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510(k) Data Aggregation

    K Number
    K200908
    Device Name
    iSMILE
    Manufacturer
    Date Cleared
    2020-12-22

    (260 days)

    Product Code
    Regulation Number
    872.5470
    Panel
    Dental
    Reference & Predicate Devices
    Predicate For
    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    iSMILE is indicated for the alignment of teeth during orthodontic treatment of malocclusion.

    The i5MLE is indicated for use in alignment of teeth during orthodontic treatment of malocclusion.

    Device Description

    The iSMILE is a sequence of transparent aligners created from a digital orthodontic treatment plan. The iSMILE aligner is fabricated of a transparent thermoformed polyurethane plastic. Each aligner delivery a unique combination of minor forces to create the planned tooth movement. The digital orthodontic treatment plan is created by a dental health professional. The iSMILE Aligner incorporates the use of attachments to create spaces and force points in order to cause minor tooth movement. These force points are located in specific areas and positioned in such a way that they provide a continuous force which slowly dissipates over time on the tooth to be moved for as long as the aligner is worn.

    AI/ML Overview

    The provided text describes a 510(k) premarket notification for the iSMILE Dental Aligners, comparing it to a predicate device, the Invisalign System. The document focuses on demonstrating substantial equivalence rather than providing a detailed study report for novel performance claims.

    Here's a breakdown of the requested information based on the provided text:

    1. Table of Acceptance Criteria and Reported Device Performance

    The text indicates that the device underwent non-clinical performance tests to demonstrate substantial equivalence. These tests focused on material properties and process validation. Rather than specific quantitative acceptance criteria for each test, the document states generally that the device met "acceptable results" or "acceptance criteria."

    Test CategorySpecific Test / PropertyAcceptance CriteriaReported Device Performance
    Material Properties (Biocompatibility)CytotoxicityPassed Biocompatibility testing per ISO 10993-1Passed
    SensitizationPassed Biocompatibility testing per ISO 10993-1Passed
    IrritationPassed Biocompatibility testing per ISO 10993-1Passed
    Acute Systemic ToxicityPassed Biocompatibility testing per ISO 10993-1Passed
    MutagenicityPassed Biocompatibility testing per ISO 10993-1Passed
    Subacute ToxicityPassed Biocompatibility testing per ISO 10993-1Passed
    Material Properties (Mechanical)Tensile Strength YieldAcceptable results in comparison to samples tested (no defined specification or standard)Produced acceptable results
    Aligner Elongation (Break Point)Acceptable results in comparison of break point (no defined specification or standard)Showing acceptable results
    Tensile Stress at Break PointAcceptable results (no defined specification or standard)Produced acceptable results
    ModulusAcceptable results between the samples tested (no defined specification or standard)Showed acceptable results between the samples tested
    Load of MaterialsAcceptable results (no defined specification or standard)Found acceptable results
    Water AbsorptionAcceptable results (no defined specification or standard)Found acceptable results
    Process ValidationProcess Flow Validation (Finished device matches software output specifications)Not explicitly stated, but implies the finished device must match the software output specifications, meaning the aligners themselves must accurately reflect the digitally planned tooth movement and morphology. The text states: "The output and work model and aligner were tested and compared. Aligners met the acceptance criteria of this testing." This indicates the acceptance criteria was likely a measure of geometric accuracy or fit.Aligners met the acceptance criteria. The iSMILE functioned as intended and observed as expected. The results of this performance testing are accepted according to acceptance criteria and do not raise any additional concerns.

    2. Sample Size Used for the Test Set and Data Provenance

    The document does not specify the sample size for the test set used for these non-clinical performance tests. For material tests (tensile strength, elongation, stress, modulus, load, water absorption), it refers to "a sample of base materials" or "samples tested." For biocompatibility, it states "the used thermoforming sheets," implying the specific material intended for the device. For Process Flow Validation, it mentions "the output and work model and aligner were tested and compared," but no numbers are provided.

    The data provenance is internal, as 3D Diagnostix Inc. completed the tests to support their 510(k) submission. There is no information regarding country of origin for test data or whether it was retrospective or prospective, as these are non-clinical engineering and material tests, not clinical studies.

    3. Number of Experts Used to Establish the Ground Truth for the Test Set and Qualifications of Those Experts

    This section is not applicable to the provided document. The tests performed are non-clinical, focusing on material and manufacturing process validation. There is no mention of a "ground truth" derived from expert consensus for clinical accuracy in the context of expert review.

    4. Adjudication Method for the Test Set

    This section is not applicable. The tests described are laboratory-based engineering and material performance tests, not clinical evaluations requiring adjudication of expert interpretations.

    5. If a Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study Was Done, If So, What Was the Effect Size of How Much Human Readers Improve with AI vs Without AI Assistance

    This section is not applicable. The device described is a physical dental aligner, not an AI diagnostic or assistive software. No MRMC study was conducted or mentioned.

    6. If a Standalone (i.e., algorithm only without human-in-the-loop performance) Was Done

    This section is not applicable. The device is a physical product (dental aligners), not an algorithm or AI software. There's mention of "software output specifications" in relation to Process Flow Validation, meaning software designs the aligners, but the performance testing is for the physical aligner's manufacturing and material properties, not the diagnostic accuracy of the software itself.

    7. The Type of Ground Truth Used (Expert Consensus, Pathology, Outcomes Data, etc.)

    For the non-clinical tests, the "ground truth" is based on established scientific and engineering principles, national/international standards (like ISO 10993-1 for biocompatibility), and internal specifications. For mechanical properties, where no external standards existed, internal comparisons of "acceptable results" were used. For Process Flow Validation, the "ground truth" was likely the digital design specifications derived from the software output. No pathology or outcomes data is mentioned as ground truth for these non-clinical tests.

    8. The Sample Size for the Training Set

    This section is not applicable. The document describes a physical medical device and its non-clinical performance tests for 510(k) clearance, not an AI algorithm that would require a training set.

    9. How the Ground Truth for the Training Set Was Established

    This section is not applicable for the same reasons as #8.

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    K Number
    K202465
    Device Name
    Night Guard
    Manufacturer
    Date Cleared
    2020-11-25

    (90 days)

    Product Code
    Regulation Number
    N/A
    Panel
    Dental
    Reference & Predicate Devices
    Predicate For
    N/A
    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    Night Guard is indicated for protection against bruxism or nighttime teeth grinding. It creates a barrier between upper and lower dentition to protect the patient's overall occlusion.

    Device Description

    Night Guards are designated to alleviate the pain and damage caused by bruxing or clenching the teeth. Severe tooth, jaw or facial muscle pains are common side effects of bruxing or clenching the teeth. These patients specific devices fit over upper or lower teeth during sleep and can offset the effects of bruxing or clenching, while protecting teeth from daily wear and tear. Night Guard is shipped non-sterile.

    AI/ML Overview

    The provided text describes the acceptance criteria and the study that proves the "Night Guard" device meets these criteria. The study focuses on non-clinical performance tests to demonstrate substantial equivalence to a predicate device.

    Here's the breakdown of the requested information:

    1. Table of Acceptance Criteria and Reported Device Performance:

    Test PerformedObjective of the TestReference StandardAcceptance CriteriaResults
    RigidityThe printed device is rigid enough to stay on the patient's dentitionNAWhen fitting the splint onto the master dentition, does it feel sufficiently rigid to stay in place and immobilize the teeth?Pass
    ToughnessPrinted device is tough enough to withstand breakingASTM D695 Compressive PropertiesDoes the material survive 180 times of flexing cycles? (180 flex cycles is based on a daily insertion of a dry splint for 6 months). Was the maximum compressive stress of the material over 77MPa before break? The material is expected to survive 77MPa of compression stress.Pass
    Avg: 159.6 MPa
    Std Dev: 1.698
    FitEnsure the device will fit snugly to a patient's dentition and not move.NABy visual examination through the splint itself, does the splint seat all the way down onto the occlusal table and/or incisal edge of the metal simulated dentition? Does the splint stay on metal dentition when turned upside down? After applying light pressure to each quadrant of the splint after it is seated on the metal simulated dentition. Does the splint stay in place without another section of the splint separating from the occlusal surfaces or incisal edges of the teeth? Does the splint stay in place without shifting after attempting to rotate the splint back and forth.Pass
    Wear ResistanceDevices are sufficiently wear-resistant to withstand teeth wear against the patient's opposing dentition.ISO 14569After 10,000 cycles of abrasion in a 37°C water bath samples must not show signs of cracking or wear to a degree that would jeopardize the efficacy or safety of the device.Pass

    Additionally, Biocompatibility testing per ISO 10993-1 was passed for cytotoxicity, sensitization, acute systemic toxicity, subacute/subchronic toxicity, genotoxicity, and implantation.
    Process Flow validation was performed to ensure that the finished device matches the software output specifications, and the Night Guard met these specifications.

    2. Sample size used for the test set and the data provenance:
    The document does not explicitly state the sample size for each test. However, for the "Toughness" test, the acceptance criteria mention "180 times of flexing cycles," and for "Wear Resistance," it mentions "10,000 cycles of abrasion," indicating the number of iterations or repetitions for these specific tests on material samples. The data provenance is not specified in terms of country of origin or whether it's retrospective or prospective; it appears to be internal testing conducted by 3D Diagnostix Inc.

    3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts:
    The document does not mention the use of experts or their qualifications for establishing ground truth for the performance tests. The "Rigidity" and "Fit" tests rely on visual examination and manual assessment, but the "expert" status is not defined.

    4. Adjudication method (e.g., 2+1, 3+1, none) for the test set:
    No adjudication method is mentioned for the test set.

    5. If a multi-reader multi-case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance:
    No MRMC comparative effectiveness study was done. This document describes the testing of a physical medical device (night guard), not an AI-assisted diagnostic tool.

    6. If a standalone (i.e., algorithm only without human-in-the-loop performance) was done:
    This question is not applicable as the subject device is a physical night guard, not an algorithm.

    7. The type of ground truth used (expert consensus, pathology, outcomes data, etc.):
    The ground truth for the performance tests (Rigidity, Toughness, Fit, Wear Resistance) is based on compliance with predefined acceptance criteria derived from internal requirements and/or relevant standards (ASTM D695, ISO 14569). It's a combination of objective measurements (e.g., compressive stress for toughness) and subjective assessment against established criteria (e.g., "feels sufficiently rigid," "stays on metal dentition when turned upside down" for fit). For biocompatibility, the ground truth is established by adherence to ISO 10993-1.

    8. The sample size for the training set:
    This section is not applicable. The Night Guard is a physical device, not a machine learning model, so there is no "training set."

    9. How the ground truth for the training set was established:
    This question is not applicable, as there is no training set for a physical device.

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