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510(k) Data Aggregation
(230 days)
The Elos Accurate® Customized Abutments are intended for attaching to dental implants in order to provide basis for single or multiple tooth prosthetic restorations. The Elos Accurate® Customized Abutment will be attached to a dental implant using the included Elos Prosthetic screw. The Elos Accurate® Customized Abutments are compatible with the implant systems listed in Table 1.
The Elos Accurate® Customized Abutment is a patient specific abutment intended for attaching to dental implants in order to provide basis for single- or multiple tooth prosthetic restorations. The Elos Accurate® Customized Abutment will be attached to the implant using the included Elos Prosthetic Screw and attached to the crown/coping manually by cementation. The Elos Accurate® Customized Abutment consists of an Abuttnent Blank used in fabricating of a full patient-specific abutment in Titanium alloy per ASTM F136. The Abutment Blank used in creation of the Elos Accurate® Customized Abutment has a pre-manufactured connection interface that fits directly to a pre-specified dental implant. The customized shape of the abutument is intended to be manufactured according to a digital dentistry workflow or intended to be manufactured at an FDA registered Elos Medtech approved milling facility. The Elos Accurate® Customized Abutment is delivered non-sterile and the final restoration including corresponding Elos Prosthetic Screw is intended to be sterilized at the dental clinic before it is placed in the patient. The Elos Accurate® Customized Abutment provides clinicians and laboratories with a prosthetic device that can be used in definitive (permanent) single- or multi restorations.
The provided document, K231307 for Elos Accurate® Customized Abutment, is an FDA 510(k) premarket notification. This document focuses on demonstrating substantial equivalence to previously cleared devices rather than presenting a standalone study with defined acceptance criteria and performance metrics in the way a clinical trial or a performance study for an AI/ML powered medical device would.
The "acceptance criteria" discussed in this document pertain to the device meeting the requirements for FDA 510(k) clearance by demonstrating substantial equivalence to predicate devices, primarily through engineering, dimensional, and non-clinical testing. There is no mention of a human-in-the-loop study, a multi-reader multi-case (MRMC) study, or an AI/ML algorithm-only standalone performance study.
Therefore, many of the requested fields regarding expert adjudication, MRMC studies, and ground truth establishment for AI/ML models are not applicable to the information contained within this 510(k) submission.
Here's an interpretation of the document's contents in relation to your request, with a focus on non-clinical testing and substantial equivalence:
1. A table of acceptance criteria and the reported device performance
The "acceptance criteria" for this device are implicitly tied to demonstrating substantial equivalence to its predicates and meeting established material and dental implant abutment standards. The document doesn't present a table with numerical acceptance criteria and performance for a diagnostic AI algorithm. Instead, it lists various non-clinical tests and their successful outcomes as evidence of substantial equivalence and safety/effectiveness.
Acceptance Criteria (Implied from testing performed) | Reported Device Performance (Summary from submission) |
---|---|
Mechanical Performance & Durability | |
Compliance with ISO 14801 (Fatigue Testing) | Fatigue testing was conducted per ISO 14801 according to FDA guidance for Root-form Endosseous Dental Implants and Endosseous Dental Abutments. This demonstrates the device's ability to withstand cyclic loading similar to mastication forces. (Specific numerical data (e.g., load cycles, applied force) for this test is not provided in the summary but is implied to have met the standard to demonstrate equivalence to predicate.) |
Dimensional Accuracy & Compatibility | Engineering and dimensional analyses were performed on original manufacturers' components (abutments, implants, & abutment screws) to determine compatibility. The nominal dimensions and tolerances of the Elos Accurate® Customized Abutment products were determined and met, ensuring proper fit with compatible implant systems as listed in Table 1 (pages 3, 7). The design library file has built-in limitations (e.g., material thickness not less than 0.4mm, gingival height not less than 0.5mm or exceed 5mm, max angulation not exceed 30°, post height not less than 4mm) which the digital workflow prevents users from exceeding, ensuring structural integrity. |
Biocompatibility | |
Compliance with ISO 10993-5 (Cytotoxicity) | Biocompatibility testing for cytotoxicity according to ISO 10993-5 was conducted. All tests on identically manufactured abutments and prosthetic screws (from the same material as subject device) showed the products to be non-cytotoxic. This data was leveraged from previous 510(k) clearances (K222044). |
Sterilization | |
Compliance with ISO 17665-1 & 17665-2 (Sterilization Validation) | Sterilization validation was performed, demonstrating a Sterility Assurance Level (SAL) of 10⁻⁶. This was leveraged from Primary Predicate Device (K171799) as material, size, and geometry are substantially equivalent. The device is delivered non-sterile and intended to be sterilized by the dental clinic. |
Magnetic Resonance (MR) Compatibility | |
Compliance with ASTM F2052, F2119, F2213, F2182 (MR Conditional) | A range of tests per ASTM standards (F2052, F2119, F2213, F2182) was performed on a worst-case assembly. The device was assessed at 1.5 Tesla and 3 Tesla for displacement, torque, heating, and image artifact. The results proved the proposed devices are MR conditional for use when having an MRI scan. This evaluation was leveraged from prior K222044 clearance. |
Digital Workflow Validation | |
Validation of CAD/CAM Design & Manufacturing Workflow | The digital dentistry workflow validation was completed on a selected model of the subject product line, including a 3Shape scanner, 3Shape Abutment Designer Software (K155415), and CORiTEC Imes-Icore milling unit. The validation demonstrated the use with the 3Shape Abutment Designer™ Software (K151455) and confirmed the design library file (DME-file) includes and enforces design limits in accordance with the Instructions For Use. Testing also verified avoidance of damage to implant-abutment connection geometry during milling and locking of restriction zones in CAM software. |
2. Sample sizes used for the test set and the data provenance
- Test Set Sample Size: The document does not specify exact "sample sizes" in terms of number of abutments or implants tested for each reported non-clinical test. The tests are general performance validations (e.g., fatigue, cytotoxicity, sterilization efficacy) and dimensional analyses that demonstrate compliance with relevant standards or a worst-case scenario. For example, fatigue testing often involves a small number of samples (e.g., 6 minimum per ISO 14801, though more are often used for statistical power) under specific loading conditions. Similarly, biocompatibility is performed on representative samples.
- Data Provenance: The data comes from the manufacturer's (Elos Medtech Pinol A/S) internal testing and leverages data from previously cleared devices where material, size, and geometry are substantially equivalent. The provenance is therefore the manufacturer's testing facilities and associated regulatory submissions. There is no indication of different countries of origin for the data concerning these non-clinical tests. The tests are prospective in nature, as they are part of the premarket submission process.
3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts
This question is not applicable. The "ground truth" for this medical device (dental abutment) is established by engineering specifications, material properties, performance standards (e.g., ISO, ASTM), and clinical safety and effectiveness data from the predicates. There is no AI/ML component described that would require expert human review or "ground truth" establishment in the context of diagnostic interpretation.
4. Adjudication method (e.g., 2+1, 3+1, none) for the test set
This question is not applicable as there is no human interpretation or diagnostic "test set" that would require adjudication.
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 question is not applicable. The device is a physical dental abutment and its associated digital design workflow, not an AI-powered diagnostic tool requiring human reader studies.
6. If a standalone (i.e., algorithm only without human-in-the-loop performance) was done
This question is not applicable. The device is not a standalone AI algorithm. The digital dentistry workflow involves CAD software and CAM software, but these are tools for designing and manufacturing the physical abutment, not for automated diagnostic interpretation or decision-making in the clinical sense of an AI/ML algorithm.
7. The type of ground truth used (expert consensus, pathology, outcomes data, etc.)
The "ground truth" for this device's performance, as demonstrated in the submission, is based on:
- Compliance with international standards (e.g., ISO 14801 for fatigue, ISO 10993-5 for biocompatibility, ISO 17665 for sterilization).
- Engineering and dimensional analysis against established dental implant system specifications.
- Physical testing results (e.g., torque, heating, displacement) for MR compatibility.
- Validation of the digital workflow ensuring design constraints and manufacturing accuracy.
- The fundamental demonstration is substantial equivalence to existing legally marketed predicate devices, implying that their established safety and effectiveness forms the basis of the "ground truth" for this device's intended use.
8. The sample size for the training set
This question is not applicable. This is not an AI/ML device that requires a training set for model development. The design software has built-in constraints ("design limitations" and "design limits in the library file"), which are more akin to pre-programmed rules and geometric parameters rather than a learned model from data.
9. How the ground truth for the training set was established
This question is not applicable. No AI/ML training set is mentioned or implied. The "ground truth" for the design limitations within the software (e.g., minimum material thickness) would be established by engineering principles, biomechanical studies (often in labs, not clinical trials), and clinical experience with dental prosthetics, which define safe and effective design parameters.
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(228 days)
The Elos Accurate® Hybrid Base™ is intended for attaching to dental implants in order to provide basis for single or multiple tooth prosthetic restorations. The Hybrid Base™ is used as an interface between a dental implant and a zirconia superstructure and will be attached to the implant using a prosthetic screw and attached to the zirconia superstructure by cementing.
The Elos Accurate® Hybrid Base™ is compatible with the implant systems listed in table 1:
Implant Platform compatibility | Platform diameter [mm] | Implant Body diameter [mm] |
---|---|---|
Nobel Replace NP | 3.5 | 3.5 |
Nobel Replace RP | 4.3 | 4.3 |
Nobel Replace WP | 5 | 5 |
Nobel Replace 6.0 | 6 | 6 |
Nobel OC 3.0 | 3 | 3 |
Nobel CC NP | 3.5 | 3.5 & 3.75 |
Nobel OC RP | 3.9 | 4.3 & 5 |
Nobel CC WP | 5.1 | 5.5 |
Straumann Bone Level NC | 3.3 | 3.3 |
Straumann Bone Level RC | 4.1 & 4.8 | 4.1 & 4.8 |
Astra Tech 3.0 | 3 | 3 |
Astra Tech 3.5/4.0 | 3.5 & 4 | 3.5 & 4 |
Astra Tech 4.5/5.0 | 4.5 & 5 | 4.5 & 5 |
Astra Tech EV 3.0 | 3 | 3 |
Astra Tech EV 3.6 | 3.6 | 3.6 |
Astra Tech EV 4.2 | 4.2 | 3.6 & 4.2 |
Astra Tech EV 4.8 | 4.8 | 4.2 & 4.8 |
Astra Tech EV 5.4 | 5.4 | 5.4 |
Brånemark NP | 3.5 | 3.3 |
Brånemark RP | 4.1 | 3.75, 4 & 5 |
Brånemark WP | 5.1 | 5 & 6 |
The zirconia superstructures for use with the Elos Accurate® Hybrid Base™ are only intended to be designed and manufactured according to digital dentistry workflow system integrates multiple components of the digital dentistry workflow: scan files from Intra-Oral Scanners, CAD software, CAM software, ceramic material, milling machine and associated tooling and accessories.
The Elos Accurate® Hybrid Base™ is intended for attaching to dental implants in order to provide basis for single or multiple tooth prosthetic restorations. The Hybrid Base™ is used as an interface between a dental implant and a zirconia superstructure and will be attached to the implant using the included prosthetic screw and attached to the zirconia superstructure by cementing. The Elos Accurate® Hybrid Base™ is a two-piece abutment composed of the Hybrid Base as the bottom-half and the zirconia superstructure as the top-half.
The Elos Accurate® Hybrid Base™ consists of a pre-manufactured prosthetic component in Titanium alloy per ASTM F136, as well as supporting digital library file for 510(k) cleared design software (i.e. 3Shape Abutment Designer Software, K151455) which facilitates the design of a patient specific zirconia superstructure by the laboratory/clinician. The Elos Accurate® Hybrid Base™ fits directly to an endosseous dental implant. The laboratory designed superstructure is manufactured from 510(k) cleared Zirconia (Lava Plus, K011394) according to digital dentistry workflow. For all Elos Accurate® Hybrid Base™ models the zirconia superstructure must be designed according to following limits:
- Minimum wall thickness 0.5 mm
- Minimum post height 4.0 mm (for single unit restorations)
- Maximum gingival height 5.0 mm
- Maximum angulation 20°
The laboratory designed superstructure is attached to the Elos Accurate® Hybrid Base by use of 510(k) cleared cement (Multilink Hybrid Abutment, K130436) and the final prosthetic restoration is attached to the implant using a Prosthetic screw. The Elos Accurate® Hybrid Base™ is delivered non-sterile and the final restoration and corresponding screw is intended to be sterilized at the dental clinic before it is placed in the patient.
The provided text describes the regulatory clearance of a dental device, the "Elos Accurate® Hybrid Base™", through a 510(k) premarket notification. This process is based on demonstrating substantial equivalence to previously marketed predicate devices, rather than proving safety and effectiveness through clinical trials with acceptance criteria traditionally associated with new drug or high-risk device approvals.
Therefore, the document does not contain information on acceptance criteria for device performance in the classical sense (e.g., sensitivity, specificity, accuracy for an AI/diagnostic device), nor does it describe a study to prove the device meets these types of acceptance criteria.
Instead, the "acceptance criteria" here refer to the regulatory requirements for demonstrating substantial equivalence. The "study that proves the device meets the acceptance criteria" refers to the non-clinical testing and analyses performed to support this substantial equivalence claim.
Here's a breakdown of the requested information based on the provided text, highlighting where information is absent or different from a typical AI/diagnostic device performance study:
1. Table of Acceptance Criteria and Reported Device Performance
As noted, the document doesn't define quantitative performance acceptance criteria like sensitivity/specificity for a diagnostic. The "acceptance criteria" for this 510(k) submission are met by demonstrating:
Acceptance Criterion (Regulatory) | Reported "Performance" / Evidence Presented |
---|---|
Intended Use Equivalence | Subject device has the same intended use as predicate: "attaching to dental implants in order to provide basis for single or multiple tooth prosthetic restorations." |
Operating Principle Equivalence | Uses the same operating principle as predicate. |
Basic Design Equivalence | Incorporates the same basic design (two-piece abutment, titanium alloy base, zirconia superstructure). |
Material Equivalence | Incorporates same or very similar materials (Ti-6Al-4V alloy for Hybrid Base and screw, 3M Lava Plus Zirconia for superstructure, specific cement). |
Sterilization Process Equivalence | To be sterilized using the same processes (non-sterile delivery, final restoration sterilized at dental clinic). |
Dimensional and Compatibility Equivalence | Engineering and dimensional analyses of original manufacturers' components (abutments, implants & abutment screws) were made to determine nominal dimensions and tolerances and ensure compatibility with listed implant systems. |
Fatigue Resistance (Mechanical Performance) | Fatigue testing per ISO 14801 was performed according to FDA guidance. |
Biocompatibility | Biocompatibility testing for cytotoxicity according to ISO 10993-5 was performed. Previous 510(k) cleared products sharing identical manufacturing processes and materials also showed non-cytotoxicity. |
Digital Workflow Validation | Validation of the digital dentistry workflow (scanner, design software, milling unit) with the subject product line, ensuring design limits are enforced by the software. |
2. Sample Sized Used for the Test Set and the Data Provenance
- Test Set Sample Size: The document does not specify a "test set" in the context of clinical data for performance evaluation (e.g., a set of medical images). The "testing" refers to mechanical and biocompatibility tests of the device components.
- For fatigue testing (ISO 14801): The sample size for this mechanical test is not explicitly stated in the provided text.
- For biocompatibility (cytotoxicity ISO 10993-5): "a complete restoration produced via the described validated workflow was performed." The exact number of samples tested is not specified.
- For engineering and dimensional analysis: The number of components analyzed is not specified.
- Data Provenance: The document does not mention human subject data or data provenance like country of origin or retrospective/prospective studies. The testing is described as non-clinical (mechanical, material, software validation).
3. Number of Experts Used to Establish the Ground Truth for the Test Set and the Qualifications of Those Experts
- This question is not applicable as the document describes non-clinical testing of a dental implant component, not a diagnostic or AI device requiring expert-established ground truth from patient data.
4. Adjudication Method for the Test Set
- This question is not applicable for the same reasons as point 3.
5. If a Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance
- This question is not applicable as the device is not an AI software intended to assist human readers. It is a physical dental implant component.
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 physical component, not an algorithm.
7. The Type of Ground Truth Used
- For the non-clinical tests:
- Mechanical Integrity (Fatigue): Ground truth is defined by the performance standards of ISO 14801, which sets limits for mechanical failure under specific loading conditions.
- Biocompatibility (Cytotoxicity): Ground truth is defined by the standards of ISO 10993-5, determining if the material elicits a cytotoxic response.
- Dimensional Accuracy/Compatibility: Ground truth is defined by engineering specifications and measurements of existing implant systems and the device itself.
8. The Sample Size for the Training Set
- This question is not applicable as there is no "training set" of data in the context of machine learning for this physical device.
9. How the Ground Truth for the Training Set was Established
- This question is not applicable for the same reasons as point 8.
In summary, the provided text details a regulatory submission for a physical dental device, focusing on demonstrating substantial equivalence through non-clinical testing (mechanical, material, digital workflow validation) rather than complex diagnostic performance studies common for AI or imaging devices.
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(98 days)
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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(160 days)
Duranext Abutments are intended for use with dental implants as a support for single or multiple toth prostheses in the maxilla or mandible of a partially or fully edentulous patient.
Duranext Abutments from Elegant Direct Corp. are a line of machinable blanks incorporating interface features compatible with eleven (11) endosseous dental implant system platforms (three (3) designs from two (2) manufacturers) and intended to be milled at an Elegant Direct Corp. validated milling center to produce patient-specific dental implant abutments. The subject device platform diameters range from 3.0 mm to 6.0 mm, and the corresponding compatible implant body diameters range from 3.0 mm to 6.0 mm.
Duranext Abutments are designed for fabrication of custom titanium alloy dental implant abutments by a CAD/CAM process. All patient-specific custom abutment fabrication is by prescription on the order of the clinician. The portion of each abutment available for milling is 9.5 mm in diameter and 20 mm long. The apical end is premanufactured to fit the compatible implant platform, as shown above, and is available in an engaging (anti-rotation) design. A feature at the coronal end of the abutment is provided to interface with the milling equipment. Each abutment is provided with a screw designed to fit the compatible implant. The patient-specific abutment is intended to support a cement-retained single crown or multi-unit restoration.
The provided document is a 510(k) summary for the Duranext Abutments, a dental device. It does not describe a study involving an AI algorithm or human-in-the-loop performance. Therefore, I cannot extract the information required for questions about AI performance, multi-reader multi-case studies, or specific details of ground truth establishment for AI training/testing.
However, I can provide information about the acceptance criteria and the non-clinical study that proves the device meets those criteria, as well as general device information.
Here's what can be extracted based on the document:
1. A table of acceptance criteria and the reported device performance
The document does not explicitly present a table of "acceptance criteria" in the format of a diagnostic test (e.g., sensitivity, specificity). Instead, substantial equivalence is claimed based on performance testing and comparison to predicate devices for mechanical properties, biocompatibility, and sterilization. The acceptance criteria are implicitly met by successful completion of these tests in accordance with relevant ISO standards.
Acceptance Criterion (implicitly met by standard) | Reported Device Performance (Summary) |
---|---|
Sterilization | Sterilization according to ISO 17665-1 (demonstrated readiness for sterilization) |
Biocompatibility | Biocompatibility according to ISO 10993-12 (for general requirements), and specifically ISO 10993-5 (cytotoxicity) |
Compatibility with OEM Implants | Reverse engineering of OEM implant bodies, OEM abutments, and OEM abutment screws (confirmed compatibility) |
Mechanical Strength / Dynamic Fatigue | Static compression and compression fatigue testing according to ISO 14801 (sufficient strength for intended use) |
Design Parameters (for CAD/CAM abutments) | Minimum wall thickness: 0.5 mm |
Minimum post height: 4.0 mm | |
Maximum abutment height from prosthetic platform: 20.0 mm | |
Maximum gingival height: 4.0 mm | |
Minimum gingival height: 0.5 mm | |
Angulation: 0° to 30° |
2. Sample size used for the test set and the data provenance (e.g., country of origin of the data, retrospective or prospective)
The document does not mention "test sets" in the context of diagnostic data. The "testing" refers to non-clinical performance testing of the physical abutment blanks. The sample sizes for these specific engineering tests (e.g., number of abutments tested for fatigue) are not provided in this summary. The provenance is implied to be from the manufacturer's testing or a contracted lab.
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, as this is a physical medical device (dental abutment) and the evaluation is based on non-clinical performance testing against engineering standards, not diagnostic interpretation by experts.
4. Adjudication method (e.g., 2+1, 3+1, none) for the test set
Not applicable. Adjudication methods like 2+1 or 3+1 are used for establishing ground truth in diagnostic studies, which is not what this document describes.
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 abutment, not an AI-powered diagnostic tool. No MRMC study was conducted.
6. If a standalone (i.e., algorithm only without human-in-the-loop performance) was done
Not applicable. This device is not an algorithm.
7. The type of ground truth used (expert consensus, pathology, outcomes data, etc.)
The "ground truth" for this device's performance is established by engineering standards and physical measurements. For example:
- Biocompatibility: Established by adherence to ISO 10993 series standards, which involves methods like cytotoxicity testing.
- Mechanical Strength: Established by dynamic fatigue testing according to ISO 14801, which defines acceptable load cycles and failure modes.
- Dimensional Compatibility: Established by reverse engineering and direct measurement against OEM specifications.
8. The sample size for the training set
Not applicable. This device is not an AI algorithm, so there is no training set in the context of machine learning.
9. How the ground truth for the training set was established
Not applicable. As above, there is no training set. The "ground truth" for the device's design and manufacturing parameters is established via engineering specifications, material properties, and adherence to relevant ISO standards, rather than a labeled dataset.
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(207 days)
The Elos Accurate® Hybrid Base™ is intended for attaching to dental implants in order to provide basis for single or multiple tooth prosthetic restorations. The Hybrid Base™ is used as an interface between a dental implant and a zirconia superstructure and will be attached to the implant using the included prosthetic screw and attached to the zirconia superstructure by cementing.
The Elos Accurate® Hybrid Base™ is compatible with the implant systems listed in Table 1.
All digitally designed zirconia superstructures for use with the Elos Accurate® Hybrid Base™ are only intended to be sent and manufactured at an FDA registered Elos Medtech approved milling facility.
The Elos Accurate Hybrid Base is a titanium base designed to interface with a dental implant and to support a patient-specific ceramic superstructure or a multi-unit direct restoration cemented to the base. The base and the superstructure form a patient-specific abutment that will support a definitive restoration, either a single crown or a multi-unit restoration. The Elos Accurate Hybrid Base Engaging is intended for single-unit restorations and Elos Accurate Hybrid Base Nonengaging is intended for multi-unit restorations. Alternatively, a definitive multi-unit restoration may be cemented directly to the Elos Accurate Hybrid Base.
Manufacture of the final finished device will be at an Elos Medtech-approved milling facility that is registered with FDA as a medical device manufacturer and is qualified as a contract manufacturer to Elos Medtech.
This submission includes a two-piece abutment (titanium base and zirconia superstructure) and abutment screws compatible with OEM implants from Dentsply Implants (Astra Tech TX, Astra Tech EV), Nobel Biocare (Nobel Active/Conical Connection and Nobel Replace) and Institut Straumann (Straumann Bone Level NC and RC).
Abutments compatible with Astra Tech implants are available in engaging (anti-rotational) designs, and all others are available in both engaging and non-engaging designs.
This document is a 510(k) Premarket Notification from the FDA regarding the "Elos Accurate® Hybrid Base" dental implant device. It primarily focuses on demonstrating substantial equivalence to a predicate device, rather than proving the device meets specific performance criteria through a study with acceptance criteria.
Therefore, the information required to directly answer some of your questions, particularly those related to the performance study design for an AI/ML-based medical device (e.g., sample size for test/training sets, expert consensus, MRMC studies, ground truth establishment for AI models), is not present in this document. This is because the device in question is a physical dental implant component, not an AI/ML algorithm.
However, I can extract the relevant information regarding the performance data provided for this physical device.
Here's a breakdown based on the provided document:
1. A table of acceptance criteria and the reported device performance
The document does not present a formal table of acceptance criteria and reported device performance in the way an AI/ML device submission would. Instead, it states that substantial equivalence is demonstrated through:
- Biocompatibility evaluation and confirmatory cytotoxicity testing: According to ISO 10993-5 (Biological evaluation of medical devices - Part 5: Tests for in vitro cytotoxicity).
- Dynamic compression-bending testing: According to ISO 14801 (Dentistry - Implants - Dynamic fatigue test for endosseous dental implants).
- Engineering and dimensional analysis: To confirm compatibility with OEM implant bodies, OEM abutments, and OEM abutment fixation screws.
- Sterilization validation: In accordance with ISO 17665-1 and ISO 17665-2.
Reported Performance/Demonstration:
- "Substantial equivalence with regard to compatibility with OEM components is supported by engineering and dimensional analysis of OEM implant bodies, OEM abutments and OEM abutment fixation screws to confirm compatibility."
- "Substantial equivalence with regard to mechanical performance is supported by dynamic testing according to ISO 14801 Dentistry – Implants – Dynamic fatigue test for endosseous dental implants."
- "The coatings used on selected screws are identical to coatings on previously cleared devices."
- "Sterilization validation of the reprocessing instructions were conducted in accordance to ISO 17665-1 and ISO 17665-2."
- "Minor differences in the designs, dimensions, sizes, or compatible OEM implant lines... do not affect substantial equivalence. These minor differences... are related to the compatible OEM implant designs or are mitigated by the mechanical performance testing."
2. Sample sized used for the test set and the data provenance (e.g. country of origin of the data, retrospective or prospective)
- Sample Size: Not specified for any of the non-clinical tests (biocompatibility, dynamic fatigue, engineering analysis, sterilization). The document indicates "No clinical data were included in this submission," further confirming that there wasn't a "test set" in the context of patient data for AI performance evaluation.
- Data Provenance: Not applicable as it's not clinical data. The tests are laboratory-based.
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 device is a physical component, not an AI/ML diagnostic tool requiring expert ground truth for image interpretation.
4. Adjudication method (e.g. 2+1, 3+1, none) for the test set
- Not applicable. As above, this is not a diagnostic study requiring adjudication.
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. No clinical or human-in-the-loop study was conducted or required for this physical device.
6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done
- Not applicable. This is not an algorithm. The "performance data" refers to the physical and mechanical properties of the dental abutment.
7. The type of ground truth used (expert consensus, pathology, outcomes data, etc)
- For the non-clinical performance data, the "ground truth" or reference standards are the ISO standards themselves (ISO 10993-5, ISO 14801, ISO 17665-1, ISO 17665-2), and the engineering specifications/dimensions of OEM implant components for compatibility analysis. This is a technical ground truth based on established material science and mechanical engineering principles, rather than medical expert consensus or patient outcomes.
8. The sample size for the training set
- Not applicable. There is no "training set" in the context of an AI/ML model for this physical device.
9. How the ground truth for the training set was established
- Not applicable. As above, no training set for an AI/ML model.
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(206 days)
The Elos Accurate® Customized Abutments are intended for attaching to dental implants in order to provide basis for single or multiple tooth prosthetic restorations. The Elos Accurate® Customized Abutment will be attached to a dental implant using the included Elos Prosthetic screw.
The Elos Accurate® Customized Abutments are compatible with the implant systems listed in table 1:
Table 1.
Elos Accurate Customized Abutment – Model Type | Platform compatibility | Platform diameter [mm] | Implant Body diameter [mm] |
---|---|---|---|
AB-ATO35 | Astra Tech 3.5/4.0 | 3.5 & 4 | 3.5 & 4 |
AB-ATO45 | Astra Tech 4.5/5.0 | 4.5 & 5 | 4.5 & 5 |
AB-ATE36 | Astra Tech EV 3.6 | 3.6 | 3.6 |
AB-ATE42 | Astra Tech EV 4.2 | 4.2 | 3.6 & 4.2 |
AB-ATE48 | Astra Tech EV 4.8 | 4.8 | 4.2 & 4.8 |
AB-ATE54 | Astra Tech EV 5.4 | 5.4 | 5.4 |
All digitally designed CAD/CAM customizations for the Elos Accurate® Customized Abutments are only intended to be sent and manufactured at a FDA registered Elos Medtech approved milling facility.
The Elos Accurate® Customized Abutment is a patient specific abutment intended for attaching to dental implants in order to provide basis for single- or multiple tooth prosthetic restorations. The Elos Accurate® Customized Abutment will be attached to the implant using the included Elos Prosthetic Screw and attached to the crown/coping manually by cementation. The Elos Accurate® Customized Abutment consists of an Abutment Blank used in fabricating of a full patient-specific abutment in Titanium alloy per ASTM F136. The Abutment Blank used in creation of the Elos Accurate® Customized Abutment has a pre-manufactured connection interface that fits directly to a pre-specified dental implant. The customized shape of the abutment is intended to be manufactured by an Elos Medtech approved milling facility. The Elos Accurate® Customized Abutment is delivered nonsterile and the final restoration including corresponding Elos Prosthetic Screw is intended to be sterilized at the dental clinic before it is placed in the patient. The Elos Accurate® Customized Abutment provides clinicians and laboratories with a prosthetic device that can be used in definitive (permanent) single- or multi restorations.
The provided document, a 510(k) Premarket Notification summary for the Elos Accurate® Customized Abutment, outlines the device's indications for use, technological characteristics, and non-clinical testing conducted to demonstrate substantial equivalence to a predicate device. However, it does not contain information typically found in an acceptance criteria and performance study for a medical device that uses an algorithm or AI. This document is for a physical dental abutment, not a device that relies on an algorithm or AI for its function.
Therefore, I cannot extract the requested information regarding acceptance criteria and a study proving device meets acceptance criteria related to an AI/algorithm-based device. The original document does not offer data points for:
- A table of acceptance criteria and reported device performance (in the context of algorithm performance)
- Sample size for a test set or data provenance
- Number of experts or their qualifications for ground truth
- Adjudication method
- MRMC comparative effectiveness study
- Standalone algorithm performance
- Type of ground truth (e.g., pathology, outcomes data)
- Sample size for a training set
- How ground truth for a training set was established
The "testing" mentioned in the document (fatigue testing, biocompatibility testing, dimensional analysis) is for the physical material and design of the abutment, not for an algorithm's performance.
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(115 days)
The Elos Accurate® Customized Abutments are intended for attaching to dental implants in order to provide basis for single or multiple tooth prosthetic restorations. The Elos Accurate® Customized Abutment will be attached to a dental implant using the included Elos Prosthetic screw.
The Elos Accurate® Customized Abutments are compatible with the implant systems listed in table 1:
Table 1.
Elos Accurate Customized Abutment – Model Type | Platform compatibility | Platform diameter [mm] | Implant Body diameter [mm] |
---|---|---|---|
AB-NBR43 | Nobel Replace RP | 4.3 | 4.3 |
AB-NBR50 | Nobel Replace WP | 5 | 5 |
AB-NBR60 | Nobel Replace 6.0 | 6 | 6 |
AB-NBA35 | Nobel CC NP | 3.5 | 3.5 & 3.75 |
All digitally designed CAD/CAM customizations for the Elos Accurate® Customized Abutments are only intended to be sent and manufactured at a FDA registered Elos Medtech approved milling facility.
The Elos Accurate® Customized Abutment is a patient specific abutment intended for attaching to dental implants in order to provide basis for single- or multiple tooth prosthetic restorations. The Elos Accurate® Customized Abutment will be attached to the implant using the included Elos Prosthetic Screw and attached to the crown/coping manually by cementation. The Elos Accurate® Customized Abutment consists of an Abutment Blank used in fabricating of a full patient-specific abutment in Titanium alloy per ASTM F136. The Abutment Blank used in creation of the Elos Accurate® Customized Abutment has a pre-manufactured connection interface that fits directly to a pre-specified dental implant. The customized shape of the abutment is intended to be manufactured by an Elos Medtech approved milling facility. The Elos Accurate® Customized Abutment is delivered nonsterile and the final restoration including corresponding Elos Prosthetic Screw is intended to be sterilized at the dental clinic before it is placed in the patient. The Elos Accurate® Customized Abutment provides clinicians and laboratories with a prosthetic device that can be used in definitive (permanent) single- or multi restorations.
The provided text describes a medical device, the Elos Accurate® Customized Abutment, and its 510(k) submission to the FDA. However, the document does not contain information regarding objective acceptance criteria (e.g., performance metrics with defined thresholds), nor does it detail a study that proves the device meets such criteria.
Instead, the document focuses on demonstrating substantial equivalence to a previously cleared predicate device (K190299) based on similar intended use, operating principle, design, materials, and sterilization processes.
Therefore, I cannot provide a table of acceptance criteria and reported device performance or information about sample sizes for test sets, expert adjudication methods, MRMC studies, standalone performance, or ground truth details, as these are not present in the provided text.
The information that is available regarding testing is non-clinical and aims to show similarity and safety compared to the predicate device, rather than meeting specific performance thresholds against a defined clinical outcome.
Here's a summary of the non-clinical testing performed, which serves as the evidence for substantial equivalence:
Non-Clinical Testing Information (as provided):
- Type of Testing:
- Engineering and dimensional analysis of original manufacturers' components (abutments, implants & abutment screws) for determination of compatibility.
- Fatigue testing per ISO 14801 according to FDA guidance for Industry and FDA Staff "Class II Special Controls Guidance Document: Root-form Endosseous Dental Implants and Endosseous Dental Abutments" dated May 12, 2004.
- Biocompatibility testing for cytotoxicity according to ISO 10993-5.
- Tests Included for Biocompatibility:
- Non-coated prosthetic screw (representative for subject device, tested on primary predicate device K190299).
- Medicarb coated prosthetic screw (representative for subject device, tested on reference predicate device K171799).
- Elos Accurate® Customized Abutment (representative for subject devices, tested on reference predicate device K171799).
- Sterilization: The primary predicate device was tested according to ISO 17665-1 & ISO 17665-2, demonstrating a Sterility Assurance Level (SAL) of $10^{-6}$. No additional testing was deemed necessary for the subject device.
Missing Information (Not provided in the document):
- Specific quantitative acceptance criteria for performance metrics.
- A clinical study designed to demonstrate performance against such criteria.
- Sample size used for a test set (as no such test set for performance evaluation is described).
- Data provenance for a test set.
- Number of experts used to establish ground truth or their qualifications.
- Adjudication method for a test set.
- Multi-reader multi-case (MRMC) comparative effectiveness study results.
- Effect size of human reader improvement with AI vs. without AI assistance.
- Standalone (algorithm-only) performance.
- Type of ground truth used (expert consensus, pathology, outcomes data, etc.).
- Sample size for the training set.
- How ground truth for the training set was established.
The document's purpose is to establish substantial equivalence for regulatory clearance, not to report on a clinical performance study with predefined acceptance criteria.
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