K Number
K991491
Device Name
FLC COMPOSITE
Date Cleared
1999-06-21

(54 days)

Product Code
Regulation Number
872.3690
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
FLOWABLE LIGHT CURE COMPOSITE: This fluid composite will flow into difficult areas and therefore indicates its use for Class V and Class III restorations.
Device Description
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More Information

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Not Found

No
The summary describes a dental composite material, which is a physical substance used for restorations, and there is no mention of any computational or analytical capabilities, let alone AI/ML.

No
The device is a composite material used for dental restorations, which is a structural material rather than a device designed to deliver therapy.

No
Explanation: The device is described as a "FLOWABLE LIGHT CURE COMPOSITE," which is a material used for restorations (filling cavities). This is a treatment material, not a device used to diagnose a condition.

No

The provided text describes a "FLOWABLE LIGHT CURE COMPOSITE," which is a material used for dental restorations. This 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: The intended use is for "Class V and Class III restorations" using a "flowable light cure composite." This describes a material used directly on the patient's teeth for restorative purposes.
  • IVD Definition: In Vitro Diagnostics are tests performed on samples taken from the human body (like blood, urine, tissue) to provide information about a person's health.

The description clearly indicates a dental restorative material used in vivo (within the living body), not a test performed in vitro (in a lab setting).

N/A

Intended Use / Indications for Use

FLOWABLE LIGHT CURE COMPOSITE: This fluid composite will flow into difficult areas and therefore indicates its use for Class V and Class III restorations.

Product codes

EBF

Device Description

Not Found

Mentions image processing

Not Found

Mentions AI, DNN, or ML

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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

Not Found

Key Metrics

Not Found

Predicate Device(s)

Not Found

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

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 seal of the Department of Health & Human Services (HHS). The seal features a stylized caduceus, a symbol often associated with medicine and healthcare, in the center. Encircling the caduceus are the words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" in a circular arrangement. The seal is presented in black and white.

Public Health Service

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

JUN 2 1 1999

Ms. Mildred M. Goldstein President Harry J. Bosworth Company 7227 North Hamlin Avenue Skokie, Illinois 60076

Re: K991491 Trade Name: FLC Composite Regulatory Class: II Product Code: EBF Dated: April 21, 1999 Received: April 28, 1999

Dear Ms. Goldstein:

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 The general controls controls provisions of the Act. provisions 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. A substantially equivalent determination assumes compliance with the Good Manufacturing Practice for Medical Devices: General (GMP) regulation (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.

1

Page 2 - Ms. Goldstein

this response to your premarket notification Please note: 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.

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 regulation (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 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/dsmamain.html".

Sincerely yours,

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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Page __ 1 _of _1

510(k) Number: K ዓ억 | ԿԳ |

Device Name:

INDICATIONS FOR USE:

FLOWABLE LIGHT CURE COMPOSITE:

This fluid composite will flow into difficult areas and therefore indicates its use for Class V and Class III restorations.

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

Company consumeration processional delivery and consideration in the considered to
Concurrence of CDRH, Office of Device Evaluation (ODE)

Prescription Usev (Per 21 CFR 801.109)

OR

Over-the-Counter Use

(Optional Format 1-2-96)

Susan Russo

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