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510(k) Data Aggregation

    K Number
    K211420
    Device Name
    Stasis Gel
    Date Cleared
    2022-03-14

    (311 days)

    Product Code
    Regulation Number
    N/A
    Panel
    Dental
    Reference & Predicate Devices
    Why did this record match?
    Product Code :

    MVL

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

    STASIS Gel is intended for sulcus retraction prior to impression making and to control bleeding and gingival oozing in restorative and operative dentistry used with gingival retraction cord. STASIS Gel facilitates the insertion of the cord into the sulcus.

    Device Description

    Stasis Gel is a 15.5% Ferric Sulfate in a water-based, viscous gel that facilitates sulcus retraction. When applied to the sulcus, the product provides physical displacement of the gingival tissue from the tooth, which in turn, provides a physical barrier to prevent gingival bleeding and oozing from following procedures. Stasis Gel is supplied in a 30 ml or 1.2 ml plastic syringe. The 30 ml syringe is used for bulk storage and 1.2 ml plastic syringe is used for delivery the gel to the sulcus.

    AI/ML Overview

    This document is a 510(k) summary for the STASIS Gel, a dental device intended for sulcus retraction and control of bleeding/gingival oozing. It primarily focuses on demonstrating substantial equivalence to a predicate device (Vista FS) rather than presenting a detailed study with acceptance criteria for a new AI/software device. Therefore, much of the requested information regarding AI device testing (e.g., sample size for test set, expert qualifications, MRMC study, standalone performance) is not applicable or provided in this document.

    However, based on the provided text, I can extract information related to the device's characteristics and the non-clinical testing performed to support its substantial equivalence.

    Here's the information that can be extracted, and where the requested information is not applicable, it is noted.

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

    Since this is a submission for a medical device (STASIS Gel) and not an AI/software device, the acceptance criteria are based on demonstrating similarity to a predicate device in terms of chemical characteristics, indications for use, and safety. The document does not explicitly state "acceptance criteria" in a quantitative performance metric sense for a software algorithm, but rather compares key attributes.

    Criteria/Characteristic (for comparison with Predicate)Predicate Device (Vista FS / Vista FS Liquid) PerformanceSubject Device (Stasis Gel) Performance
    Indications for UseSulcus retraction prior to impression making and to control bleeding and gingival oozing in restorative and operative dentistry used with gingival retraction cord. Facilitates the insertion of the cord into the sulcus.Sulcus retraction prior to impression making and to control bleeding and gingival oozing in restorative and operative dentistry used with gingival retraction cord. Facilitates the insertion of the cord into the sulcus.
    Chemical Characteristics20% Ferric Sulfate (Vista FS), 15.5% Ferric Sulfate (Vista FS Liquid)15.5% Ferric Sulfate
    Mechanism of ActionPhysical displacement of gingival tissue by viscous gel; facilitates cord insertion.Physical displacement of gingival tissue by viscous gel; facilitates cord insertion.
    ViscosityUnknown≥ 55,000 cps
    pH1-31-3
    BiocompatibilityCytotoxicityCytotoxicity, Skin Sensitization, Skin Irritation (all demonstrated low risk)
    Ferric Sulfate ContentNot explicitly stated for performance, but implied by 15.5% / 20%.Tested and found similar to predicate device.
    Shelf-Life18 months24 months (based on accelerated testing, real-time ongoing)

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

    Not applicable. This document describes the non-clinical testing of a physical medical device (STASIS Gel), not an AI/software device. There is no "test set" in the context of clinical images or patient data for AI performance evaluation. The "testing" refers to bench testing and biocompatibility studies.

    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)

    Not applicable. This is for a physical medical device, not an AI/software device requiring expert ground truth for image interpretation or diagnosis.

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

    Not applicable. There is no test set or human adjudication process as this is not an AI/software device.

    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 for a physical medical device, not an AI/software device, so an MRMC study is not relevant.

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

    Not applicable. This is not an AI/software device.

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

    For the physical characteristics and safety:

    • Biocompatibility: In-vitro and in-vivo testing according to ISO 10993-1 standards, which serve as objective ground truth for safety assessments.
    • Chemical Characteristics (Ferric Sulfate content, pH): Laboratory analytical methods that provide objective measurements.
    • Viscosity: Laboratory rheometry methods that provide objective measurements.
    • Shelf-Life: Accelerated aging studies and ongoing real-time aging studies, which provide objective data on product stability over time.

    8. The sample size for the training set

    Not applicable. This is not an AI/software device that uses "training sets."

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

    Not applicable. This is not an AI/software device.

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    K Number
    K211419
    Device Name
    Gingi-Aid Gel
    Date Cleared
    2022-01-10

    (248 days)

    Product Code
    Regulation Number
    N/A
    Panel
    Dental
    Reference & Predicate Devices
    Why did this record match?
    Product Code :

    MVL

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

    GINGI-AID Gel is intended for gingival retraction prior to impression making and to control bleeding and gingival oozing in restorative and operative dentistry when used with gingival retraction cords. The gel facilitates the insertion of the cord into the sulcus.

    Device Description

    Gingi-Aid Gel is a 25% Aluminum Chloride in a water-based, viscous gel that facilitates gingival retraction. When applied to the sulcus, the product provides physical displacement of the gingival tissue from the tooth, which in turn, provides a physical barrier to prevent gingival bleeding and oozing from following procedures. Gingi-Aid Gel is supplied in a 30 ml or 1.2 ml plastic syringe. The 30 ml syringe is used for bulk storage and 1.2 ml plastic syringe is used for delivery the gel to the sulcus.

    AI/ML Overview

    This document is a 510(k) Premarket Notification from the FDA regarding the Gingi-Aid Gel. It focuses on demonstrating the substantial equivalence of the Gingi-Aid Gel to an existing predicate device, rather than providing details on acceptance criteria and performance data for a new, AI-based device that would typically involve the comprehensive testing requested.

    Therefore, most of the requested information regarding "acceptance criteria and the study that proves the device meets the acceptance criteria" for an AI/CADe device, specifically:

    • A table of acceptance criteria and the reported device performance: Not applicable. This document is for a dental gel, not an AI/CADe device. The "performance" is based on chemical and physical properties and intended use.
    • Sample sized used for the test set and the data provenance: Not applicable in the context of AI/CADe. The "testing" here involves biocompatibility, bench testing for aluminum chloride content, and shelf-life testing, not a clinical study on a large test set of images or patient data.
    • Number of experts used to establish the ground truth for the test set and the qualifications of those experts: Not applicable. Ground truth for an AI/CADe device is usually established by medical experts (e.g., radiologists, pathologists). This is a chemical product.
    • Adjudication method (e.g., 2+1, 3+1, none) for the test set: Not applicable.
    • 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.
    • If a standalone (i.e. algorithm only without human-in-the-loop performance) was done: Not applicable.
    • The type of ground truth used (expert consensus, pathology, outcomes data, etc): Not applicable in the AI/CADe sense. The "ground truth" for this device would be established by chemical analysis and standard biocompatibility testing.
    • The sample size for the training set: Not applicable. This is not an AI/ML device.
    • How the ground truth for the training set was established: Not applicable.

    However, I can extract the following information relevant to the submission:

    1. Device Description and Characteristics (replacing "Acceptance Criteria" with "Key Characteristics" and "Performance" with "Reported Data"):

    The document primarily focuses on demonstrating substantial equivalence to predicate devices (Vista Clear, K193389, and ViscoStat Clear, K123215). The "acceptance criteria" are implicitly met by demonstrating that the Gingi-Aid Gel is chemically and functionally similar and safe.

    Key CharacteristicAcceptance Criteria (Implied by Predicate)Reported Data (Gingi-Aid Gel)
    Device Identification25% Aluminum Chloride in water-based gel25% Aluminum Chloride in a water-based, viscous gel
    Primary Active IngredientAluminum Chloride25% Aluminum Chloride
    FormulationViscous GelViscous gel
    Intended UseGingival retraction, bleeding/oozing control (with cord)Intended for gingival retraction prior to impression making and to control bleeding and gingival oozing in restorative and operative dentistry when used with gingival retraction cords. The gel facilitates the insertion of the cord into the sulcus.
    Environment of UseHealthcare facility/Dental officeHealthcare facility/Dental office
    Target PopulationHealthcare professionalsHealthcare professionals
    Prescription/OTCPrescription UsePrescription Use
    Anatomical SiteOral CavityOral Cavity
    Mechanism of ActionPhysical displacement of gingival tissue, facilitates cord insertionPlacement of the viscous gel results in physical displacement of gingival tissue from the tooth. Material also facilitates insertion of the cord into the sulcus.
    pHSimilar to predicate (ViscoStat Clear: 2.65)2.62 (Compared to ViscoStat Clear's 2.65, demonstrating similarity)
    Packaging Configuration1.2mL pre-filled syringe; 30mL syringe1.2mL pre-filled syringe with applicator tips; 30mL syringe with empty 1.2mL syringes and applicator tips.
    SterilityNon-sterileNon-sterile (Gingi-Aid Gel is not supplied as sterile.)
    Shelf-LifeAt least 24 months24 months (Based on accelerated testing; real-time aging being performed to support shelf life).
    Recommended Contact Time1-3 minutes1-3 minutes
    BiocompatibilityLow cytotoxicity, no skin sensitization/irritationBiocompatibility testing performed according to ISO 10993-1. Device demonstrated low cytotoxicity, no skin sensitization or skin irritation. (Testing included Cytotoxicity, Skin Sensitization, Skin Irritation).
    Aluminum Chloride ContentSimilar to predicateGingi-Aid Gel has been tested for aluminum chloride content and is found to be similar to predicate device.

    2. Study Design and Data Provenance (for this specific device which is NOT AI/CADe):

    • Sample size and Data Provenance: Not applicable in the context of a clinical study for AI/CADe. The "study" here involves lab testing.
      • Bench Testing: Gingi-Aid Gel's aluminum chloride content was compared to the predicate device.
      • Biocompatibility Testing: Performed according to ISO 10993-1. (Specific sample sizes for these tests are not provided but are standard for material testing).
      • Shelf-Life Testing: Accelerated testing supported 24 months, with real-time aging ongoing.
      • The "data provenance" is from in-house lab testing by the manufacturer (Belport Company, Inc. / Gingi-Pak). The document does not specify country of origin for the data, but the submission is to the US FDA. The nature of these tests is not "retrospective" or "prospective" in a clinical trial sense, but rather lab-based validation.

    3-9. Information Not Applicable to this Type of Device (Gingi-Aid Gel is not an AI/CADe device):

    As explained above, questions concerning experts for ground truth, adjudication methods, MRMC studies, standalone algorithm performance, direct patient ground truth, and training set details are entirely irrelevant to this submission, which is for a dental chemical product. The substantial equivalence is based on comparing its physical, chemical, and functional properties to similar, already-cleared predicate devices.

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    K Number
    K213149
    Manufacturer
    Date Cleared
    2021-12-09

    (73 days)

    Product Code
    Regulation Number
    N/A
    Panel
    Dental
    Reference & Predicate Devices
    N/A
    Why did this record match?
    Product Code :

    MVL

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

    For temporary retraction of the marginal gingiva to provide a dry gingival sulcus when the periodontium is healthy prior to, e.g - analogue or digital impressions - cementation of temporary and permanent restorations - preparation of class II and V fillings

    Device Description

    Not Found

    AI/ML Overview

    The provided text is a 510(k) clearance letter from the FDA for a dental product called "VOCO Retraction Paste". This document does not contain any information about acceptance criteria or a study that proves a device meets acceptance criteria. Instead, it outlines the regulatory status of the device, its indications for use, and general regulatory requirements.

    Therefore, I cannot fulfill your request to describe acceptance criteria and a study based on the provided input. The details you are asking for, such as sample size, data provenance, expert qualifications, adjudication methods, MRMC studies, standalone performance, training set information, and ground truth establishment, are not present in this regulatory clearance letter.

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    K Number
    K200764
    Device Name
    STATSTIX
    Date Cleared
    2020-10-15

    (205 days)

    Product Code
    Regulation Number
    N/A
    Panel
    Dental
    Reference & Predicate Devices
    Why did this record match?
    Product Code :

    MVL

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

    StatStix is applied to control temporary bleeding caused by minor cuts and abrasions that may occur on gingival tissue during dental procedures.

    Device Description

    StatStix is designed incorporating a hand-held polypropylene handle with a nylon polyamide applicator tip coated with a dried solution of 25% Aluminum Sulfate Hydrate Solution with Mint Flavor. The device is configured in two sizes to help control minor gingival bleeding intended for transient use by a dentist during dental restorative procedures.

    AI/ML Overview

    The provided FDA document describes the premarket notification (510(k)) for the StatStix device (K200764). It details the device's intended use and compares its characteristics to a predicate device for substantial equivalence. However, it explicitly states that clinical testing has not been performed on this product. Therefore, a study proving the device meets acceptance criteria based on clinical performance in humans is not present in this document.

    The document does, however, discuss non-clinical performance data and establishes acceptance criteria for those tests.

    Here's a breakdown of the available information:

    1. Table of Acceptance Criteria and Reported Device Performance (Non-Clinical):

    Acceptance Criteria (Non-Clinical)Reported Device Performance (Non-Clinical)
    Biocompatibility:Meets ISO 10993-5 (cytotoxicity)
    - CytotoxicityMeets ISO 10993-10 (sensitization/irritation)
    - Sensitization/Irritation
    Physical Properties:Performed according to standard laboratory benchtop practices
    - FTIR
    - pH
    - Dosage Weight
    Shelf-Life:Allows for a two-year expiration dating
    - Consistent with ASTM F1980

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

    • Clinical Test Set: Not applicable, as no clinical testing was performed for StatStix.
    • Non-Clinical Test Set: Not specified for biocompatibility, physical properties, or shelf-life testing. The document states "standard laboratory benchtop practices" for physical properties and "consistent with ASTM F1980" for shelf-life, implying standard sample sizes for these types of tests would have been used, but specific numbers are not detailed.
    • Data Provenance: Not explicitly stated, but assumed to be from Centrix Incorporated or their contracted laboratories given they are the submitter.

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

    • Clinical Test Set: Not applicable.
    • Non-Clinical Test Set: Not specified. For non-clinical lab tests, "ground truth" is established by the methodologies and reference standards themselves, as opposed to expert human interpretation.

    4. Adjudication Method for the Test Set:

    • Clinical Test Set: Not applicable.
    • Non-Clinical Test Set: Not applicable. Adjudication methods are typically relevant for subjective assessments or when multiple human readers/experts are involved in ground truth establishment.

    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, "Clinical testing has not been performed on this product." Therefore, there is no information on how much human readers improve with AI vs. without AI assistance. The StatStix device is a physical product (applicator with astringent), not an AI-powered diagnostic or assistive tool.

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

    • No, a standalone performance study in the context of an algorithm or AI was not done. StatStix is a physical device, not an algorithm.

    7. Type of Ground Truth Used:

    • Clinical Ground Truth: Not applicable, as no clinical testing was performed.
    • Non-Clinical Ground Truth: Established through standardized laboratory testing methodologies (e.g., ISO, ASTM, FTIR/pH/dosage weight analysis) where the outcomes are measurable and objective.

    8. Sample Size for the Training Set:

    • Not applicable. This device is a physical product, not an AI/machine learning algorithm requiring a "training set" of data.

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

    • Not applicable, as there is no training set for this type of device.
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    K Number
    K193389
    Device Name
    Vista Clear
    Date Cleared
    2020-03-04

    (89 days)

    Product Code
    Regulation Number
    N/A
    Panel
    Dental
    Reference & Predicate Devices
    Why did this record match?
    Product Code :

    MVL

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

    Vista Clear is intended for sulcus retraction prior to impression making and to control bleeding and gingival oozing in restorative and operative dentistry used with gingival retraction cord. Vista Clear facilitates the insertion of the cord into the sulcus.

    Device Description

    Vista Clear is used to facilitate sulcus retraction prior to taking a dental impression of a tooth. This entails placement of the device into the sulcus which provides physical displacement of the gingival tissue from the tooth. If using a gingival retraction cord, the subject device facilitates the insertion of the cord into the sulcus while also creating a physical barrier to prevent gingival bleeding and oozing from affecting restorative and tissue management procedures.

    AI/ML Overview

    The provided text describes a 510(k) premarket notification for a medical device called "Vista Clear." This type of submission focuses on demonstrating substantial equivalence to a legally marketed predicate device rather than undergoing extensive clinical trials or performance testing against specific acceptance criteria for efficacy in the same way a novel device might.

    Therefore, the document does not contain information on "acceptance criteria" and "study that proves the device meets the acceptance criteria" in the context of clinical performance or diagnostic accuracy. Instead, the "device performance" described relates to non-clinical testing demonstrating equivalence to a predicate device.

    Here's an analysis based on the provided text, addressing your questions to the extent possible, and highlighting what's not present:

    Key Takeaway: This 510(k) summary is for a device with a clear physical/chemical function (sulcus retraction, bleeding control) and claims substantial equivalence based on technological characteristics and non-clinical testing, not clinical performance or diagnostic accuracy with human interpretation.


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

    The concept of "acceptance criteria" in this 510(k) largely revolves around demonstrating substantial equivalence to the predicate device and meeting relevant non-clinical performance standards. There are no explicit quantitative clinical performance acceptance criteria (e.g., sensitivity, specificity, AUC) stated in the document, as it's not a diagnostic device.

    Reported Device Performance (from "Non-Clinical Performance Testing and Compliance"):

    Acceptance Criteria (Implied by Equivalence & Standards)Reported Device Performance (Vista Clear)
    Technological Characteristics Substantial Equivalence:
    - Same Intended Use: Sulcus retraction and bleeding/gingival oozing control.- Meets. Nearly identical indications for use as the predicate device.
    - Same Common Name / Product Code Classification (MVL).- Meets.
    - Same Recommended Contact Time (1-3 minutes).- Meets.
    - Same Form/Mechanism: Aqueous gel for physical retraction.- Meets. "identical to the predicate device as both products are aqueous gels which aid in the physical retraction of gingival tissue."
    - Same Target Population & Anatomical Site: Healthcare professionals, oral cavity.- Meets.
    - Same Prescription Use classification.- Meets.
    - Same Packaging/Configuration.- Meets. "offered in the same configurations as the predicate device (i.e. prefilled syringes with applicator tips, or bulk syringes with unfilled smaller syringes and applicator tips)."
    - Similar Chemical Characteristics (Aluminum chloride based).- Meets. Contains 26.6% aluminum chloride hexahydrate vs. predicate's 25% aluminum chloride. Stated this difference "does not raise any safety or efficacy concerns as they are analogous materials."
    - Similar pH (Implied by "identical technological characteristics").- Meets. "Both medical devices have an identical pH."
    - Non-Sterile classification.- Meets.
    Non-Clinical Performance Acceptance Criteria:
    - Analytical Testing: Verified manufacturing and comparable results to predicate.- Meets. "Results from testing are commensurate with the predicate device, supporting substantial equivalence..."
    - Cytotoxicity Testing (ISO 10993-1): No significant cytotoxicity, comparable to predicate.- Meets. "Vista Clear exhibited the same cytotoxicity result as the predicate device (ViscoStat Clear) sold for the same intended use." This "confirms that the subject device is substantially equivalent to the predicate device."
    - Microbiological Testing: Mitigation of contamination risks, support shelf stability.- Meets. "Vista Clear exhibits bactericidal properties." This "helps to support shelf stability and multiple use of non-patient contacting materials." Note: Not claiming a "bactericidal effect" on the patient, but rather internal contamination control.
    - Shelf-Life Testing: Demonstrate stability for stated shelf-life (24 months).- Meets. "Based on accelerated testing, a shelf life of two years is supported for Vista Clear." (Predicate has 42 months, but this difference is deemed acceptable with appropriate labeling.) Real-time aging is ongoing.
    - Transit Testing: Packaging withstands simulated transit conditions without negative effect on product.- Meets. "Moreover, the products performed satisfactory post-transit. which confirms that transit did not have a negative effect on the products themselves."
    - Compliance with applicable standards (e.g., ISO 10993-1, ISO 14971, ISO 594-1/2 for Luer taper).- Stated that these standards were followed for evaluation and risk management. No specific results are given for general standards like ISO 14971 (risk management).

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

    • Test Set (for non-clinical performance): The document does not specify a "test set" in the context of clinical or diagnostic performance data (e.g., number of patient cases, images). The testing refers to laboratory-based evaluations of the device's material properties, packaging, and stability.
      • Data Provenance: N/A. This is a submission for a new device, and the data provenance refers to materials/engineering tests, not patient data. No country of origin for patient data (as there isn't any provided in text) or retrospective/prospective study type is mentioned as no clinical studies were performed.

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

    • N/A. This information is relevant for studies involving human interpretation or diagnostic accuracy. For this type of device and 510(k) submission, ground truth relates to the results of objective laboratory tests (e.g., is it cytotoxic?), not expert consensus on clinical findings.

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

    • N/A. As no expert consensus or human interpretation of clinical cases was performed, no adjudication method is relevant or described.

    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

    • N/A. This device is a dental material, not an AI or diagnostic imaging device. Therefore, no MRMC study was conducted or is applicable.

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

    • N/A. This is not an algorithm-based device.

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

    • The "ground truth" for this device is based on objective laboratory test results (e.g., analytical chemistry, toxicology, microbiology, stability) that confirm the material properties, safety, and functionality of the device compared to established scientific principles and the predicate device's known characteristics. It's not clinical outcomes or expert labels.

    8. The sample size for the training set

    • N/A. This term is relevant for machine learning models. No training set is applicable for this type of medical device submission.

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

    • N/A. As there is no training set, this question is not applicable.
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    K Number
    K190220
    Date Cleared
    2019-06-10

    (125 days)

    Product Code
    Regulation Number
    N/A
    Panel
    Dental
    Reference & Predicate Devices
    Why did this record match?
    Product Code :

    MVL

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

    Vista FS and Vista FS Liquid are intended for sulcus retraction prior to impression making and to control bleeding and gingival oozing in restorative and operative dentistry used with gingival retraction cord. Vista FS Liguid facilitate the insertion of the cord into the sulcus.

    Device Description

    Vista FS and Vista FS Liquid are medical devices used to facilitate sulcus retraction prior to taking a dental impressions of a tooth. This entails placement of the sulcus which provides physical displacement of the gingival tissue from the tooth. If using a gingival retraction cord, the subject devices facilitate the insertion of the cord into the sulcus while also facilitating the creating of a physical barrier to prevent gingival bleeding and oozing from affecting restorative and tissue management procedures.

    AI/ML Overview

    The provided text does not contain specific acceptance criteria for performance metrics (such as sensitivity, specificity, or F1 score) or detailed results from a clinical study that would allow a direct comparison to such criteria. Instead, the document focuses on demonstrating substantial equivalence to predicate devices through comparisons of technological characteristics, intended use, and non-clinical performance testing.

    Therefore, many of the requested fields cannot be directly extracted from the provided text. However, based on the information available, here's what can be provided:

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

    The document does not explicitly state quantitative acceptance criteria in terms of clinical performance metrics. The evaluation is based on demonstrating substantial equivalence to predicate devices. The "reported device performance" in this context refers to the results of non-clinical testing confirming manufacturing, cytotoxicity, shelf-life, microbiological properties, and transit resilience.

    Acceptance Criteria (Implicit from Substantial Equivalence Goal)Reported Device Performance
    Manufacturing quality and consistencyTesting verified manufacturing, commensurate with predicate devices.
    Biocompatibility (Cytotoxicity)No differences in cytotoxicity compared to predicate device (ViscoStat Clear); same result at all dilutions.
    Shelf-life stability (interim)All test data for 18-month time point significantly within test acceptance criteria.
    Microbiological safety (bactericidal properties)Exhibit bactericidal properties, mitigating contamination risks and supporting shelf stability.
    Packaging integrity during transitPackaging configurations sufficient, product performed satisfactorily post-transit.
    Clinical performance (equivalent to predicates)Clinical performance is not deemed necessary given substantial equivalence demonstration based on other factors.

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

    The document describes non-clinical laboratory testing. It does not refer to a "test set" in the context of clinical data or a patient population. The samples for testing were likely materials from the manufactured devices themselves (e.g., aliquots for analytical testing, cell cultures for cytotoxicity). No information on the country of origin of data or whether it was retrospective or prospective is provided, as these are not relevant to the described non-clinical tests.

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

    Not applicable. This information is relevant for studies relying on expert-derived ground truth, typically in image analysis or diagnostic scenarios. The provided document concerns non-clinical testing of a dental product.

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

    Not applicable. Adjudication methods are used in studies involving human interpretation or subjective assessments, which are not described in this document for the evaluation of this dental product.

    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 device is a dental product (sulcus retraction material) and not an AI-assisted diagnostic tool.

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

    Not applicable. This device is a dental product and not an algorithm.

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

    The "ground truth" for the non-clinical tests described would be the established scientific standards and methods for analytical chemistry, cytotoxicity assessment, stability testing, and microbiological evaluation. For example, for cytotoxicity, the "ground truth" is typically determined by observing cell viability and growth inhibition according to standardized protocols (e.g., ISO 10993).

    8. The sample size for the training set

    Not applicable. There is no mention of a "training set" as this document describes non-clinical testing of a physical medical device, not a machine learning model.

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

    Not applicable. As there is no training set for a machine learning model, this question is not relevant to the provided document.

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    K Number
    K171577
    Manufacturer
    Date Cleared
    2018-05-03

    (338 days)

    Product Code
    Regulation Number
    N/A
    Panel
    Dental
    Reference & Predicate Devices
    Why did this record match?
    Product Code :

    MVL

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

    Smartcord is knitted retraction cord made from 100% cotton for the temporary gingival retraction.

    Smartcord X is knitted retraction cord made from 100% cotton, impregnated with Aluminum Chloride for the temporary gingival retraction and hemostasis of the gingival margin.

    Device Description

    Smartcord is non-impregnated knitted retraction cord made from 100% cotton. Smartcord X is knitted retraction cord made from 100% cotton, impregnated with Aluminum Chloride Hexahydrate.

    AI/ML Overview

    The provided document is a 510(k) summary for the medical devices Smartcord and Smartcord X. It primarily focuses on demonstrating substantial equivalence to a predicate device rather than presenting detailed acceptance criteria and a study proving the device meets those criteria.

    Therefore, many of the requested sections about acceptance criteria, study details, sample sizes, expert ground truth, adjudication methods, multi-reader multi-case studies, and standalone performance results are not available in this type of document.

    Here's an analysis based on the information available in the document:

    1. Table of Acceptance Criteria and Reported Device Performance:

    The document does not explicitly define specific performance acceptance criteria (e.g., minimum tensile strength, specific retraction efficacy metrics) or report quantitative results for the device against such criteria. Instead, it relies on demonstrating equivalence in material composition, intended use, and general properties to the predicate device.

    The "performance" described is in the context of biocompatibility testing, which confirmed the device is biocompatible as directed.

    Acceptance Criteria (Not Explicitly Stated, Inferred from Equivalence)Reported Device Performance (Summary from Biocompatibility)
    Biocompatible for gingival sulcus contact (
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    K Number
    K162662
    Date Cleared
    2017-10-20

    (389 days)

    Product Code
    Regulation Number
    N/A
    Panel
    Dental
    Reference & Predicate Devices
    Why did this record match?
    Product Code :

    MVL

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

    For the temporary retraction and hemostasis of the gingival margin during dental procedures such as, but not limited to, taking an impression, cementation and cavity preparation.

    Device Description

    GingiDent gingival retraction paste is an astringent formulated to provide gingival retraction and hemostasis. GingiDent gingival retraction paste contains Aluminum Chloride and is intended to be used for the temporary retraction and hemostasis of the gingival margin during dental procedures. This product is a blue-green paste developed exclusively for transient surgically invasive use in the oral cavity. The paste contains Aluminum Chloride in a water-based clay inert carrier.

    AI/ML Overview

    This document describes the premarket notification (510(k)) for the GingiDent Gingival Retraction Paste. The submission primarily relies on non-clinical bench testing and comparison to predicate devices, rather than a clinical study involving human subjects. Therefore, many of the requested categories related to clinical study design and outcomes (like sample size for test sets, expert ground truth, adjudication methods, MRMC studies, or standalone algorithm performance) are not applicable in this context.

    Here's a breakdown of the available information:

    1. Table of Acceptance Criteria (Bench Test Results) and Reported Device Performance:

    TestAcceptance Criteria (Implied by Predicate Range)GingiDent (Subject Device) PerformancePredicate Device 1 (Expa-syl) PerformancePredicate Device 2 (Traxodent) Performance
    Aluminum Chloride HexahydrateWithin range of predicates (15.80% - 21.76%)16.42%15.80%21.76%
    pHWithin range of predicates (2.99 - 3.47)3.223.472.99
    Viscosity (cP)Not explicitly defined, but between predicates995,000>1 million763,000

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

    • Sample Size: Not applicable. The testing described is bench testing of the product itself, not a clinical test set with human subjects.
    • Data Provenance: Not applicable for a clinical test set. The data originates from laboratory bench testing conducted by the manufacturer, Pac-dent International, Inc.

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

    • Not applicable. This was bench testing, not a clinical study requiring expert ground truth for patient data.

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

    • Not applicable. This was bench testing.

    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 device is a gingival retraction paste, not an AI-powered diagnostic or assistive technology. No MRMC study was conducted.

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

    • No. This is a physical dental paste, not an algorithm.

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

    • Not applicable to a clinical test set. For the bench tests, the "ground truth" was established by standard laboratory measurement techniques for pH, viscosity, and chemical concentration.

    8. The sample size for the training set:

    • Not applicable. This is not a machine learning device; therefore, there is no training set in the context of AI/ML.

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

    • Not applicable.

    Additional Information from the Document:

    • Biocompatibility Tests: Performed in accordance with ISO 10993, including skin sensitivity and oral mucosa irritation tests in hamsters. Results showed no evidence of causing skin sensitization or oral mucosa irritation.
    • Stability Tests: Accelerated stability testing was conducted at 50 °C and 60 °C, evaluating AlCl3-6H2O concentration, pH value, extrusion force, and weight loss. Estimated shelf life for room temperature storage is 2.8 years.
    • Clinical Performance Test: "No clinical testing was provided." The submission relies solely on non-clinical (bench) testing and comparison to legally marketed predicate devices to establish substantial equivalence.
    • Conclusion: The manufacturer concluded that GingiDent Gingival Retraction Paste is substantially equivalent to the identified predicate devices based on non-clinical performance testing. The FDA concurred with this determination for the purpose of market authorization.
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    K Number
    K162948
    Manufacturer
    Date Cleared
    2017-08-08

    (291 days)

    Product Code
    Regulation Number
    N/A
    Panel
    Dental
    Reference & Predicate Devices
    Why did this record match?
    Product Code :

    MVL

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

    Aluminum Chloride impregnated retraction material are for the temporary retraction of the gingival margins and hemostasis procedures. The Retraction Cord is place the gingival tissues for a short period prior to making an impression or for other restorative procedures.

    Device Description

    As part of a tissue management procedure, Styptin, Hemogin-L, Hemodettes, and GingiGEL are aluminum chloride containing astringent/ hemostatic solutions and gels that are intended to be supplied with gingival retraction cord or cotton pellets that are either pre-impregnated or for end-user impregnation by soaking the cords or cotton pellets in these solutions. The aluminum chloride impregnated retraction material is then packed into the sulcus to temporarily displace gingival tissue to expose the sub-gingival margins and control sulcular seepage and hemorrhage for impression taking and other restorative treatments. The supplied retraction material is available as an aqueous aluminum chloride solution or gel and either unit-dose 2"-pieces of braided cotton cord, braided cotton-polyester cord, or unit-dose cotton pellets.

    AI/ML Overview

    The provided document is a 510(k) Pre-market Notification from the FDA for dental retraction materials (Styptin, Hemogin-L, Hemodettes, and GingiGEL Aluminum Chloride Impregnated Retraction Cord/Materials). This type of document is focused on demonstrating substantial equivalence to existing legally marketed devices, rather than establishing acceptance criteria and conducting studies to prove performance against those criteria in the way one might for a novel device or software.

    Therefore, much of the requested information regarding detailed acceptance criteria and a specific study proving the device meets those criteria (especially clinical performance, AI/ML specific details like sample sizes for training/test sets, expert adjudication, or MRMC studies) is not applicable or not present in an FDA 510(k) summary for this type of device.

    Here's a breakdown of what information can be extracted or inferred from the document based on your request:


    1. Table of Acceptance Criteria and Reported Device Performance

    Formal acceptance criteria, as in numerical thresholds for accuracy, sensitivity, or specificity commonly seen for diagnostics, are not presented for this device. Instead, the "acceptance criteria" are implied through demonstration of substantial equivalence to predicate devices, focusing on shared intended use, indications for use, fundamental technological characteristics, and safety profiles. Performance is primarily assessed through non-clinical testing and comparison of characteristics.

    Acceptance Criteria Category (Derived from Substantial Equivalence)Reported Device Performance (as demonstrated by comparison and non-clinical tests)
    Intended UseSame as predicates: Temporary retraction of gingival margins and hemostasis procedures.
    Indications for UseSame as predicates: Temporary retraction of gingival margins and hemostasis for impression taking or other restorative procedures.
    Target UsersSame as predicates: Licensed dental professionals.
    Primary Mode of ActionSame as predicates: Mechanical displacement of gingival tissues.
    Astringent/Hemostatic AgentAluminum Chloride (similar to reference predicates; primary predicate uses Aluminum Potassium Sulfate).
    AlCl3 Content (weight/volume %)GingiGel: 20%; Styptin: 20%; Hemogin-L: 25%; Hemodettes: 20% (Comparable to reference predicates Expa-syl (15%) and ViscoStat Clear (25%)).
    Contact Time
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    K Number
    K162536
    Manufacturer
    Date Cleared
    2017-02-03

    (144 days)

    Product Code
    Regulation Number
    N/A
    Panel
    Dental
    Reference & Predicate Devices
    Why did this record match?
    Product Code :

    MVL

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

    GingiKnit+, GingiBraid+, GingiBraid+ Shortcut, and UniBraid+ impregnated Aluminum Potassium Sulfate Retraction Cord are for the temporary retraction of the gingival margins and hemostasis procedures. The Retraction Cord is placed in the sulcus to displace the gingival tissues for a short period prior to making an impression or for other restorative procedures.

    Device Description

    Dental retraction materials are used to aid in creating accurate impressions of subgingival margins by temporary gingival displacement, and control of sulcular seepage and hemorrhage. Cords are impregnated with Aluminum Potassium Sulfate. The braided GingiBraid+ and the knitted GingiKnit+ are made of cotton fiber with a different color strand running through the cord for identification of the diameter. Retraction Cords have a yellow background color for medicament identification. The usage is inherently of transient nature. Typical exposure time is less than five minutes. The braided and knitted cord configurations are available in different sizes to fit the sulcus.

    AI/ML Overview

    This document describes Kerr Corporation's dental retraction cords (GingiKnit+, Gingibraid+, Gingibraid+ Shortcut, and Unibraid+ impregnated Aluminum Potassium Sulfate Retraction Cord) and their substantial equivalence to a predicate device.

    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

    Acceptance Criteria / Performance MetricReported Device Performance
    Non-Clinical Performance DataStability: Performed. (No specific results provided, but implied to be acceptable for substantial equivalence determination.)
    Cutting Test: Performed. (No specific results provided, but implied to be acceptable for substantial equivalence determination.)
    Water Contact Test: Performed. (No specific results provided, but implied to be acceptable for substantial equivalence determination.)
    Biocompatibility Testing (ISO 10993-1: 2009 & ISO 10993-5:2009): Performed.
    - Results: Biocompatibility meets requirements.
    Material CompatibilityBiocompatibility meets requirements. (Explicitly stated in Table 8.1 for both Predicate and Proposed Device.)
    Technological CharacteristicsDesigns are similar to the predicate KnitPak+. Braided or knitted cotton also contains a surfactant and Aluminum Potassium Sulfate for hemostasis. The braided material is made of cotton fiber and a solid cord for strong physical retraction, not splitting or collapsing. The knitted cord is formed by many tiny loops, places easily without fraying or memory, and conforms to the sulcus with gentle, outward force. Cuts cleanly if touched by a high-speed instrument. (Implied to meet acceptance criteria for substantial equivalence by being "virtually identical" to the predicate in key characteristics.)
    Intended UseFor the temporary retraction and hemostasis of the gingival margin during dental procedures such as, but not limited to, dental impressions, seating of temporary and permanent restorations, restorations of cavities and placement of a rubber dam. (Matches the predicate's intended use.)
    Indications for UseFor the temporary retraction of the gingival margins and hemostasis procedures. The Retraction Cord is placed in the sulcus to displace the gingival tissues for a short period prior to making an impression or for other restorative procedures. (Matches the predicate's indications for use, albeit with a different hemostatic agent mentioned primarily in the description.)
    Safety and EffectivenessNo new questions of safety or effectiveness raised by noted differences in technological characteristics (specifically the different hemostatic agent, Aluminum Potassium Sulfate vs. Aluminum Chloride, and configuration).

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

    The document does not describe a clinical test set in the traditional sense for evaluating the device's performance against specific acceptance criteria for diagnostic accuracy or detection. This is a 510(k) submission focused on substantial equivalence to a predicate device.

    • Test Set for Non-Clinical Performance Data: The sample sizes for the Stability, Cutting Test, Water Contact Test, and Biocompatibility testing are not specified in the provided text.
    • Data Provenance: Not explicitly stated for the non-clinical tests. However, the standards used (ISO 10993-1: 2009 and ISO 10993-5:2009) are international standards. This type of testing is generally performed in laboratory settings.

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

    This information is not applicable as the document describes non-clinical performance and substantial equivalence, not a study evaluating human interpretation or a diagnostic device where ground truth would be established by experts.

    4. Adjudication Method for the Test Set

    This information is not applicable for the reasons stated above.

    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

    This information is not applicable. This device is a dental retraction cord, not an AI software or diagnostic imaging device. No MRMC study was conducted or is relevant to this submission.

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

    This information is not applicable. This is a physical medical device, not an algorithm.

    7. The Type of Ground Truth Used

    For the non-clinical tests mentioned:

    • Biocompatibility: The ground truth is established by the specified ISO standards (ISO 10993-1 and ISO 10993-5), which define acceptable biological responses and methodology.
    • Other Non-Clinical Tests (Stability, Cutting, Water Contact): The "ground truth" or acceptance criteria for these tests would likely be internal specifications derived from the predicate device's performance or industry standards, ensuring the device functions as intended and safely. Specific criteria are not detailed in the provided text.

    8. The Sample Size for the Training Set

    This information is not applicable. This is a physical medical device, not a machine learning model, so there is no "training set."

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

    This information is not applicable for the reasons stated above.

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