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MIS Dental Implant Systems are intended to be surgically placed in the bone of the upper or lower jaw arches to provide support for prosthetic devices, such as artificial teeth, in order to restore masticatory function. When a one-stage surgical procedure is applied, the implant may be immediately loaded when good primary stability is achieved, and the occlusal load is appropriate.

Narrow implants (Ø3.3mm) are indicated for use in surgical and restorative applications for placement only in the mandibular central, lateral incisor and maxillary lateral incisor regions of partially edentulous jaws, to provide support for prosthetic devices such as artificial teeth. Mandibular central and lateral incisors must be splinted if using two or more narrow implants adjacent to one another.

The long MIS (18 & 20 mm) implants can be used in a tilted manner.

MIS short implants are to be used only with straight abutments. M4 short implants are indicated for delayed loading only.

The subject MIS Dental Implant Systems are endosseous dental implant devices which are modified as subject to this premarket notification with a revised sterile packaging configuration. There are no modifications subject to this premarket notification which relate to the geometric or material composition design of the subject dental implant devices themselves. The individual product variants of the MIS Dental Implant Systems which are modified as subject to this premarket notification will be rebranded "MIS CLEAR". The subject implants are identical to the predicate and reference MIS implant systems in terms of their indications for use, design, constituent materials and manufacturing process. The subject MIS Dental Implants Systems only differ in their final packaging configuration, as subject to this premarket notification. The subject, predicate and reference MIS Dental Implants Systems are supplied in a double tube packaging configuration, wherein the outer tube serves as the sterile barrier, and the implant device is located within the inner tube. While the predicate and reference MIS Dental Implants Systems are supplied within a "dry" inner package tube, the subject devices as modified in this premarket notification are supplied in a modified inner tube containing liquid, in the form of NaCl solution. The liquid environment is intended to maintain the super-hydrophilic property (contact angle exhibited by water in contact with the surface is equal to zero degrees) of the subject MIS Dental Implants Systems, as subject to this premarket notification, until their use in patients. The outer tube serving as the sterile barrier is unchanged compared to the predicate and reference devices.

The provided context describes a 510(k) premarket notification for MIS Dental Implant Systems. The primary change being assessed is a modification to the inner packaging of the implants, specifically, the introduction of an NaCl solution to maintain the super-hydrophilic property of the implants.

Here's an analysis of the acceptance criteria and supporting studies based on the provided text:

1. Table of Acceptance Criteria and Reported Device Performance

The document does not explicitly present a table of predetermined acceptance criteria. Instead, it describes various non-clinical tests performed and states that the data supports the desired outcome. The device's performance, as reported, is that it meets the requirements of these tests.

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

The document does not specify the sample sizes used for each non-clinical test mentioned (e.g., number of implants tested for cytotoxicity).

The data provenance is from non-clinical bench testing performed to support this premarket notification. The country of origin of the data is not specified, but the applicant, Dentsply Sirona, is based in York, Pennsylvania, USA, and MIS Implants Technologies Ltd. (a Dentsply Sirona company) is listed as the manufacturer.

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

This section is not applicable because the studies detailed are non-clinical (bench testing) rather than clinical studies involving human observers or expert interpretation. Therefore, there was no ground truth requiring expert consensus.

4. Adjudication Method for the Test Set

This section is not applicable as the studies are non-clinical bench tests and do not involve human adjudication.

5. Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study

No. A Multi-Reader Multi-Case (MRMC) comparative effectiveness study was not done. The document explicitly states: "No human clinical data was included in this premarket notification to support the substantial equivalence..."

6. Standalone (Algorithm Only Without Human-in-the-Loop Performance) Study

This question is not applicable as the device is a physical dental implant system, not an algorithm or AI software for which standalone performance would be assessed.

7. Type of Ground Truth Used

For the non-clinical performance data, the "ground truth" or reference criteria would be defined by the standards and methods used for each test:

• Cytotoxicity: Negative control or established biocompatibility standards.
• Chemical Characterization: Baseline material composition and absence of unexpected leachables.
• Sterilization: Sterility assurance level (SAL) of 10^-6^ as per ISO 11137-1:2015 and ISO 11137-2:2015.
• Transportation: No damage or compromise to packaging or device integrity after simulated transport, as per ASTM 4332-14 and ASTM D 4169-16.
• Hydrophilicity: Maintenance of super-hydrophilic properties (contact angle of water is zero degrees).
• Fatigue Testing: Mechanical endurance limits established by ISO 14801:2016 for dental implants (referenced from predicate devices).

8. Sample Size for the Training Set

This section is not applicable. There is no "training set" as this is a physical medical device, not an AI/ML algorithm that requires training data.

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

This section is not applicable for the same reason as above.

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MIS Dental Implant Systems are intended to be surgically placed in the bone of the upper or lower jaw arches to provide support for prosthetic devices, such as artificial teeth, in order to restore masticatory function. When a one-stage surgical procedure is applied, the implant may be immediately loaded when good primary stability is achieved and the occlusal load is appropriate.

Narrow implants (Ø3.3mm) are indicated for use in surgical and restorative applications for placement only in the mandibular central, lateral incisor and maxillary lateral incisor regions of partially edentulous jaws, to provide support for prosthetic devices such as artificial teeth. Mandibular central and lateral incisors must be splinted if using two or more narrow implants adjacent to one another. MIS short implants are to be used only with straight abutments.

The proposed MIS Dental Implant System entails a material modification and line extension of the MIS Lance+ Internal Hex Dental Implants and new offering of MIS Internal Hex Cobalt Chrome Abutments.

Lance+ Dental Implants: A modification and line extension to the originally cleared Lance implants (K040807). Manufactured from titanium alloy, Ti- 6Al-4V ELI, compared to the prior CP titanium grade 4. Additional sizes are being added as a line extension.

MIS Internal Hex Cobalt Chrome (CoCr) abutments: Pre-manufactured prosthetic components directly connected to the endosseous dental implant and intended for use as an aid in prosthetic rehabilitation. Intended for permanent restoration for single tooth or multiple units screw retained restorations. The lower part of the abutment is made of CoCr alloy, and the upper part is made of plastic (POM). The plastic part is dissolved during the casting process. The abutment is connected to the implant by a prosthetic screw.

This document is a 510(k) Pre-market Notification for the MIS Dental Implant System. It describes the device, its intended use, and comparative studies to establish substantial equivalence to previously cleared devices, rather than a study proving performance against acceptance criteria for a novel AI/software device. Therefore, much of the requested information regarding AI device acceptance criteria and study design is not applicable or cannot be extracted from this document.

However, I can extract the information related to the device's technical performance and the non-clinical studies conducted.

Here's a breakdown of the relevant information:

1. Table of acceptance criteria and the reported device performance:

Since this is not an AI/software device, there aren't traditional "acceptance criteria" for metrics like sensitivity, specificity, or accuracy. Instead, the acceptance criteria relate to engineering and biocompatibility standards. The reported device performance is demonstrated by meeting these standards.

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

• Sample Size for Test Set: The document does not specify a distinct "test set" in the context of an AI/software device. For the non-clinical performance tests like fatigue and corrosion, the sample sizes are determined by the respective ISO/ASTM standards. These details are not provided in this summary.
• Data Provenance: Not applicable in the context of clinical data for an AI/software device. The non-clinical testing was conducted by MIS Implants Technologies.

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

• Not Applicable. This is a medical device (dental implant and abutments), not an AI/software device that relies on expert interpretation for ground truth.

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

• Not Applicable. See point 3.

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. This is not an AI-assisted device.

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

• Not Applicable. This is a physical medical device.

7. The type of ground truth used:

• Defined by Engineering Standards and Material Properties: The "truth" for this device is its adherence to mechanical performance standards (e.g., fatigue strength), biocompatibility (e.g., non-cytotoxicity, corrosion resistance), and physical characteristics (e.g., dimensions, material composition). This is established through laboratory testing following ISO and ASTM guidelines.

8. The sample size for the training set:

• Not Applicable. There is no "training set" as this is not an AI/software device.

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

• Not Applicable. See point 8.

Summary of applicable information from the document:

This 510(k) summary focuses on demonstrating the substantial equivalence of the modified MIS Dental Implant System (Lance+ Internal Hex Implants and Cobalt Chrome Abutments) to existing legally marketed predicate devices. The evidence presented primarily consists of non-clinical performance data:

• Fatigue testing: Conducted according to ISO 14801:2016 for the implants.
• Corrosion testing: For the Cobalt Chrome (CoCr) abutments, indicating low risk of galvanic corrosion when coupled with titanium.
• Biocompatibility testing: Cytotoxicity testing for the CoCr abutments, with implants relying on prior testing for the same materials.
• Surface treatment characterization: Confirmed to be identical to predicate devices.
• Packaging integrity validation: Conducted per ISO 11607-1:2009 and ASTM F1929-12.
• Sterilization validation: For both radiation (implants) and moist heat (abutments), adhering to relevant ANSI/AAMI/ISO standards to achieve an SAL of 10^-6.

The document explicitly states: "No human clinical data were included to support substantial equivalence." This means the device relies entirely on non-clinical engineering and material science data to prove its safety and effectiveness relative to existing, cleared devices.

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The MIS Dental Implant System is indicated for use in surgical and restorative applications for placement in the bone of the upper or lower jaw to provide support for prosthetic devices, such as artificial teeth, in order to restore the patient's chewing function.

The MIS Dental Implant System consists of one and two stage implants, internal and external hexagonal; cover screw and healing caps; abutment systems and suprastructures; surgical instruments.

The provided text does not contain information about acceptance criteria or a study proving that the device meets such criteria. The document describes a 510(k) summary for the "MIS Dental Implant System," which is a premarket notification to the FDA to demonstrate substantial equivalence to existing legally marketed devices.

The information primarily focuses on:

• Device Description: Components of the MIS Dental Implant System (implants, cover screws, healing caps, abutments, surgical instruments).
• Materials: Implants are made from medical grade 4 (GD-4) pure titanium (ASTM F67-95).
• Intended Use: Surgical and restorative applications in the upper or lower jaw to support prosthetic devices and restore chewing function.
• Predicate Devices: Comparison to 3i Dental Implant System and ITI Dental Implant System.
• Substantial Equivalence Claim: The device has the same intended use and equivalent performance characteristics to the predicate devices.
• FDA Clearance Letter: Confirmation of substantial equivalence by the FDA.

Therefore, I cannot provide a table of acceptance criteria and reported device performance, nor details about a study, sample sizes, expert qualifications, ground truth, or MRMC studies, as this information is not present in the provided text. The document is a regulatory submission, not a scientific study report.

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