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The Dentsply Sirona Titanium Bases system is intended for use in partially or fully edentulous mandibles and maxillae in support of single cement-retained restorations.

For AT EV 3.0 S, AT TX 3.0 S, BH 3.0 S, and SB L 3.3 L titanium bases, the indication is restricted to the replacement of single lateral incisors in the maxilla and lateral and central incisors in the mandible.

The system comprises three parts:

• Abutment Block material (CEREC Cercon 4D Abutment Block)
• Titanium Base (TiBase)
• CAD/CAM system

The TiBase is recommended for use with two-piece hybrid abutments and hybrid abutment crowns, used in conjunction with endosseous dental implants.

The proposed Dentsply Sirona Titanium Bases system are connected to Dentsply Sirona or third-party dental implants to facilitate the prosthetic dental restoration of edentulous areas of the oral anatomy. The proposed TiBase components are assembled (through extraoral cement bonding) with the patient specific CEREC Cercon 4D Abutment Block (K234018), to form the complete, two-piece CAD/CAM Titanium Base system abutments. The bottom half of the abutment is the TiBase component, which interfaces with the implant system-specific geometry, while the top half of the abutment is the abutment block material that is milled to form either an abutment crown or a meso-structure (the latter is subsequently finished with a crown). The TiBase component therefore serves as the "platform" on which the customized milled abutment crown or the meso-structure is bonded to, forming the complete CAD/CAM Titanium Base system abutment. The completed CAD/CAM Titanium Base system abutment is attached to the dental implant with an abutment screw.

The TiBase system is part of a workflow that includes CAD/CAM software cleared in predicate device, K193408, CAD/CAM system with CEREC Chairside Software, and reference device, K200191, CAD/CAM System with inLab Software, and the abutment crown and meso-structure material cleared in reference device, K234018.

The TiBase components are made of the same material as the predicate device (K193408) TiBases, which is titanium alloy Ti6Al4V, complying with ASTM F136-13. While the lower part connects to the implant system, the upper part consists of a tapered, cylindrical center post which is designed to receive the abutment crown or meso-structure to complete the finished CAD/CAM abutment.

The TiBase components come in small and large sizes depending on the diameter size of the connecting implant. A notch feature on the cylindrical part of the upper portion (i.e. rotational reference and lock) ensures that there is only one position to mount either a scanbody or the abutment crown/meso-structure.

The TiBase component center post includes a through-channel through which a corresponding abutment screw is inserted to allow retention of the finished abutment to the implant. The abutment screw, made of the same Titanium material, when assembled with the proposed TiBase component, is located in the internal geometry of the titanium base and does not seat in the finalized abutment crown/meso-structure.

The minimum/maximum design specification limits are as follows:

• Maximum angulation for the Zirconia top-half material: 20˚
• Minimum wall thickness of the Zirconia top-half material: 0.5 mm
• Gingival heights of the TiBase component: 1, 2, 3 mm
• TiBase component post height (i.e., length above the gingival height): ≥ 4 mm

This document is a 510(k) clearance letter for the Dentsply Sirona Titanium Bases system, which specifies its indications for use and compares it to predicate and reference devices to demonstrate substantial equivalence. It does not describe the specific acceptance criteria and detailed study results that prove the device meets those criteria in a format applicable to AI/ML software performance studies.

The document details the technical aspects of the dental implant components and their mechanical testing for safety and performance (e.g., fatigue testing), biocompatibility, reprocessing validation, and MR compatibility. However, it does not involve the types of performance metrics, test set characteristics, or ground truth establishment typically associated with AI/ML device evaluations.

Therefore, for aspects related to AI/ML device performance (like accuracy metrics, expert review, MRMC studies, standalone performance), the answer is "Not applicable" or "Not provided" as this is a traditional medical device clearance, not an AI/ML software clearance.

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

1. Table of Acceptance Criteria and Reported Device Performance

The document describes several non-clinical tests that the device was subjected to and that it "met acceptance criteria" or "showed similar results" to reference devices. However, the specific quantitative acceptance criteria (e.g., "fatigue strength must be > X N") and the exact reported quantitative performance values achieved by the Dentsply Sirona Titanium Bases system are not explicitly stated in this clearance letter. The letter generally refers to compliance with standards.

For example, for fatigue testing, it states: "The TiBases systems were subjected to fatigue testing per the following requirements and showed similar results when compared to the reference devices (K213961, K241485)" and refers to ISO 14801:2016 and FDA Special Controls Guidance. It does not provide the numerical results or the specific acceptance mechanical load values. The same applies to MR testing, reprocessing, and biocompatibility.

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

• Sample Size: Not explicitly stated in terms of the number of unique devices/tests in the provided text. The fatigue testing mentions "the proposed device performs as well as the reference devices (K213961, K241485)," implying a comparison and potentially new tests for the specific new TiBases. However, specific counts are not given.
• Data Provenance: The studies are non-clinical (laboratory tests) rather than human patient data. Therefore, "country of origin" and "retrospective/prospective" are not applicable in the context of patient data. The tests were performed to demonstrate compliance with international standards (ISO, ASTM) and FDA guidance.

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

• Not Applicable (N/A). This is a mechanical/material device clearance, not an AI/ML software evaluation based on expert-labeled data. The "ground truth" for these tests refers to the objective results conforming to engineering and material science standards (e.g., a device either fractures at a certain load or it doesn't, a material is biocompatible or not).

4. Adjudication method for the test set

• Not Applicable (N/A). Adjudication methods like 2+1 or 3+1 are used for resolving discrepancies in expert labeling for AI/ML ground truth, which is not relevant here.

5. If a multi-reader multi-case (MRMC) comparative effectiveness study was done

• No. This is not an AI/ML software device that involves human interpretation of medical images.

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

• Not Applicable (N/A). This is a physical device, not an algorithm. The "software system verification" refers to confirming that the CAD/CAM software correctly integrates the design parameters for the physical components, not an AI algorithm's standalone diagnostic performance.

7. The type of ground truth used

• For mechanical (fatigue) testing: Compliance with ISO 14801:2016 and FDA guidance, meaning the physical behavior of the device under specified loads.
• For MR testing: Compliance with ASTM standards, meaning objective measurements of displacement, torque, and image artifacts.
• For software verification: Conformation that design parameters are correctly implemented in CAD/CAM software.
• For reprocessing and biocompatibility: Compliance with ISO standards and FDA guidance, meaning objective evaluations of sterility and biological response.

8. The sample size for the training set

• Not Applicable (N/A). There is no AI/ML model involved; therefore, no training set.

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

• Not Applicable (N/A). There is no AI/ML model involved; therefore, no training set.

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Indications for CEREC Cercon 4D™ CAD/CAM Blocks are:

• Crowns and bridges in the posterior and anterior tooth region
• Bridges with a maximum of two pontics
• Inlays, onlays and veneers

CEREC Cercon 4D™ CAD/CAM Block are pre-sintered zirconia blocks composed of yttria stabilized zirconia, which are designed for CAD/CAM milling. The proposed CEREC Cercon 4D™ CAD/CAM Blocks possess a 3-dimensional contour of dentine powder to mimic the natural tooth build-up. The aim of the 3D contour technology is to achieve more aesthetic restorations than with blocks based on the current multi-layer technology. The CEREC Cercon 4D™ CAD/CAM Blocks are used for fabrication of a dental restoration. The CEREC Cercon 4D™ CAD/CAM Blocks are not provided as the finished, fully finished dental restoration. The blocks are single use, meaning that they can only be milled once and are not recommended for re-milling. The blocks are materials supplied to dental professionals that must be further processed/manufactured using CAD/CAM milling and subsequent sintering to fabricate all ceramic restorations and they are not intended to be reused as in the context of direct patient-applied devices and materials. Therefore, no reprocessing, cleaning or disinfection instructions apply because it is a dental material and not a finished dental restoration itself. After sintering of the restoration, the dental professional will finish the restoration via polishing or glazing, before insertion into the patient's mouth.

This document describes a 510(k) premarket notification for the "CEREC Cercon 4D CAD/CAM Blocks," a dental material. The information provided is for regulatory clearance and focuses on demonstrating substantial equivalence to existing predicate devices, rather than a clinical effectiveness study of an AI-powered diagnostic device.

Therefore, many of the requested fields related to AI performance, ground truth, expert adjudication, and comparative effectiveness studies are not applicable or cannot be extracted from this document.

Here's the information that can be extracted and a clear indication of what is not applicable or not provided in the document:

1. Table of Acceptance Criteria and Reported Device Performance

The acceptance criteria are generally "Pass" for conformance to ISO standards and biocompatibility tests. The reported device performance is that it passed these tests.

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

This document describes non-clinical bench testing and biocompatibility assessments, not a study involving a "test set" of patient data for an AI algorithm. Therefore, this information is not applicable in the context of an AI device. The tests performed are on material samples, and the document does not specify the number of samples used for each test. The provenance of the test samples (e.g., country of origin) is not provided.

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

Not applicable. This is for a dental material, not an AI diagnostic device requiring expert interpretation of a test set.

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

Not applicable. This document pertains to materials testing, not diagnostic performance with a test set 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. This is not an AI diagnostic device.

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

Not applicable. This is not an AI device.

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

The "ground truth" in this context is adherence to established international standards (ISO standards) for ceramic dental materials and biocompatibility assessment. The "truth" is whether the material meets the specified physical, mechanical, and biological performance requirements defined by these standards.

8. The sample size for the training set

Not applicable. This is not an AI device that requires a training set.

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

Not applicable. This is not an AI device that requires a training set.

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Cercon® yo ML is indicated in the anterior and posterior segments for:

• Crowns
• Multi-unit bridges (with a maximum of two pontics between abutment crowns)
• Inlays, onlays and veneers

The proposed Cercon® yo ML is a partially sintered ceramic blank composed of yttrium oxide-(yttria-) stabilized zirconium oxide (zirconia) (Y-TZP). Cercon® yo ML is a multilayer disk built out of different shade layers and yttrium oxide contents which create a natural gradient of the restoration after sintering. The proposed device is supplied to dental professionals as a blank and then processed by machining and subsequent sintering to fabricate dental ceramic restorations.

The provided text describes acceptance criteria and the study conducted for the Cercon® yo ML device, specifically focusing on non-clinical performance data.

Here's a breakdown of the requested information:

1. A table of acceptance criteria and the reported 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)

The document does not explicitly state the sample sizes for the bench tests. It refers to general standards (ISO 6872, ISO 9693, ISO 10993 series) which typically define the number of samples required for each test. The data provenance is not mentioned, but these are non-clinical engineering and biological tests, not patient-specific data.

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 section is not applicable. The studies described are non-clinical bench tests and biocompatibility assessments, which rely on established scientific and engineering standards and laboratory measurements, not expert consensus for ground truth.

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

This section is not applicable. Adjudication methods are typically used in clinical studies involving interpretation of data by multiple experts. The described studies are non-clinical bench tests.

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

There is no mention of an MRMC study or AI assistance in the provided text. The device, Cercon® yo ML, is a partially sintered ceramic blank for dental restorations, not an AI-powered diagnostic or assistive device.

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

This section is not applicable. The device is a material for dental restorations, not a software algorithm.

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

For the non-clinical performance data:

• Material properties (Flexural Strength, CTE, Solubility, Radioactivity, Shrinkage factor, Uniformity, Freedom from extraneous materials): The ground truth is based on the specified physical, chemical, and mechanical properties as defined by the ISO 6872:2015 Amd 1. 2018 standard. The "ground truth" is the established limit or range defined by the standard.
• Compatibility (De-bonding / crack-initiation, Thermal shock resistance): The ground truth is based on the specified performance criteria defined by the ISO 9693:2019 standard.
• Biocompatibility: The ground truth is established by the requirements of the ISO 10993 series of standards and USP , which define acceptable biological responses and toxicity levels.

8. The sample size for the training set

This section is not applicable as the studies described are non-clinical bench tests and biocompatibility assessments, not machine learning model training.

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

This section is not applicable as there is no training set mentioned or implied for this type of device and testing.

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