GRADIA DIRECT LOFLO

K042348 · GC America, Inc. · EBF · Nov 18, 2004 · Dental

Device Facts

• Record ID: K042348
• Device Name: GRADIA DIRECT LOFLO
• Applicant: GC America, Inc.
• Product Code: EBF · Dental
• Decision Date: Nov 18, 2004
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 872.3690
• Device Class: Class 2
• Attributes: Therapeutic

Intended Use

This product is a light-cured fluoride releasing microfilled hybrid composite restorative resin. Recommended Indications: 1. Restoration of Class I, II, III, IV, V cavities (particularly for small Class I cavities/ shallow Class V cavities/ other small cavities). 2. Restoration of root surface caries. 3. Restorations in deciduous teeth. 4. Filling tunnel shaped cavities. 5. Sealing hypersensitive areas. 6. Liner/base/filling in cavity undercuts. 7. Sealant. 8. Fixation of mobile teeth. 9. Additions to composite restorations.

Device Story

Gradia Direct LoFlo is a light-cured, fluoride-releasing microfilled hybrid composite restorative resin. Used by dental professionals in clinical settings for various restorative procedures, including cavity filling, sealing, and tooth fixation. Material is applied to the tooth structure and cured using a dental light source. Provides structural support and aesthetic restoration for dental caries and defects. Benefits include fluoride release and versatility across multiple cavity classifications.

Clinical Evidence

No clinical data provided; bench testing only.

Technological Characteristics

Light-cured microfilled hybrid composite resin; fluoride-releasing; dental restorative material; class II device; product codes EBF and EMA.

Indications for Use

Indicated for patients requiring dental restorations, including Class I-V cavities, root surface caries, deciduous teeth, tunnel cavities, hypersensitive area sealing, cavity liners/bases, sealants, mobile tooth fixation, and composite restoration additions.

Regulatory Classification

Identification

Tooth shade resin material is a device composed of materials such as bisphenol-A glycidyl methacrylate (Bis-GMA) intended to restore carious lesions or structural defects in teeth.

Submission Summary (Full Text)

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NOV 1 8 2004

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

Ms. Terry L. Joritz Director, Regulatory Affairs & Quality Control GC America, Incorporated 3737 West 127th Street Alsip, Illinois 60803

Re: K042348

Trade/Device Names: Gradia® Direct LoFlo Regulation Number: 21 CFR 872.3690 Regulation Name: Tooth Shade Resin Material Regulatory Class: II Product Codes: EBF and EMA Dated: August 27, 2004 Received: September 07, 2004

Dear Ms. Joritz:

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 grneral controls provisions of the Act include requirements for annual registration, listing of devenes, 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 public further announcements concerning your device in the Federal Register.

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Page 2 - Ms. Terry L. Joritz

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]. 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 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.

Curt

Chiu S. Lin, PhD Director Division of Anesthesiology, General Hospital, Infection Control and Dental Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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## Indications for Use

510(k) Number (if known): K042348

Device Name:

Indications for Use:

GRADIA DIRECT LoFlo

This product is a light-cured fluoride releasing microfilled hybrid composite restorative resin.

Recommended Indications:

- 1. Restoration of Class I, II, III, IV, V cavities (particularly for small Class I cavities/ shallow Class V cavities/ other small cavities).
- 2. Restoration of root surface caries.
- 3. Restorations in deciduous teeth.
- 4. Filling tunnel shaped cavities.
- 5. Sealing hypersensitive areas.
- 6. Liner/base/filling in cavity undercuts.
- 7. Sealant.
- 8. Fixation of mobile teeth.
- 9. Additions to composite restorations.

Prescription Use
(21 CFR Part 801 Subpart D)

AND/OR

Over-The-Courter Use (21 CFR Part 807 Subpart C)

(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON AMOTHER PAGE IF NEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)

Kée Waler for MIR

UNISION of Anesthesion V. General Hosnital

510(k) Number: K042348