DENTAURUM MIX TWO-PASTE BRACKET ADHESIVE

K030977 · Dentaurum · DYH · Aug 25, 2003 · Dental

Device Facts

• Record ID: K030977
• Device Name: DENTAURUM MIX TWO-PASTE BRACKET ADHESIVE
• Applicant: Dentaurum
• Product Code: DYH · Dental
• Decision Date: Aug 25, 2003
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 872.3750
• Device Class: Class 2
• Attributes: Therapeutic

Intended Use

Dentaurum MIX Two-paste Bracket Adhesive is a self-cure orthodontic bracket adhesive used with a liquid primer and an enamel etching gel (37.4% phosphoric acid gel) to adhere orthodontic brackets to tooth surfaces.

Device Story

Dentaurum MIX Two-paste Bracket Adhesive is a self-cure resin system for orthodontic applications. The device consists of two pastes mixed by a clinician to initiate polymerization. It is used in conjunction with a liquid primer and 37.4% phosphoric acid etching gel to bond orthodontic brackets to tooth enamel. The system is applied by dental professionals in a clinical setting. The adhesive provides the mechanical bond necessary to secure brackets to teeth during orthodontic treatment, facilitating tooth movement and alignment.

Clinical Evidence

No clinical data provided; bench testing only.

Technological Characteristics

Two-paste self-cure resin system; includes liquid primer and 37.4% phosphoric acid etching gel. Classified under 21 CFR 872.3750 (Bracket Adhesive Resin and Tooth Conditioner).

Indications for Use

Indicated for use by dental professionals to bond orthodontic brackets to tooth enamel surfaces using a self-cure adhesive system, liquid primer, and 37.4% phosphoric acid etching gel.

Regulatory Classification

Identification

A bracket adhesive resin and tooth conditioner is a device composed of an adhesive compound, such as polymethylmethacrylate, intended to cement an orthodontic bracket to a tooth surface.

Submission Summary (Full Text)

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AUG 2 5 2003

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

Mr. Jan W.A. Doorschodt General Manager Dentaurum, Incorporated 10 Pheasant Run Newtown, Pennsylvania 18940

Re: K030977

Trade/Device Name: Dentaurum MIX Two-Paste Bracket Adhesive Regulation Number: 21 CFR 872.3750 Regulation Name: Bracket Adhesive Resin and Tooth Conditioner Regulatory Class: II Product Code: DYH Dated: August 13, 2003 Received: Augut18, 2003

Dear Mr. Doorschodt:

We have reviewed your Section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food, Drug, and Cosmetic Act (Act) that do not require approval of a premarket approval application (PMA). You may, therefore, market the device, subject to the general controls provisions of the Act. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to such additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.

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Page 2 - Mr. Jan W.A. Doorschodt

Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencies. You must comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act): 21 CFR 1000-1050.

This letter will allow you to begin marketing your device as described in your Section 510(k) premarket notification. The FDA finding of substantial equivalence of your device to a legally marketed predicate device results in a classification for your device and thus, permits your device to proceed to the market.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please contact the Office of Compliance at [phone]. Additionally, for questions on the promotion and advertising of your device, please contact the Office of Compliance at [phone]. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97) you may obtain. Other general information on your responsibilities under the Act may be obtained from the Division of Small Manufacturers, International and Consumer Assistance at its toll-free number [phone] or [phone] or at its Internet address http://www.fda.gov/cdrh/dsma/dsmamain.html

Sincerely yours.

Susan Runse

Susan Runner, DDS, MA Interim Director Division of Anesthesiology, General Hospital, Infection Control and Dental Devices Office of Device Evaluation Center for Devices and Radiological Health

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Ko30977 510 (k) NUMBER (IF KNOWN):

DEVICE NAME: Dentaurum MIX Two-paste Bracket Adhesive

INDICATIONS FOR USE:

Dentaurum MIX Two-paste Bracket Adhesive is a self-cure orthodontic bracket adhesive used with a liquid primer and an enamel etching gel (37.4% phosphoric acid gel) to adhere orthodontic brackets to tooth surfaces.

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Concurrence of CDRH, Office of Device Evaluation (ODE)

Prescription Use (Per 21 CFR 801.109

OR

Over-The-Counter Use

Kein Mulvey for MSN

n Sian-Off Division of Anesthesiolog Infection Control, Den

510(k) Number: K030977