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510(k) Data Aggregation

    K Number
    K251869
    Date Cleared
    2025-09-15

    (89 days)

    Product Code
    Regulation Number
    872.4200
    Panel
    Dental
    Reference & Predicate Devices
    Predicate For
    N/A
    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    Disposable Prophy Angle is intended to be attached to a low speed dental handpiece and used by professional dentists and dental hygienists for polishing and cleaning the surface of teeth. It is intended for single use, and should be discarded after each patient.

    Device Description

    Disposable Prophy Angle is a dental rotational device that consists of a prophy cup, a plastic body, a gear and a shaft with gear, which connects to a low-speed dental handpiece. The gear has the prophy cup attached to the end which holds dental tooth polishing paste. Prophy Angle is held in a dental handpiece by a shaft, which rotates the device's gear at speed as the polishing/ cleaning paste is applied to the surface of the teeth.

    AI/ML Overview

    N/A

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    K Number
    K240950
    Date Cleared
    2025-05-28

    (415 days)

    Product Code
    Regulation Number
    872.4200
    Panel
    Dental
    Reference & Predicate Devices
    Predicate For
    N/A
    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    The intended use of DPA is for polishing and cleaning teeth.

    Device Description

    Plastic one-piece housing (external casing) with 1 internal drive shaft and a spindle installed and aligned at right angle (90 degree) with each other. The tip of spindle is fitted with rubber prophy cup for cleaning and polishing teeth. A small amount of food-grade grease is added between the drive shaft and the spindle as lubrication. The disposable prophylaxis angle is available in a soft cup and firm cup format, which differ in the material used to form the cup. The Medicom and Practicon brands differ in logo and packaging, but utilize the same design.

    AI/ML Overview

    This FDA 510(k) clearance letter pertains to a Disposable Prophy Angle, a dental device, not an AI/ML medical device. Therefore, much of the requested information regarding AI/ML device testing (e.g., sample size for test set, data provenance, expert ground truth, MRMC study, training set details) is not applicable to this document.

    However, I can extract the relevant information regarding performance criteria and testing for this device.


    Acceptance Criteria and Study for Disposable Prophy Angle (K240950)

    This document describes the 510(k) clearance for a Disposable Prophy Angle, a dental handpiece accessory used for polishing and cleaning teeth. The device is not an AI/ML medical device, and thus, many of the typical AI/ML study parameters are not applicable.

    The submission demonstrates substantial equivalence to predicate devices by meeting recognized performance requirements through non-clinical testing.

    1. Table of Acceptance Criteria and Reported Device Performance

    The documentation references compliance with a specific industry standard for performance.

    Acceptance Criterion (Standard Ref.)Device Performance
    Conformance to ANSI ADA Spec. No. 85, Part I: Disposable Prophy Angles, section 5.5The device "conforms to the performance requirements (nonclinical tests) as specified in ANSI ADA Specification No. 85, Part I: Disposable Prophy Angles, section 5.5." This implies that all criteria within this section of the standard were met.
    Temperature Rise (relative to predicate)"Temperature rise...testing were performed on all models of the device (soft cup and firm cup) to demonstrate equivalent performance to the predicate device." (It passed, indicating equivalent or better performance against the predicate concerning temperature rise).
    Vibration (relative to predicate)"Vibration testing were performed on all models of the device (soft cup and firm cup) to demonstrate equivalent performance to the predicate device." (It passed, indicating equivalent or better performance against the predicate concerning vibration).

    Note: The specific numerical values or thresholds for "temperature rise" and "vibration" are not provided in this summary but would be detailed in the full test reports submitted to the FDA.

    2. Sample size used for the test set and the data provenance

    Not Applicable (N/A). This is a hardware dental device. The testing described is non-clinical performance testing (temperature rise, vibration) based on engineering specification compliance, not an AI/ML model evaluated on a test set of data. The "test set" would refer to the physical samples of the device and its components. The document doesn't specify the number of units tested, only that "all models of the device (soft cup and firm cup)" were tested.

    3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts

    Not Applicable (N/A). Ground truth based on expert review is specific to AI/ML or diagnostic image analysis. For this device, "ground truth" refers to established engineering standards (ANSI ADA Specification No. 85) and comparative performance against a predicate device.

    4. Adjudication method for the test set

    Not Applicable (N/A). Adjudication methods (like 2+1, 3+1) are used for resolving disagreements among multiple human readers in AI/ML or diagnostic studies. This is a non-clinical, hardware performance test.

    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

    Not Applicable (N/A). This is not an AI/ML device; therefore, an MRMC study and analysis of human reader improvement with AI assistance are irrelevant.

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

    Not Applicable (N/A). This is not an algorithm or software device.

    7. The type of ground truth used

    The "ground truth" (or basis for acceptance) for this device's performance testing is:

    • Established engineering standards: Specifically, "ANSI ADA Specification No. 85, Part I: Disposable Prophy Angles, section 5.5."
    • Comparative equivalence: Demonstration of "equivalent performance to the predicate device" for temperature rise and vibration.

    8. The sample size for the training set

    Not Applicable (N/A). This is a hardware device; there is no training set for an AI/ML model.

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

    Not Applicable (N/A). There is no training set for an AI/ML model.

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    K Number
    K103157
    Date Cleared
    2011-01-24

    (90 days)

    Product Code
    Regulation Number
    872.4200
    Panel
    Dental
    Reference & Predicate Devices
    N/A
    Predicate For
    N/A
    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    This Device is to be used by a Dentist or A Dental Hygienist for cleaning procedures on teeth.

    Device Description

    Disposable Prophy Angle

    AI/ML Overview

    I am sorry, but based on the provided text, there is no information about acceptance criteria or a study that proves a device meets such criteria.

    The document is an FDA 510(k) clearance letter for a device called "Disposable Prophy Angle Project's 020,021." This letter confirms that the FDA has reviewed the premarket notification and determined the device is substantially equivalent to legally marketed predicate devices.

    The letter explicitly states that the FDA's issuance of a substantial equivalence determination "does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencies." It focuses on regulatory compliance rather than performance data or study results.

    Therefore, I cannot provide the requested table or answer the specific questions about sample sizes, expert qualifications, adjudication methods, MRMC studies, standalone performance, ground truth types, or training set details.

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