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NobelZygoma TiUltra implants

The NobelZygoma TiUltra implants are endosseous dental implants intended to be surgically placed in the zygomatic bone to support a dental prosthesis in the upper arch, in order to restore patient esthetics and chewing function. The NobelZygoma Implants are appropriate for immediate loading when good primary stability is achieved and with appropriate occlusal loading.

Multi-Unite Abutment Xeal Zygoma

The Multi-unit Abutments Xeal Zygoma are indicated to support the placement of multiple unit, screw-retained prosthetic restorations in the maxilla including full arch dentures.

NobelZygoma Multi-Unite Abutment Xeal Zygoma Screws

The NobelZygoma Multi-Unit Abutment Screws are indicated for use to secure a dental abutment or framework to a dental implant for supporting tooth replacements and are indicated as an aid in prosthetic rehabilitation.

The Subject Device NobelZygoma TiUltra Implant system is composed of three device lines: NobelZygoma TiUltra Implants, Multi-unit Abutments Xeal Zygoma and NobelZygoma Multi-unit Abutment Xeal Zygoma Screws.

The NobelZygoma TiUltra Implants are endosseous dental implants surgically placed in the zygomatic bone to provide support for prosthetic devices. They are used with patients with severe bone resorption in the maxilla to provide multi-point support of the dental reconstruction. The NobelZygoma TiUltra Implants are used to support the rehabilitation of a fully or a partially edentulous maxilla. The Subject Devices are only intended for extra-maxillary placement.

The subject Implants are made from unalloyed titanium grade 4 (ASTM F67) and present a two-level anodized surface with a soluble salt (protective) layer. Two variants of the Implants are available based on the collar angulation: the NobelZygoma 0° and the NobelZygoma 45° TiUltra Implants. The NobelZygoma 0° CC TiUltra Implants feature a conical connection platform with an internal hex (size RP). The NobelZygoma 45° Ext Hex TiUltra Implants include an external hexagonal platform (size RP).

The NobelZygoma TiUltra implants are available in lengths ranging from 30 mm to 60 mm, in 2.5 mm increments. They feature a partially threaded design. The neck portion, measuring 3.6 mm from the platform, and the shaft portion which varies depending on the implant length, are unthreaded. For all implant lengths, threading consistently begins at the apex and extends 18 mm coronally.

The NobelZygoma TiUltra Implants are co-packed with an implant mount, which is attached via a pre-assembled implant mount screw to the platform of the implant.

The Multi-unit Abutments Xeal Zygoma are premanufactured prosthetic components intended to be connected to the compatible NobelZygoma TiUltra Implants to support the placement of a dental prosthesis.

The Multi-unit Abutment (MUA) Xeal Zygoma are made from Titanium alloy (Ti-6Al-4V (90% titanium, 6% aluminum, 4% vanadium, ASTM F136) and feature a non-porous oxide layer with a soluble salt (protective) layer. The Multi-unit Abutments Xeal Zygoma are attached to the respective NobelZygoma TiUltra Implants by the compatible NobelZygoma Multi-unit Abutment Xeal Zygoma Screw.

The Multi-unit Abutment Xeal Zygoma are available in four different angulations (straight or 0°, 17°, 45° and 60°) and in different heights ranging from 3 to 9mm (2mm increase). The 45° and 60° angulations are used with the NobelZygoma 0° TiUltra implants, while the Straight (or 0°) and 17° angulations are compatible with the NobelZygoma 45° TiUltra Implants. The 17° MUA is only available in two heights (3 and 5mm).

The Multi-unit Abutments Xeal Zygoma are provided sterile and co-packed with the respective abutment handle and NobelZygoma Multi-Unit Abutments Xeal Zygoma Screw.

The NobelZygoma Multi-unit Abutment Xeal Zygoma Screws are dental implant screws designed to fasten dental implant system components to a dental implant or to another component.

The subject screws are made of titanium alloy (Ti-6Al-4V (90% titanium, 6% aluminum, 4% vanadium, ASTM F136) and are partially DLC-coated. They are available in different design and sizes to fit the different Multi-unit Abutments Xeal Zygoma. The Straight NobelZygoma Multi-unit Abutment Xeal Zygoma Screws are available in four sizes to fit the respective Straight Multi-Unit Abutment heights. The screws for the 45°/60° Multi-Unit Abutments and the 17° Multi-Unit Abutment are only available in one size that fits all abutment sizes.

The NobelZygoma Multi-unit Abutment Xeal Zygoma Screws are co-packed with the compatible Mult-unit Abutment Xeal Zygoma and are also available separately.

The provided document is a 510(k) Clearance Letter from the FDA for the "NobelZygoma TiUltra Implant system." This type of document primarily focuses on establishing substantial equivalence to previously cleared predicate devices, rather than explicitly detailing acceptance criteria and presenting a single, comprehensive study proving the device meets those criteria.

However, the document does contain information about non-clinical and clinical testing performed to support the substantial equivalence claim. I will extract the relevant information to answer your questions to the best of my ability, acknowledging that not all requested details may be explicitly present in this type of regulatory submission summary.

Here's a breakdown of the requested information based on the provided text:

1. Table of Acceptance Criteria and Reported Device Performance

Note: The document does not explicitly list acceptance criteria in a formal table with pass/fail values. Instead, it describes various tests performed and compares the subject device's performance to predicate devices or established standards. The "Reported Device Performance" column reflects the summary of findings from the validation studies described.

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

• Test Set Sample Size: The document does not provide specific sample sizes for the non-clinical tests (fatigue, torque, MR, biocompatibility, packaging, sterilization, endotoxin, surface roughness). These are typically determined by relevant standards.
  • For clinical published literature, the sample sizes varied:
    • Three studies on non-full arch applications involved 176 similar zygomatic implants.
    • Systematic literature review on quad configuration reported data for a mean implant survival rate (implies a larger, unspecified number of cases).
    • Two clinical studies involving Nobel Biocare zygomatic implants: n=15 (minimum 79 months follow-up) and n=302 (mean 7.9 years follow-up).
    • A total of 40 clinical publications were provided to support the established history of safe clinical use (number of implants/patients unspecified in this summary).
    • Seven clinical cases with a total of 16 NobelZygoma TiUltra implants were presented.
    • 36 clinical publications on NobelReplace and TiUltra implant family (number of implants/patients unspecified in this summary).
• Data Provenance:
  • Clinical Studies: Published literature (implies peer-reviewed, multi-center, potentially international data).
  • Real-world evidence (RWE): Post-market surveillance for the Subject Devices from July 2024 to May 2025. This is prospective data specific to the subject device after initial market introduction (likely under a different clearance or within a broader market).
  • Clinical Case Studies: Seven cases presented directly by the submitter.
  • The document implies that data from various regions would be included in "published literature" and "post-market surveillance." No specific countries of origin are mentioned beyond "Nobel Biocare" (Sweden/Switzerland) and "Southern Implants (Pty) Ltd" (implies South Africa). The nature of most clinical data is retrospective (published studies, post-market surveillance).

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

The document does not specify the number of experts used to establish ground truth for the test set (clinical studies). Clinical studies typically rely on diagnoses and assessments made by treating clinicians (dental surgeons, prosthodontists) based on established medical practices and diagnostic criteria, rather than a separate "ground truth" panel for the study itself, unless it's a specific adjudication or consensus study. Such details are usually found within the full study protocols and reports, which are not part of this 510(k) summary.

4. Adjudication Method (e.g., 2+1, 3+1, none) for the Test Set

The document does not specify any adjudication methods for the clinical data presented. This information would typically be detailed in the methodology sections of the individual clinical studies or systematic reviews referenced, which are not provided in this summary.

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

The document describes a dental implant system (hardware), not an AI-powered diagnostic or assistive tool. Therefore, a Multi-Reader Multi-Case (MRMC) comparative effectiveness study focusing on human reader improvement with/without AI assistance is not applicable and was not performed.

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

This question is not applicable as the device is a dental implant system, not an algorithm.

7. The Type of Ground Truth Used (expert consensus, pathology, outcomes data, etc.)

• Non-Clinical Tests: Ground truth is based on established engineering and materials science principles, international standards (ISO, ASTM), and FDA guidance documents. Performance is evaluated against these benchmarks.
• Clinical Performance Data: Ground truth is primarily based on outcomes data, specifically:
  • Implant survival rate: Directly reported as percentage (e.g., 97.4%, 100%, 89.9%, 99.5%).
  • Reported adverse events and complications: Clinical observations and diagnoses by treating dentists/surgeons. Resolution of these events are considered outcomes.
  • Osseointegration: Inferred from success rates and lack of failure/complaints related to implant stability.
  • Patient esthetics and chewing function: These are indications, and clinical data indirectly supports their achievement through successful implant function.

8. The Sample Size for the Training Set

The concept of a "training set" is typically associated with machine learning or AI algorithms. Since this is a physical medical device (dental implant system), it primarily relies on engineering design, materials science, and clinical validation. Therefore, a "training set" in the context of an algorithm is not applicable. The development and testing would involve design iterations and validation studies, but not an algorithmic training process with a distinct training set.

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

As noted in point 8, the concept of a "training set" in the context of an AI/ML algorithm is not applicable to this physical device. Therefore, the establishment of ground truth for such a set is also not applicable. The "ground truth" for the device's design and performance validation is derived from established scientific principles, pre-clinical testing, and clinical outcomes for the device itself and its predicates.

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S.I.N. Dental Implant System Zygomatic implants are intended for placement in the maxillary arch to provide support for fixed or removable dental prostheses in patients with partially or fully edentulous maxillae. When a one-stage surgical approach is applied, the S.I.N. Dental Implant System Zygomatic implants are intended for immediate loading when good primary stability is achieved and with appropriate occlusal loading.

The purpose of this submission is to add components to the S.I.N. Dental Implant System. This submission includes zygomatic dental implants and mating abutments for screw-retained, multi-unit prostheses.

The subject device Zygomatic Plus Morse Taper implants have a body diameter of 4.0 mm that tapers to approximately 2.3 mm at the apex. The implants have a Morse taper ("CM") abutment interface connection, with an internal 16° cone taper. The abutment platform is 4.0 mm. All implants are threaded starting at the apex and extending approximately 17 mm in the coronal direction, with a major thread diameter of 4 mm; the thread tapers over the final 6 mm of the implant to the apex. The implants are provided with overall lengths of 30, 32.5. 35. 37.5. 40. 42.5.45. 47.5. 50. 52.5.57.5. and 60 mm. The surface of all subject device implants is acid-etched from the implant platform to the apex, followed by application of a hydroxyapatite coating (HA nano).

The subject device abutments are multi-unit, indexed abutments for use only with the subject device Zygomatic Plus Morse Taper implants for maxillary full-arch restorations. The subject device abutments have a prosthetic platform diameter of 4.8 mm, and gingival heights of 1.5, 2.0, and 2.5 mm. The prosthetic post is angled 52° or 60° to the long axis of the implant. These components are used with previously cleared abutment screws.

All subject device dental implants are manufactured from unalloyed titanium conforming to ASTM F67. All implants have an acid-etched HA100 surface treatment, identical to that cleared in K231127. All subject device abutments are manufactured from titanium alloy (Ti-6A1-4V) conforming to ASTM F136. All subject device implants and abutments are provided sterile to the end user.

The provided text is a 510(k) Summary for a dental implant system. It explicitly states that no clinical data were included in this submission to support substantial equivalence (see "No clinical data were included in this submission." on page 6 of 9).

Therefore, it is not possible to provide specific details about acceptance criteria, device performance, sample sizes, expert ground truth establishment, adjudication methods, or MRMC studies, as这些 types of studies were not conducted or reported in this 510(k) submission.

The "Performance Data" section (pages 6-7 of 9) refers to non-clinical data only:

• mechanical testing
• gamma irradiation sterilization
• bacterial endotoxin testing
• MR environment evaluation
• sterile barrier shelf life data
• biocompatibility data

These tests are typically conducted to assess the physical and biological characteristics of the device, not its clinical performance in patients as would be measured in an AI/MRMC study.

In summary, based on the provided document, no study was conducted to prove the device meets acceptance criteria related to AI/MRMC performance as outlined in your request. The submission relies on substantial equivalence to predicate devices, supported by non-clinical performance data.

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S.I.N. Dental Implant System Zygomatic implants are intended for placement in the maxillary arch to provide support for fixed or removable dental prostheses in patients with partially or fully edentulous maxillae. When a one-stage surgical approach is applied, the S.I.N. Dental Implant System Zygomatic implants are intended for immediate loading when good primary stability is achieved and with appropriate occlusal loading.

The purpose of this submission is to add components to the S.I.N. Dental Implant System. This submission includes zygomatic dental implants, mating abutments for screw-retained, multi-unit prostheses, and the corresponding abutment screws.

The subject device Zygomatic Plus Morse Taper implants have a body diameter of 4.0 mm that tapers to 1.65 mm at the apex. The implants have a Morse taper ("CM") abutment interface connection, with an internal 16° cone taper. The abutment platform is 4.0 mm. All implants are threaded starting at the apex and extending approximately 17 mm in the coronal direction, with a major thread diameter of 4 mm; the thread tapers over the final 6 mm of the implant to the apex. The implants are provided with overall lengths of 30, 32.5, 35, 37.5, 40, 42.5, 45, 47.5, 50, 52.5, 57.5, and 60 mm. The surface of all subject device implants is acid-etched from the implant platform to the apex, followed by application of a hydroxyapatite coating (HA nano).

The subject device abutments are multi-unit, indexed abutments for use only with the subject device Zygomatic Plus Morse Taper implants for maxillary full-arch restorations. The subject device abutments have a prosthetic platform diameter of 4.8 mm, and gingival heights of 2 mm and 3 mm. The prosthetic post is angled 45° to the long axis of the implant. These components are used with subject device abutment and prosthetic screws, or previously cleared screws.

All subject device dental implants are manufactured from unalloyed titanium conforming to ASTM F67. All implants have an acid-etched HA1200 surface treatment, identical to that cleared in K200992. All subject device abutments are manufactured from titanium alloy (Ti-6A1-4V) conforming to ASTM F136. All subject device implants, abutments, and abutment screws are provided sterile to the end user.

I am sorry, but based on the provided text, I cannot provide a comprehensive description of the acceptance criteria and the study that proves the device meets them, as requested. The document is an FDA 510(k) summary for a dental implant system. While it mentions performance data, it primarily focuses on establishing substantial equivalence to predicate devices rather than providing detailed acceptance criteria and a full study report of the subject device's performance against those criteria.

Here's why I cannot fulfill each requested point:

1. A table of acceptance criteria and the reported device performance: The document does not explicitly state acceptance criteria for the new device in a quantifiable way beyond citing compliance with standards like ISO 11137-1, ISO 11137-2, ASTM F2052, ASTM F2213, ASTM F2182, ASTM F2119, ASTM F67, and ASTM F136. It mentions mechanical testing was done "to demonstrate that the subject device abutments... have sufficient strength for the intended use," but it doesn't provide specific numerical acceptance limits or the reported performance values against them.

2. Sample sized used for the test set and the data provenance (e.g. country of origin of the data, retrospective or prospective): The text states "Non-clinical data provided in this submission...mechanical testing conducted using a method modified from ISO 14801 and engineering analysis," but it does not specify the sample size used for this mechanical testing. There is no information about data provenance (country of origin, retrospective/prospective). No clinical data was included in this submission.

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): This information is not relevant to the type of non-clinical, mechanical, and sterilization testing described in the document. No expert review of a "test set" in the context of clinical interpretation or diagnosis is mentioned.

4. Adjudication method (e.g. 2+1, 3+1, none) for the test set: Not applicable, as no expert "test set" for clinical evaluation is 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. The device is a dental implant system, not an AI-assisted diagnostic tool.

6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done: Not applicable. The device is a dental implant system, not a software algorithm.

7. The type of ground truth used (expert consensus, pathology, outcomes data, etc): The "ground truth" here would be the physical properties and performance characteristics determined by established engineering and sterilization standards (e.g., sterility assurance level, mechanical strength, biocompatibility, MR compatibility). These are not expert consensus in a clinical sense, pathology, or outcomes data.

8. The sample size for the training set: Not applicable. This is a physical medical device, not an AI/machine learning model that requires a training set.

9. How the ground truth for the training set was established: Not applicable, for the same reason as point 8.

The document focuses on demonstrating that the S.I.N. Dental Implant System (specifically the new zygomatic implants and abutments) is substantially equivalent to legally marketed predicate devices through non-clinical data, including:

• Gamma irradiation sterilization validation.
• Mechanical testing (modified from ISO 14801).
• MR compatibility testing (referenced from K222231 and standards ASTM F2052, ASTM F2213, ASTM F2182, ASTM F2119).
• Sterile barrier shelf life data (referenced from K203725).
• Biocompatibility data (referenced from K200992 and standards ASTM F67, ASTM F136).

The substantial equivalence argument highlights similarities in indications for use, design principles, materials, manufacturing, sterilization, and shelf life to various predicate and reference devices. However, it does not provide detailed acceptance criteria and specific performance results for the subject device beyond qualitative statements like "sufficient strength."

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Noris Medical Dental Implants System is intended to replace missing tooth/teeth in either jaw for supporting prosthetic devices that may aid in restoring the patient's chewing function. The procedure can be accomplished in a one-stage or two-stage surgical operation. All implants are appropriate for immediate loading when good primary stability is achieved and with appropriate occlusal loading. Noris Medical Zygomatic Dental Implant System is intended to be implanted in the upper jaw arch to provide support for fixed or removable prosthetic devices in patients with partially or fully edentulous maxillae.

The Noris Medical Dental Implants System includes Multi Unit and Vari Connect abutments with various gingival heights and angles (17°, 30°, 45°, 52°, 60°), and Vari Connect Extenders. The system also includes abutment fixation screws. The abutments are intended to be used with specific Noris Medical Dental implants (K151909 and K140440). The Multi-Unit system provides a solution for screw-retained prostheses, while the Vari-Connect system is for removable prostheses. The components are manufactured from Titanium alloy.

The provided text describes a 510(k) submission for the Noris Medical Dental Implants System. While it discusses the device's equivalence to predicate devices and presents clinical data, it does not explicitly state acceptance criteria or a specific study proving the device meets those criteria in the format requested.

Instead, the document focuses on demonstrating substantial equivalence to previously cleared predicate devices through comparisons of:

• Intended Use: Similar to predicate devices.
• Technological Characteristics: Similar to predicate devices (e.g., material, design, connection type).
• Performance Testing: Biocompatibility, sterilization, and mechanical fatigue tests were performed, but specific acceptance criteria for these tests within the context of a "device performance" summary are not detailed.
• Clinical Data (Real-World Evidence): Retrospective studies on both a predicate device and the subject device are presented to support clinical performance, but these are comparative rather than against pre-defined acceptance criteria for a new device.

Therefore, many of the requested fields cannot be directly extracted from the provided text because the study presented is a comparative effectiveness study (comparing the Noris Medical device to predicate devices and real-world evidence, which serves as a benchmark rather than a fixed acceptance criterion).

However, I can extract information related to the clinical data presented, which serves as the closest equivalent to a "study" proving performance in this context of a 510(k) submission.

Here's an attempt to answer the questions based on the available information, noting where information is not present:

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

The document does not provide a formal table of explicit acceptance criteria with numerical targets. Instead, it relies on demonstrating "substantial equivalence" and reporting success rates from retrospective clinical studies, comparing them to predicate device performance.

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

• Subject Device (Noris Medical Multi Unit):
  • Sample Size: 33 patients, encompassing 88 Multi Unit abutments.
  • Data Provenance: Retrospective study. Country of origin not explicitly stated but the company is "Noris Medical Ltd. 8 Hataasia street, Nesher 3688808, Israel," suggesting the data could be from Israel or a region where Noris Medical devices are used. The implants were placed between 2013 and 2020.
• Predicate Device (Nobel Biocare Multi Unit):
  • Sample Size: 44 completely edentulous maxillary rehabilitations (77 Multi unit abutments).
  • Data Provenance: Retrospective study, "Real-world evidence... from the literature" (Ref. 1: J. Clin. Med. 2021, 10, 3600). The specific country of origin for this study is not detailed beyond the journal citation, but the reference indicates "Armando L, Miguel de Araújo Nobre, Ana Ferro, Carlos Moura Guede, Ricardo Almeida and Mariana Nunes," suggesting a potential origin in Portugal or similar European context.

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)

• The document does not specify the number or qualifications of experts used to establish the ground truth for either the Noris Medical or Nobel Biocare retrospective studies. Clinical outcomes (success/failure) were reported, likely by the treating clinicians or study investigators, but expert adjudication details are not provided.

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

• The document does not specify any adjudication method for the clinical outcomes reported in either retrospective study.

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, an MRMC comparative effectiveness study was not done. The studies presented are clinical outcome studies on dental implants and abutments, not diagnostic imaging studies involving human readers and AI. This question is not applicable to the type of device and studies described.

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

• No, a standalone (algorithm-only) performance study was not done. This product is a physical dental implant system, not a software algorithm. This question is not applicable.

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

• For both the Noris Medical and Nobel Biocare clinical studies, the "ground truth" was based on clinical outcomes data (prosthetic success, abutment success, complications, absence of micro movements, bleeding, soft tissue downgrowth, pain) observed over a follow-up period by clinicians.

8. The sample size for the training set

• The document describes studies for substantial equivalence and clinical performance evaluation, not machine learning model training. Therefore, a "training set" in that context is not applicable or described. The clinical studies mentioned are test sets for device performance.

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

• As a "training set" is not applicable in this context, the method for establishing its ground truth is also not applicable.

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The Mini Conical Abutments are indicated for use with Zygomatic Implants, in cases of severe jaw resorption, in order to restore patient aesthetics and chewing function. It may be used with single-stage procedures, for multiple unit restorations, and may be loaded immediately when good primary stability is achieved and with appropriate occlusal loading.

Mini Abutments 60°

• Intended for single use;
• Provided sterile via ethylene oxide gas;
• Manufactured of titanium alloy (Ti6Al4V-ELI) per ASTM F136;
• Available in different gingival heights;
• Screw-retained to the implant;
• Provided with an anti-rotational implant-to-abutment interface compatible with GM Zygomatic Implants;
• Provided with coronal geometries in rotational (non-indexed) versions to support multi-unit restorations
• . The subject devices are compatible with Impression copings, Provisional cylinders, Protective cylinders and Copings of the Neodent GM Line previously cleared per market.

The provided document is a 510(k) Summary for the Neodent Implant System - Mini Abutment 60°. It describes the device, its indications for use, and a comparison to predicate devices, focusing on demonstrating substantial equivalence through non-clinical performance data.

Based on the provided text, there is no information about a clinical study involving human subjects or AI performance. The summary explicitly states "SUMMARY OF NON-CLINICAL PERFORMANCE DATA". Therefore, most of the requested information regarding acceptance criteria, study type, sample sizes, experts, ground truth, and MRMC studies for AI devices is not available in this document.

Here's what can be extracted:

Acceptance Criteria and Reported Device Performance

The document describes non-clinical acceptance criteria related to mechanical properties, sterilization, and biocompatibility.

Information not available in the document:

2. Sample size used for the test set and the data provenance: Not applicable. The document describes non-clinical (laboratory) testing, not a test set of data from clinical subjects.
3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts: Not applicable. Ground truth for clinical data is not relevant to these non-clinical tests.
4. Adjudication method (e.g. 2+1, 3+1, none) for the test set: Not applicable.
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 MRMC study was done, as this is not an AI device.
6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done: No standalone algorithm performance was done, as this is not an AI device.
7. The type of ground truth used (expert consensus, pathology, outcomes data, etc): Not applicable, as this is not an AI device and no clinical ground truth was established for the non-clinical tests. The "ground truth" for these tests are objective measurements against established standards (e.g., ISO 14801, ISO 11135).
8. The sample size for the training set: Not applicable, as this is not an AI device.
9. How the ground truth for the training set was established: Not applicable, as this is not an AI device.

In summary, this document pertains to a traditional medical device (dental abutment) and relies on non-clinical engineering and materials testing to demonstrate substantial equivalence, not AI algorithm performance or clinical trial data.

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The NobelProcera® Zirconia Implant Bridge are indicated for use as a bridge anatomically shaped and/or framework in the treatment of partially or totally edentulous jaws for the purpose of restoring chewing function.

NobelProcera Zirconia Implant Bridges (Dental Bridges) are patient-specific, dental implant supported, screw-retained dental implant bridges which are connected to compatible Nobel Biocare root-form endosseous dental implants or Multi-unit abutments and are intended to restore chewing function in partially and fully edentulous patients. The Dental Bridge is available as either a Framework requiring veneering in a dental lab or as a Full Contour design requiring minimum laboratory processing.

NobelProcera Zirconia Implant Bridges are made from 'Nacera Pean' (yttriastabilized tetragonal zirconia), Reference Device #1, K143071. The Dental Bridges are designed in a dental laboratory, hospital or dental practice by scanning, designing and ordering the restoration using dental CAD/CAM software and a Nobel Biocare/KaVo-approved dental scanner.

The finished design is sent to Nobel Biocare manufacturing facility for industrial production. After production, the Dental Bridge is sent to the laboratory for finishing.

NobelProcera Zirconia Implant Bridges are available for use with Nobel Biocare's root-form endosseous dental implants (Dental Implants) havinq Internal Conical Connection (CC), External Hex Connection, Internal Tri-Channel Connection and Nobel Biocare's Multi-unit Abutment Connections (for MUA and MUA Plus). One Dental Bridge can feature connections to 2 to 10 Dental Implants.

All NobelProcera Zirconia Implant Bridges are provided with the required clinical and/or Prosthetic Screw: The clinical screw connects the Dental Bridge with the Dental Implant. The Prosthetic Screw connect the Dental Bridge with a Multi-unit Abutment.

Dental Bridge connections on the Internal Conical Connection Dental Implant require use of Clinical Metal Adapters. Clinical Metal Adapters are provided with the Dental Bridge. No adapter is needed for the external hex, internal tri-channel, or Multi-unit abutment connections.

The provided text is a 510(k) Summary for a medical device (NobelProcera Zirconia Implant Bridge) seeking substantial equivalence to a predicate device. It describes performance testing but does not present the specific acceptance criteria or the reported device performance in a table, nor does it detail a study designed to directly prove the device meets pre-defined acceptance criteria in the manner requested.

Instead, the document focuses on demonstrating substantial equivalence to a predicate device through a comparison of technological characteristics and performance data. The performance data mentioned are from fatigue testing and biocompatibility evaluation, suggesting these are the key areas where the device's performance needs to be comparable to or better than the predicate.

Here's an analysis of the available information in the context of your request:

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

The document does not provide a table explicitly outlining acceptance criteria and reported device performance. It only states that "The results of the testing were used to address questions related to substantial equivalence based on difference in design between the Subject and Predicate Devices." and that "The performance testing results provided in this submission supports that the Subject Device performs as well as the Predicate Devices for its intended use."

The closest to "acceptance criteria" are the standards used for testing:

• Fatigue Performance: Modified version of ISO 14801 (in saline solution) to reflect clinical loading. The specific acceptance criteria (e.g., minimum fatigue limit, number of cycles) are not detailed. It only states that the fatigue limit was determined.
• Biocompatibility: ISO 10993-1:2018. Acceptance is implied by the statement "The results demonstrated that biocompatibility testing... is appropriate to assess the biological safety of the subject device." and "The results demonstrate the biocompatibility of the subject device."
• Sterilization: ISO 17665-1, ISO 17665-2, ANSI/AAMI ST79, and ANSI/AAMI TIR 12. Acceptance is implied by "Validation for the cleaning and sterilization... was conducted."

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

• Sample Size for Test Set: Not explicitly stated for performance testing.
• Data Provenance: Not specified. It's likely from testing conducted by the manufacturer, Nobel Biocare AB (Sweden), or a contracted lab. The document does not specify if the data is retrospective or prospective.

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

This information is not applicable as the evaluation did not involve human interpretation or a "ground truth" derived from expert consensus in the sense of image analysis or diagnostic accuracy. The performance testing is engineering/laboratory-based.

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

This information is not applicable for the type of performance testing described. Adjudication methods are typically used in clinical studies or expert reviews.

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 as the device is a dental implant bridge, not an AI-powered diagnostic or assistive tool for human readers.

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

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

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

The "ground truth" for the performance testing is based on:

• Engineering standards: ISO 14801 for fatigue.
• Biocompatibility standards: ISO 10993-1.
• Sterilization standards: ISO 17665-1, ISO 17665-2, ANSI/AAMI ST79, and ANSI/AAMI TIR 12.
• The performance is compared to a predicate device rather than an absolute clinical "ground truth."

8. The sample size for the training set:

This information is not applicable as the device is a physical medical device, not an AI model requiring a training set.

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

This information is not applicable as the device is a physical medical device.

Summary of what is available regarding the study:

The study described is a performance testing study aimed at demonstrating that the NobelProcera Zirconia Implant Bridge is substantially equivalent to a predicate device.

• Objective: To show that new technological characteristics (material Nacera Pearl, MUA Plus connection, DLC coating on prosthetic screw, maximum of 10 implants instead of 14) do not raise new concerns and that its performance is comparable to the predicate.
• Key Tests Conducted:
  • Fatigue testing: Using a modified version of ISO 14801 (in saline solution) to reflect clinical loading. "Worst-case assessment" was followed.
  • Biocompatibility evaluation: According to ISO 10993-1:2018, specifically cytotoxicity and chemical characterization using GC-MS analysis.
  • Sterilization validation: According to ISO 17665-1, ISO 17665-2, ANSI/AAMI ST79, and ANSI/AAMI TIR 12.
• Comparison Basis: The subject device and predicate device were tested under identical conditions. The results "support that the Subject Device performs as well as the Predicate Devices for its intended use."
• Clinical Data: "No clinical data was used to support the decision of Substantial Equivalence."

In conclusion, the document provides evidence of engineering and biological performance testing against relevant standards and in comparison to a predicate device, rather than a study with explicit acceptance criteria for diagnostic accuracy or human performance improvement.

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Zygomatic Implants are indicated for surgical installation in the zygoma region, in cases of severe jaw resorption, in order to restore patient esthetics and chewing function. Zygomatic Implants are recommended for the posterior (pre-molar/ molar) region, one implant on each side, with at least two standard dental implants in the anterior region to support a fixed restoration. Zygomatic Implants may be loaded immediately when good primary stability is achieved and with appropriate occlusal loading.

The subject implant devices are single use devices, provided sterile by Gamma Radiation, made of commercially pure Titanium grade 4 (ASTM F67 – ISO 5832-2). The Zygomatic Implant with an external diameter of 4.0 mm, conical apex, helical flutes, trapezoidal thread and GM prosthetic interface. Indicated for rehabilitation surgical procedures in atrophic maxilla cases, for installation in the zygomatic bone.

The subject abutment devices are single use devices, provided sterile by Ethylene Oxide, made of Titanium allov (TI6AI4V-ELI). They are 45 degrees prosthetic abutments with anti-rotational feature, anatomic gingiva region and GM prosthetic interface to be installed on the implant, offering a structure to support the prosthesis. Indicated for rehabilitation of screw-retained bridges.

The provided text describes the acceptance criteria and the studies performed for the K190718 Zygomatic Implants. However, it does not detail any studies involving AI, human readers, ground truth establishment methods in the AI context, or sample sizes related to AI model training or testing. The document focuses on the substantial equivalence of the Zygomatic Implants and abutments to legally marketed predicate devices based on physical and performance characteristics, and biocompatibility.

Here's the information extracted from the document regarding the acceptance criteria and related studies:

Acceptance Criteria and Device Performance

The document does not explicitly present a table of acceptance criteria with reported device performance in a quantitative format for all characteristics. Instead, it compares the subject device's characteristics to predicate devices. The "Equivalence Discussion" column in the "TECHNOLOGICAL CHARACTERISTIC COMPARISON TABLE" implicitly serves as the acceptance criteria for substantial equivalence, where "Same" or "Equivalent" signifies meeting the criteria.

Study Details (No AI/ML Component in the Provided Text)

The document is a 510(k) summary for a dental implant system. It focuses on demonstrating "substantial equivalence" to predicate devices through design comparisons and mechanical/biological testing, not on the performance of a medical artificial intelligence/machine learning (AI/ML) device. Therefore, information related to AI-specific parameters (sample size for test set, data provenance, number of experts for ground truth, adjudication method, MRMC studies, standalone AI performance, type of ground truth for AI, training set size, and ground truth for training set) is not applicable to this document.

The studies mentioned are primarily bench testing and biological assessments:

1. Dynamic fatigue test per ISO 14801: To determine the fatigue strength for the implant construct.
2. Torsion Test: To evaluate the implant and abutment screw under static torsional loading.
3. Insertion Test: To evaluate the insertion torque of the implant in jawbone material (types II, III, and IV).
4. Sterilization Validation (Implants): Via gamma irradiation (25 kGy minimum dose) according to ISO 11137-2, achieving a minimum SAL of 1 x 10^-6. Relevant data was leveraged from K141777.
5. Sterilization Validation (Abutments): Via ethylene oxide gas (overkill method) according to ISO 11135, achieving a minimum SAL of 1 x 10^-6. Relevant data was leveraged from K163194.
6. Ethylene Oxide Residuals Assessment: Per ISO 10993-7.
7. Biological Safety Assessment: Guided by ISO 10993-1. Biocompatibility information for implants leveraged from K141777 and for abutments from K163194.
8. Cytotoxicity testing: Per ISO 10993-5.
9. Chemical characterization: Per ISO 10993-18.
10. Biocompatibility sample preparation: Per ISO 10993-12.
11. MRI Compatibility: Leveraged from K182620.

Regarding your specific points (since it's a non-AI device context):

1. Sample sized used for the test set and the data provenance (e.g. country of origin of the data, retrospective or prospective): Not specified for the bench tests. These are typically controlled laboratory tests, not clinical data. The sponsor is JJGC Indústria e Comércio de Materiais Dentários SA in Curitiba, Parana, Brazil.
2. 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, as these are technical performance tests, not diagnostic or clinical evaluations requiring expert ground truth in that sense.
3. Adjudication method (e.g. 2+1, 3+1, none) for the test set: Not applicable for these engineering and biological tests.
4. 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; no AI component.
5. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done: Not applicable; no AI component.
6. The type of ground truth used (expert concensus, pathology, outcomes data, etc): For mechanical tests, the "ground truth" is defined by the physical properties and failure points according to engineering standards (e.g., ISO 14801). For biological tests, it's defined by established biocompatibility assays.
7. The sample size for the training set: Not applicable; no AI component involved in a training set.
8. How the ground truth for the training set was established: Not applicable; no AI component.

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