (Act). You may, therefore, rood, Drug, and commons to the general controls provisions The general controls provisions of the Act of the Act. include requirements for annual registration, listing of Include requiremufacturing 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 (opecial ochorsuch additional controls. Existing major be subject to back accoundevice can be found in the Code of Federal Regulations, Title 21, Parts 800 to 895. A rederal Regulation ent determination assumes compliance with the Good Manufacturing Practice for Medical Devices: General (GMP) regulation (21 CFR Part 820) and that, through periodic (URL) regections, the Food and Drug Administration (FDA) will verify such assumptions. Failure to comply with the GMP vegulation 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

4

Page 2 - Mr. Fujita

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 described in your tial equivalence of your device to a legally Finding of substancial equires in a classification for your marketed predicate device burned 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" (21 CFR 807.97). Other general information on your responsibilities under the Act may be Information on Jour Chilison of Small Manufacturers Assistance at its toll-free number (800) 638-20#1 or (301) 443-6597 or at its internet address "http://www.fda.gov/cdrh/dsmamain.html".

Sincerely yours

Timothy A. Ulatowski

Timo Directbr Division of Dental, Infection Control, and General Hospital Devices Office of Device Evaluation Center for Devices and Radioloqical Health

Enclosure

5

Image /page/5/Picture/0 description: The image shows the text "K990040" in a bold, sans-serif font. Below this, the text "[CLEARFIL SE BOND, Kuraray]" is printed in a smaller, serif font. The text appears to be part of a label or product identifier.

Page 1 of 1

510(k) Number (if known): ____________________________________________________________________________________________________________________________________________________ K990040

CLERFIL SE BOND Device Name: _

Indications For Use

CLEARFIL SE BOND is indicated for the following applications:

Ard III OL DOND is managing light-curing composite or compomer 1)

  • Cavity sealing as a pretreatment for indirect restorations 2)
  • Oavity seaming as a prositive and/or exposed root surfaces 3)
  • Treatment of dypersensitive andor exposed root successor
    Intraoral repairs of fractured facing crowns made of porcelain, hybrid ceramics and cured 4) composite resin
  • composite resin
    Surface treatment of prosthetic appliances made of porcelain, hybrid ceramics and cured 5) composite resin

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

Concurrence of CDRH, Office of Device Evaluation (ODE) *** Over-The-Counter Use_ OR Prescription Use_6 (Part 21 CFR 801.109) (Optional Format 1-2-96) us not of the 1100 (Division Sign-Off) Division of The'. Infect නාවිතා and General Siot pital Develop remov 510(k) Number