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For Standard Length IBR36d Implant Range:

Southern Implants' External Hex Implants are intended for surgical placement in the upper or lower jaw to provide a means for prosthetic attachment of crowns, bridges or overdentures utilizing delayed or immediate loading. Southern Implants' External Hex Implants are intended for immediate function when good primary stability with appropriate occlusal loading is achieved.

When using Southern Implants' Standard Length IBR36D Implants with angulation of 36° a minimum of 4 implants must be used and splinted

The angled Co-Axis External Hex Implants are intended to be used with straight multiple-unit abutments (Compact Conical abutments) only with no additional angulation allowable on the restoration.

For Extra Length IBR36d Implant Range:

Southern Implants' External Hex Implants are intended for surgical placement in the upper or lower jaw to provide a means for prosthetic attachment of crowns, bridges or overdentures utilizing delayed or immediate loading. Southern Implants' External Hex Implants are intended for immediate function when good primary stability with appropriate occlusal loading is achieved.

Extra Length IBR36d Implants can be placed bicortically in cases of reduced bone density. Extra Length IBR36d Implants are only indicated for multiple unit restorations in splinted applications that utilize at least two implants. Extra Length IBR36d Implants are indicated for surgical installation in the pterygoid region only, in cases of severe jaw resorption, in order to restore patient esthetics and chewing function.

The angled Co-Axis External Hex Implants are intended to be used with straight multiple-unit abutments (Compact Conical abutments) only with no additional angulation allowable on the restoration.

For Extra Length IBR24d Implant Range:

Southern Implants' External Hex Implants are intended for surgical placement in the upper jaw to provide a means for prosthetic attachment of crowns, bridges or overdentures utilizing delayed or immediate loading. Southern Implants' External Hex Implants are intended for immediate function when good primary stability with appropriate occlusal loading is achieved.

Southern Implants' Extra Length IBR24d Implant Range when placed in the maxilla are only indicated for multiple unit restorations in splinted applications that utilize at least two implants.

The angled Co-Axis External Hex Implants are intended to be used with straight multiple-unit abutments (Compact Conical abutments) only with no additional angulation allowable on the restoration.

External Hex implants are fully-threaded, tapered, root-form dental implants with an external hexagonal abutment interface, and are threaded internally for attachment of mating multiple-unit abutments, cover screws, or healing abutments. The External Hex implants have a Co-Axis design with the prosthetic platform angled at 36° and 24° (inclined) from orthogonal to the long axis of the implant.

Additionally, the External Hex implants are provided in two configurations, regular surface and MSC surface implants. The regular surface implants are fully roughened excluding a machined collar at the coronal aspect of the implant. The MSC surface implants have an extended length of machined area at the coronal aspect of the implant, with the remaining implant length being roughened.

The implants subject to this submission are the External Hex IBR36d and IBR24d implant range. The reduced platform MSC-IBR24d implants are only provided as Co-Axis implants, in both the regular surface and MSC surface configuration. The reduced platform IBR36d implants are only provided as Co-Axis implants, in regular surface configuration. The IBR36d implants are available in two body configurations depending on the implant length.

The IBR36d implants of overall lengths 8.5 mm to 18 mm have a major body diameter of 4.20 mm tapering to 2.60 mm. The IBR36d implants of overall lengths 20 mm to 24 mm have a major body diameter of 4.20 mm tapering to 2.00 mm. Both the IBR24d and MSC-IBR24d implants of overall lengths 20 mm have a major body diameter 4.07 mm tapering to 2.60 mm. All of the subject device implants utilize the same prosthetic connection, previously cleared in K163634.

All External Hex implants are manufactured from unalloyed titanium (cold-worked, grade 4, UTS ≥ 900 MPa). The MSC-IBR24d implants have a smooth machined surface of length 3 mm extending parallel from the implant prosthetic platform for all implant lengths. The remainder of the implant is grit-blasted with aluminum oxide particles to provide a surface roughness of 1-2 um. The subject device implant material and surface are identical to those of the implants cleared in K163634.

The IBR36d and IBR24d External Hex implants are provided with a dedicated pre-mounted fixture mount of 36° and 24 respectively, similar to that provided with the other Co-Axis External Hex implants cleared in K163634.

All of the subject device implants utilize the same prosthetic connection, previously cleared in K163634 for the External Hex IBR24d and MSC-IBR24d implants. The External Hex implants are used in conjunction with the same abutments cleared for use with the External Hex IBR24d implants (implants cleared in K163634). These abutments are cleared in K053478, K070841, K093562, and K163634. The components that are compatible with the External Hex implants include Cover Screw, Healing Abutment, and Compact Conical Abutments. The Compact Conical Abutments are compatible with Temporary Titanium Abutment Cylinders, Gold Abutment Cylinders, and Passive Abutments.

The subject device Co-Axis implants are indicated for use with straight multiple-unit abutments with a 0° allowable restoration angle, only. This includes restricting straight abutments, that can be restored on a multi-unit abutment, that have an allowable restoration angle of up to 20° associated with them, so that they may only have a restoration angle of 0°. Thus, all the possible compatible abutments will have a 0° allowable restoration angle.

All External Hex implants are provided sterile to the end-user in a single-unit package, and are for single-patient, single-use only.

The provided text describes the 510(k) summary for the "External Hex Implant System" and references performance data to support its substantial equivalence to legally marketed predicate devices. However, it does not contain explicit "acceptance criteria" for the device, nor a study design with specific performance metrics against those criteria in the way typically seen for AI/ML device evaluations.

Instead, the document focuses on demonstrating substantial equivalence based on non-clinical performance data (mechanical testing and biocompatibility) and clinical literature review. The clinical literature review is used to show that similar devices with comparable characteristics (e.g., angulation, length) have proven safe and effective.

Therefore, I cannot directly provide a table of acceptance criteria and reported device performance with specific metrics like sensitivity, specificity, or AUC, as these are not defined or reported in the provided text. The "performance" discussed relates to the device's mechanical strength and the success rates of similar implants documented in clinical literature, not an AI algorithm's diagnostic performance.

However, I can extract the relevant information regarding the studies referenced to support the device's safety and effectiveness, interpreting "acceptance criteria" as the demonstration of substantial equivalence through various assessments:

Interpretation of "Acceptance Criteria" for this device:

For this device, "acceptance criteria" are not quantitative performance metrics in the traditional sense for diagnostic AI. Instead, they are met by demonstrating the device's substantial equivalence to legally marketed predicate devices through:

• Biocompatibility: Conformance to ISO 10993-1.
• Mechanical Performance: Conformance to ISO 14801 (static and dynamic compression-bending fatigue test), with results showing sufficient strength for intended use.
• Sterilization: Conformance to ISO 11137-1, ISO 11137-2, and USP 39-NF 34 for bacterial endotoxin.
• Dimensional Analysis: Verification of critical dimensions.
• Clinical Safety and Performance (via Literature Review): Demonstrated favorable survival rates and clinical indices for comparable implants under similar conditions and specifications (length, angulation, loading protocols). This implicitly acts as an "acceptance criterion" for clinical effectiveness by showing established safety and effectiveness of similar devices.
• MR Safety: Conformance to FDA Guidance Document "Testing and Labeling Medical Devices for Safety in the Magnetic Resonance (MR) Environment" (ASTM F2503, ASTM F2013, ASTM F2182, ASTM F2119).

Summary of Information from the Provided Text:

1. Table of "Acceptance Criteria" (interpreted as equivalence demonstration points) and "Reported Device Performance":

| Area of "Acceptance Criteria" (Demonstration of Equivalence) | Reported Device Performance / Evidence |
| Biocompatibility | Evaluated according to ISO 10993-1 (referenced from K163634). |
| Mechanical Performance (Static & Dynamic Compression-Bending) | Testing to ISO 14801 was performed on representative worst-case constructs for angulation and abutment/screw materials. Twelve (12) samples for each subject device group were subjected to fatigue testing. The fatigue limit was determined to be where a total of three (3) samples endured 5 x 10^6 cycles with no failures. Results confirmed that the strength of the subject device is sufficient for its intended use. |
| Sterilization & Shelf Life | Sterilization according to ISO 11137-1, ISO 11137-2. Bacterial endotoxin according to USP 39-NF 34. Sterile barrier shelf life (referenced from K222457). |
| Dimensional Analysis | Performed. (No specific values reported in this section, but implied to meet design specifications). |
| Clinical Safety & Performance (Standard Length IBR36d) | Retrospective analysis of real-world clinical data (literature review). The literature review demonstrated that implants with lengths of 7-18mm and angulation range of 20-50° as part of a splinted approach showed similar success rates to standard implants. Survival rates and clinical indices were favorable in both maxillary and mandibular applications, with immediate and delayed loading protocols. The subject device (8.5-18mm lengths, 36° angle) falls within this "window of successful implants." |
| Clinical Safety & Performance (Extra Length IBR36d) | Retrospective analysis of real-world clinical data (literature review). The literature review supported the use of long implants (10-25mm) placed at angles of 15-90° in the pterygoid region, showing similar success rates to standard implants. The subject device (20-24mm lengths, 36° angle) falls within this "window of successful implants." |
| MR (Magnetic Resonance) Safety | MR safety testing (ASTM F2503, F2013, F2182, F2119) was performed on previously cleared devices (referenced from K222457). The subject devices are considered equally MR Safe as the predicate devices because they are not worst-case components in terms of material, size, or shape. |

2. Sample Size and Data Provenance for Test Set (Clinical Literature Review):

• Standard Length IBR36d: A retrospective analysis of real-world clinical data was conducted by reviewing 14 clinical literature articles.

  • Sample Size (Patients/Implants, per article):
    • Article 1: Not specified, but follow-up up to 17 years.
    • Article 2: Not specified (100% survival rate), follow-up 3 years (42 months).
    • Article 3: Not specified (98.7% survival rate), follow-up 3 years.
    • Article 4: Not specified (96.1% and 95.7% survival rates), follow-up 5 years.
    • Article 5: "High level of implant failures (10%), however; the same number of tilted implants and straight implants failed." Follow-up 1 year.
    • Article 6: Not specified (96.6% survival rate), follow-up 5 years.
    • Article 7: Not specified (94.5% survival rate), follow-up 7 years.
    • Article 8: Not specified (94.8% survival rate), follow-up 10 years.
    • Article 9: Not specified (98.1% for tilted implants), follow-up 3 years.
    • Article 10: Not specified (93.9% cumulative survival rate), follow-up 5-13 years.
    • Article 11: Not specified (93% survival rate), follow-up 18 years.
    • Article 12: Not specified (100% survival rate for tilted implants), follow-up 13 months.
    • Article 13: Not specified, follow-up 3 years (42 months).
    • Article 14: Not specified (100% survival rate), follow-up 3 years (42 months).
    • Note: Specific sample sizes (number of patients or implants) for each referenced article are generally not provided in the summary, which is common for literature reviews used in 510(k) submissions to support equivalence.
  • Data Provenance: Retrospective analysis of real-world clinical data (published literature). The country of origin of the data is not specified for individual studies but can be inferred from the journal names and author affiliations in the references (e.g., Clinical Oral Implants Research, Odontology, Journal of Oral Implantology, Clin Implant Dent Rel Res, European Journal of Oral Implantology, The Journal of the American Dental Association, Dentistry Journal).

• Extra Length IBR36d: A retrospective analysis of real-world clinical data was conducted by reviewing 5 clinical literature articles.

  • Sample Size (Patients/Implants, per article):
    • Article 1: "Many authors have reported success rates of pterygoid implants ranging from 90% to 100% after follow-up period ranging from 1 to 12 years."
    • Article 2: "Thirteen articles were included, reporting a total of 1053 pterygoid implants in 676 patients."
    • Article 3: "121/125 of the implants were considered successful" after 2 years.
    • Article 4: "A total of 634 patients received 1,893 pterygoid implants."
    • Article 5: Not specified (93.9% survival rate), follow-up 3 years.
  • Data Provenance: Retrospective analysis of real-world clinical data (published literature). The country of origin of the data is not specified for individual studies but can be inferred from the journal names and author affiliations in the references (e.g., International Journal of Contemporary Dental and Medical Reviews, Journal of Oral Implantology, Dent Adv Res, Journal of Craniomaxillofacial Surgery, International Journal of Oral Maxillofacial Implants).

3. Number of Experts and Qualifications for Ground Truth: No direct "ground truth" establishment by experts for specific cases in the context of an AI algorithm is mentioned in this document. The clinical studies cited in the literature review represent real-world clinical outcomes and expert clinical practice by the authors of those papers. Their original reports would have involved clinical expertise to determine success/failure, bone loss, etc.

4. Adjudication Method: Not applicable. This document relies on published clinical literature, not an internal test set requiring adjudication for ground truth. The adjudication method, if any, would have been part of each individual study in the literature review.

5. Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study: No. This document does not pertain to an AI algorithm or human-in-the-loop performance. It describes a physical dental implant device.

6. Standalone (Algorithm Only) Performance Study: No. This document describes a physical dental implant device, not an algorithm.

7. Type of Ground Truth Used (for Clinical Performance): The "ground truth" for the clinical performance claims is derived from real-world clinical outcomes data reported in the referenced scientific literature. This includes:
* Implant survival rates
* Marginal bone loss (MBL)
* Clinical indices (e.g., pain, prosthetic mobility, bleeding, discomfort)
* Success rates of implants under various loading protocols (immediate/delayed) and angulations.

8. Sample Size for the Training Set: Not applicable. This document describes a physical dental implant system, not a machine learning model that requires a training set. The "training" for the device's design would be engineering principles, material science, and clinical experience/literature.

9. How the Ground Truth for the Training Set was Established: Not applicable, as it's not an AI/ML device.

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