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510(k) Data Aggregation

    K Number
    K102575
    Manufacturer
    Date Cleared
    2010-10-29

    (51 days)

    Product Code
    Regulation Number
    872.3820
    Panel
    Dental
    Reference & Predicate Devices
    Predicate For
    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use
    • Orthograde root canal filling material
    • Repair of root perforations during root canal therapy(endodontic therapy), or as a consequence of internal resorption
    • Repair of root canals as an apical plug during apexification
    • Root end filling
    • Pulp capping
    Device Description

    Ortho MTA (Mineral Trioxide Aggregate) is ideal for orthograde root canal filling. Ortho MTA (Mineral Trioxide Aggregate) is compositionally formulated to have the physical properties, setting requirements and characteristics necessary for a clinically effective root canal filling material.

    AI/ML Overview

    The provided text describes a medical device called Ortho MTA (Mineral Trioxide Aggregate), a root canal filling material, and its substantial equivalence to a predicate device, White MTA Material (K011009). The document focuses on demonstrating that Ortho MTA has similar properties and performance to the predicate device, thus not raising new questions about safety and effectiveness.

    However, the provided text does not include specific quantitative acceptance criteria or a detailed study methodology that would typically be used to prove a device meets such criteria in the way a diagnostic AI device would. Instead, it relies on demonstrating "similar physical and biocompatible properties" and "comparable performance specifications" to a predicate device.

    Therefore, many of the requested items related to acceptance criteria, sample size, expert ground truth, adjudication, and AI-specific studies cannot be extracted from this document, as they are not present.

    Here's a summary based on the available information:

    1. Table of Acceptance Criteria and Reported Device Performance

    The concept of specific performance metrics with acceptance criteria, as one might see for a diagnostic AI, is not present here. Instead, the acceptance is based on demonstrating substantial equivalence to a predicate device.

    Acceptance Criterion (Implicit)Reported Device Performance
    Similar physical properties to predicate deviceOrtho MTA has similar physical properties to White MTA Material. (Explicit statement: "Ortho MTA... has similar physical... properties, and demonstrates comparable performance specifications to White MTA Material")
    Similar biocompatible properties to predicate deviceOrtho MTA has similar biocompatible properties to White MTA Material. (Explicit statement: "Ortho MTA... has similar physical and biocompatible properties, and demonstrates comparable performance specifications to White MTA Material")
    Comparable performance specifications to predicate deviceOrtho MTA demonstrates comparable performance specifications to White MTA Material. (Explicit statement: "Ortho MTA... has similar physical and biocompatible properties, and demonstrates comparable performance specifications to White MTA Material")
    Comparable delivery system to predicate deviceOrtho MTA has a comparable delivery system to White MTA Material. (Explicit statement: "In addition, Ortho MTA (Mineral Trioxide Aggregate) has a comparable delivery system to White MTA Material.")
    Differences do not raise new questions of safety and effectivenessBench and biocompatibility testing performed demonstrates that any differences in technological characteristics do not raise any new questions as to safety and effectiveness.
    Safe and effective for indicated usesConcluded as safe, effective, and substantially equivalent to the predicate device.

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

    Not applicable/mentioned. The study is described as "bench and biocompatibility testing," not a test set in the context of data for AI.

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

    Not applicable/mentioned.

    4. Adjudication method for the test set

    Not applicable/mentioned.

    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. 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 not an algorithm.

    7. The type of ground truth used

    The "ground truth" here is effectively the accepted properties and performance of the predicate device (White MTA Material). The new device is compared against these established characteristics through "bench and biocompatibility testing."

    8. The sample size for the training set

    Not applicable/mentioned. This is not an AI device with a training set.

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

    Not applicable/mentioned. This is not an AI device with a training set.

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