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510(k) Data Aggregation

    K Number
    K240038
    Date Cleared
    2024-04-04

    (90 days)

    Product Code
    Regulation Number
    872.5470
    Reference & Predicate Devices
    Why did this record match?
    Device Name :

    Clear Moves Aligners

    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    The Clear Moves Aligners are indicated for the treatment of tooth malocclusion in patients with permanent dentition (i.e. all second molars). The Clear Moves Aligners position teeth by way of continuous gentle force.

    Device Description

    The Clear Moves Aligner is a series of clear, light weight thermoformed plastic aligners designed to be worn in sequence to facilitate the movement of the teeth to the final desired position. The sequential aligners introduce increments that move teeth by way of gentle continuous force. The aligners are to be worn 20 to 22 hours a day and are to be removed for eating and for cleaning. Generally the typical wear time for each aligner is a two weeks duration prior to being replaced by the next aligner in sequence.

    A digital or traditional mold impression of the patient's dentition is provided by a dental health professional (e.g. orthodontist or dentist). From the digital data of the patient's dentition, a specialized orthodontic CAD/CAM software is used to develop treatment plan. Using the software, dental technicians design a series of intermediate models corresponding to each stage of treatment, gradually realigning the patient's teeth according to the dental health profession's prescription.

    The prescribing doctor reviews and approves the model scheme and treatment plan before the molds/models are produced.

    Once approved. the specialized orthodontic software is used to generate standard format 3D files which are used to physically produce each model/mold in the treatment plan for aligner fabrication. Space Maintainers Laboratories produces the aligner trays by thermal forming a plastic sheet over each model in the treatment plan. The trays are provided to the dental health care professional who provides them to the patients in sequential stages, confirming fit and design. The dental health professional monitors treatment from the moment of the first aligner is delivered to when the final aligner is finished and treatment is complete. The aligners are held in place by pressure and can be removed by the patient at any time.

    AI/ML Overview

    Based on the provided text, the device in question is the "Clear Moves Aligners," which is an orthodontic device. The FDA document K240038 is a 510(k) premarket notification, indicating that the manufacturer is seeking substantial equivalence to a legally marketed predicate device rather than outright approval based on a clinical efficacy study.

    Therefore, the "acceptance criteria" and "study that proves the device meets the acceptance criteria" in this context refer to the demonstration of substantial equivalence to a predicate device, rather than a clinical trial demonstrating efficacy of the aligners themselves beyond what is already established for this class of device.

    The document states multiple times that "there was no clinical testing necessary to support this device" due to the well-established clinical performance of sequential aligners and the device's equivalence to its predicate.

    Here's an analysis of the provided information concerning the acceptance criteria for substantial equivalence and the "study" (non-clinical testing and comparison) proving this:


    1. A table of acceptance criteria and the reported device performance

    The "acceptance criteria" for this 510(k) submission are based on demonstrating substantial equivalence to a predicate device (K223141 STR8 Clear Aligners and another reference predicate). This means showing that the new device has the same intended use and similar technological characteristics, or if there are differences, that those differences do not raise new questions of safety or effectiveness.

    Acceptance Criteria (based on Substantial Equivalence to Predicate)Reported Device Performance (Clear Moves Aligners)Outcome / Discussion
    Intended Use & Indications for Use: Same as predicate. (Treatment of tooth malocclusion in patients with permanent dentition by way of continuous gentle force.)"The Clear Moves Aligners are indicated for the treatment of tooth malocclusion in patients with permanent dentition (i.e. all second molars). The Clear Moves Aligners position teeth by way of continuous gentle force."Same: Slight wording difference deemed not to affect intended use/indications.
    Regulation Number: 21 CFR 872.547021 CFR 872.5470Same
    Classifications: Class IIClass IISame
    Product Code: NXCNXCSame
    Mode of Action: Alignment of teeth by application of continuous gentle force, by sequential use of preformed plastic trays."Alignment of teeth by application of continuous gentle force, by sequential use of preformed plastics trays"Same
    Material: Zendura FLX (copolyester and polyurethane composite)Zendura FLX (copolyester and polyurethane composite)Same
    Biocompatibility: YesYesSame: Demonstrated by using same material and manufacturing processes as predicate, and additional testing.
    Software: FDA cleared for intended use (PNN product code)Guidemia Ortho+ (K162850), FDA cleared under PNN.Different but Equivalent: Different software, but both are FDA cleared for their intended use (PNN product code), thus not affecting substantial equivalence.
    Software Design Process: Uses digital scan of impression, generates final state and intermediate states, dental practitioner approval, software converts files to produce aligners."The standard ortho dental software uses a scan of tooth impression or a digital scan to generate the image of a final, treated state and then interprets a series of images that represent intermediate teeth states. Once the dental practitioner approves the treatment plan, the software converts the files to produce the series of patient specific aligners."Similar: Described as "Similar, does not affect substantial equivalence."
    Manufacture Method: ThermoformingThermoformingSame
    Rx or OTC: RxRxSame
    Sterility: Non-sterileNon-sterileSame
    Design: AlignersAlignersSimilar: Described as "Similar, does not affect substantial equivalence."
    Manufacturing Dimensional Accuracy: Translational measurements within 0.150mm (150 microns) of target, and acceptable final aligner fit."Translational measurement were within 0.150mm (150microns) of the target input value, the predefined tolerance of the manufacturing process. The testing results are within the acceptance criteria to demonstrate dimensional accuracy. Additionally, the final aligner fitness evaluation by a trained physician demonstrate all the aligners including in the study passed and were deemed an excellent fit."Met: Internal manufacturing validation confirmed.
    Biocompatibility Testing: Material certified to ISO 10993 standards (Tests for in vitro cytotoxicity, Skin Irritation, Sensitization, Subacute/Subchronic Toxicity, Genotoxicity)Material tested according to ISO 10993-1, 10993-5, 10993-10, 10993-11, 10993-3; additional cytotoxicity on final product.Met: Extensive biocompatibility testing conducted on the material.
    Physical Properties Testing: Tensile Strength, Elongation, Elastic Modulus, Flexural StrengthASTM D638 and ASTM D790 tests conducted by material manufacturer.Met: Physical properties of material tested.

    2. Sample size used for the test set and the data provenance (e.g. country of origin of the data, retrospective or prospective)

    • Test Set (Non-Clinical Performance Data):
      • Manufacturing Validation: The document states "An internal manufacturing validation was performed to demonstrate the dimensional accuracy of the manufacturing for Clear Moves Aligner." and "all the aligners including in the study passed and were deemed an excellent fit." However, it does not specify the sample size (number of aligners or manufacturing runs) used for this internal validation.
      • Biocompatibility & Physical Properties: The data provenance for these tests is the "material manufacture." This implies the tests were conducted by the supplier of the Zendura FLX material, not SML. No country of origin is specified for these tests. These are presumably prospective tests performed on the material and (for cytotoxicity) the final product.
      • Clinical Performance Data: The document explicitly states: "The clinical performance of sequential aligners (product code NXC) has been well established since the first device of this category was cleared by the FDA in 1998. The Clear Moves aligners have equivalent indication and method of use to its predicate, therefore there was no clinical testing necessary to support this device." Thus, there is no clinical "test set" in the context of a new human clinical study performed for this specific device.

    3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts (e.g. radiologist with 10 years of experience)

    • Manufacturing Validation: "A trained physician" evaluated the final aligner fitness. The exact number of physicians or their specific qualifications (e.g., years of experience) are not specified, beyond being "trained."
    • Other Data: Given that no new clinical study was conducted for this device, the concept of "experts establishing ground truth for a test set" involving human patients does not directly apply to this 510(k) submission's safety and effectiveness demonstration beyond the general scientific and regulatory consensus on the predicate.

    4. Adjudication method (e.g. 2+1, 3+1, none) for the test set

    • Manufacturing Validation: The document mentions "a trained physician" evaluated the fit. It does not mention any adjudication method (e.g., multiple readers, consensus, etc.). If only one physician was involved, the adjudication method would implicitly be "none" in terms of multiple expert reviews.
    • Other Data: Not applicable as no multi-reader evaluation was performed for the device's performance given the nature of the submission.

    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 Study: The document explicitly states "there was no clinical testing necessary to support this device." Therefore, no MRMC comparative effectiveness study was done.
    • No AI Assistance Element: This device (aligners) is a physical medical device, not an AI software intended to assist human readers (e.g., radiologists interpreting images). The software mentioned is for treatment planning, not for image interpretation by clinicians requiring AI assistance.

    6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done

    • Manufacturing Validation: An "internal manufacturing validation" was done, assessing dimensional accuracy and fit. This is a standalone performance test of the manufacturing process and aligner product, but not an "algorithm" in the sense of AI.
    • Software: The Guidenia Ortho+ software is mentioned as FDA-cleared (K162850), implying it has its own standalone performance characteristics for the purpose of treatment planning, but this submission isn't validating that software itself, only confirming its cleared status.

    7. The type of ground truth used (expert concensus, pathology, outcomes data, etc)

    • Manufacturing Validation: The "ground truth" for the manufacturing validation implicitly involved predefined engineering tolerances (0.150mm) for dimensional accuracy and a trained physician's assessment of "excellent fit" as an acceptance criterion.
    • Substantial Equivalence: The primary "ground truth" for this 510(k) submission is the established safety and effectiveness profile of the predicate device (STR8 Clear Aligners, K223141) and the established clinical practice for sequential aligners in general.

    8. The sample size for the training set

    • No new training set data: Since no new clinical study was performed for this 510(k), there is no "training set" of patient data in the typical sense of an efficacy trial.
    • Manufacturing Process/Software: The software used (Guidemia Ortho+) and the manufacturing processes would have their own internal validation/training data, but these details are not provided in this 510(k) summary as SML is not validating the software itself, only using a cleared one, and the manufacturing process details are proprietary.

    9. How the ground truth for the training set was established

    • Not applicable for this 510(k) context: As explained above, no new clinical training set was established. The ground truth for the predicate device's initial clearance and the general understanding of orthodontic aligners is based on historical clinical data and expert consensus over many years in the field of dentistry and orthodontics.
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