ARTISAN SPACE MAINTENANCE SYSTEM

K120271 · Medtronic Sofamor Danek USA, Inc. · JEY · May 30, 2012 · Dental

Device Facts

• Record ID: K120271
• Device Name: ARTISAN SPACE MAINTENANCE SYSTEM
• Applicant: Medtronic Sofamor Danek USA, Inc.
• Product Code: JEY · Dental
• Decision Date: May 30, 2012
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 872.4760
• Device Class: Class 2
• Attributes: Therapeutic

Intended Use

The ARTISAN™ Space Maintenance System is indicated for use as temporary implants to stabilize and support autograft, autograft extenders, allograft, and bone void fillers and/or fractured bone segments with or without bone plates or titanium mesh in bony defects of oral maxillofacial anatomy. The ARTISAN™ Space Maintenance System is intended for temporary use in oral maxillofacial surgical reconstruction and dental regeneration procedures for maintaining space during bone grafting procedures and to support soft tissue until bone formation.

Device Story

System of temporary implants for oral maxillofacial bone grafting; includes porous titanium mesh, fixation screws, tenting screws, and socket preservation screws. Used to stabilize/support bone graft materials and fractured bone segments; prevents soft-tissue collapse into graft sites. Operated by oral maxillofacial surgeons in clinical settings. Provides semi-protected space for bone regeneration. Subject of 510(k) to establish MR-Conditional labeling for 1.5T and 3T environments.

Clinical Evidence

No clinical data. Evidence based on bench performance testing including static axial pullout, subsidence, cantilever bending, and removal torque testing per ASTM F543-02, and MRI safety assessments (field interaction, torque, heating, and artifact) per ASTM F2052-06, F2213-06, F2182-11, and F2119-07.

Technological Characteristics

System components: porous titanium mesh, titanium alloy fixation/tenting/socket preservation screws. Materials: medical grade titanium, titanium alloy, cobalt-chromium-molybdenum alloy. Testing standards: ASTM F543-02 (mechanical), ASTM F2052-06, F2213-06, F2182-11, F2119-07 (MRI safety). MR-Conditional at 1.5T and 3T.

Indications for Use

Indicated for patients requiring temporary stabilization and support of bone grafts (autograft, allograft, bone void fillers) or fractured bone segments in oral maxillofacial bony defects. Used in surgical reconstruction and dental regeneration to maintain space and support soft tissue during bone formation.

Regulatory Classification

Identification

A bone plate is a metal device intended to stabilize fractured bone structures in the oral cavity. The bone segments are attached to the plate with screws to prevent movement of the segments.

Predicate Devices

• ARCHITEX™ Space Maintenance System (K100779)
• ARCHITEX™ Space Maintenance System (K110259)

Submission Summary (Full Text)

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# ARTISAN™ Space Maintenance System 510(k) Summarv

MAY 3 0 2012

Below is the 510(k) summary submitted to the FDA containing information per Code of Federal Requlations, Title 21, Part 807.92: This 510(K) is submitted for one reason: to provide appropriate MRI labeling for the subject devices, while also providing MRI technologists with a method of concluding whether an MRI scan can be performed on the device and specific instructions on how to perform the scan.

- Submitter Information 1.
Medtronic Sofamor Danek Sponsor: 1800 Pyramid Place Memphis. TN 38132

Contact Person: Lin Wu, Regulatory Affairs Specialist [e-mail] [phone]

Date Prepared: April 18, 2012

- 11. Device Name
Proprietary Trade Name: ARTISAN™ Space Maintenance System Common/Usual Names:

Classification Name: Bone Plate (Regulation Number 21 CFR 872.4760) JEY, DZE Product Code:

#### lll. Predicate Devices

ARCHITEX™ Space Maintenance System (K100779 SE 12/13/2010, and K110259 SE 04/13/2011)

#### IV. Device Description

The ARTISAN™ Space Maintenance System is a comprehensive, allinclusive system which contains a variety of implants designed to temporarily reconstruct bony deficiencies common to the oral cavity that are not intrinsic to the stability of the bony structure. Bony deficiencies

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may be naturally occurring osseous defects, surgically created osseous defects, or osseous defects created from traumatic injury to the bone.

The ARTISAN™ Space Maintenance System includes a selection of Socket Preservation screws which are designed to aid in extraction socket grafting while simultaneously supporting the original gingival margins and papilla. The system contains a porous titanium mesh (with only one size of 76mm x 44mm x 0.2mm), titanium allov mesh fixation screws (with sizes of 1.2mm or major diameters x 4mm or 6mm or 10mm or 10mm or 12mm or 14mm lengths, and with sizes of 1.4mm maior diameters x 3mm or 5mm or 7mm lengths), titanium allov tenting screws (with sizes of 1.2mm or 1.4mm major diameters x 8mm or 10mm or 12mm or 14mm lengths x 5mm head diameter), and titanium allov socket preservation screws (with sizes of 1.2mm or 1.4mm major diameters x 14mm or 18mm or 20mm lengths x 3/4mm or 4/5mm or 5/6mm head diameters). When used as indicated, this system provides a semi-protected space to stabilize, support, and protect bone graft (autograff, autograft extenders, allograft, and bone void fillers) by minimizing soft-tissue collapse into the graft recipient site.

## Never use stainless steel and titanium implant components in the same construct.

Medical grade titanium, titanium alloy, and medical grade cobaltchromium-molybdenum allov may be used together.

# Technological Characteristics

The ARTISAN™ Space Maintenance System has the same design, same materials, and physical properties as their respective predicate devices, and is substantially equivalent to their predicate devices.

#### V. Indications for Use

The ARTISAN™ Space Maintenance System is indicated for use as temporary implants to stabilize and support autograft, autograft extenders, allograft, and bone void fillers and/or fractured bone segments with or without bone plates or titanium mesh in bony defects of oral maxillofacial anatomy.

The ARTISAN™ Space Maintenance System is intended for temporary use in oral maxillofacial surqical reconstruction and dental reqeneration procedures for maintaining space during bone grafting procedures and to support soft tissue until bone formation.

The ARTISAN™ Space Maintenance System has the same indications for use as their respective predicate devices.

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#### VI. General discussion of the non-clinical tests submitted

For a determination of substantial equivalence, the following analyses and bench performance tests were performed on Subject Devices and Predicate Devices: h

- > Analysis of Dimensional and Material Features
- Static Axial Pullout Testing in accordance with ASTM F543-02: A
- Static Subsidence Testing (to date there are no industry standards); >
- A Static Cantilever Bending Testing (to date there are no industry standards):
- Static "Removal Torque" and "Torque to Failure" testing in accordance A with ASTM F543-02

For a determination of MRI labeling and safety information, the following analyses and bench tests were performed on the Subject Devices:

- > Magnetic Field Interaction Evaluation at 3-Tesla (ASTM F2052-06)
- Qualitative Torque Assessment (ASTM F2213-06) >
- > MRI related Heating Assessment at 1.5-Resla and 3-Tesla (ASTM F2182-11)
- > Artifact Assessment at 3-Tesla (ASTM F2119-07)

#### VII. Conclusions drawn from the non-clinical Tests

Results of the MRI testing have demonstrated that the ARTISAN™ Space Maintenance System can be classified as MR-Conditional in 1.5 and 3 Tesla environments.

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### Public Health Service

Food and Drug Administration 10903 New Hampshire Avenue Document Control Room -WO66-G609 Silver Spring, MD 20993-0002

Mr. Lin Wu Regulatory Affairs Specialist Medtronic Sofamor Danek USA, Inc. 1800 Pyramid Place Memphis, Tennessee 38132

MAY 3 0 2012

Re: K120271

Trade/Device Name: ARTISAN™ SPACE MAINTENANCE SYSTEM Regulation Number: 21 CFR 872.4760 Regulation Name: Bone Plate Regulatory Class: II Product Code: JEY, DZE Dated: May 24, 2012 Received: May 24, 2012

Dear Mr. Wu: -

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. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you, however, that device labeling must be truthful and not misleading.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to 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. Wu

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); medical device reporting (reporting of medical device-related adverse events) (21 CFR 803); 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.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please go to http://www.fda.gov/AboutFDA/CentersOffices/CDRH/CDRHOffices /ucm115809.htm for the Center for Devices and Radiological Health's (CDRH's) Office of Compliance. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to http://www.fda.gov/MedicalDevices/Safety/ReportaProblem/default.htm for the CDRH's Office of Surveillance and Biometrics/Division of Postmarket Surveillance.

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/MedicalDevices/Resourcesfor You/Industry/default.htm.

Sincerely yours,

Anthony D. Owens

Anthony D. Watson, B.S., M.S., M.S., M.B.A. 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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### 510(k) Number (if known):

# Device Name: ARTISAN™ SPACE MAINTENANCE SYSTEM

### INDICATIONS FOR USE:

The ARTISAN™ Space Maintenance System is indicated for use as temporary implants to stabilize and support autograft extenders, allograft, and bone void fillers and/or fractured bone segments with or without bone plates or titanium mesh in bony defects of oral maxillofacial anatomy.

The ARTISAN™ Space Maintenance System is intended for temporary use in oral maxillofacial surgical reconstruction and dental regeneration procedures for maintaining space during bone grafting procedures and to support soft tissue until bone formation.

Prescription Use × (Part 21 CFR 801 Subpart D) AND/OR

Over-The-Counter Use (21 CFR Subpart C)

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Susa Russer

(Division Sign-Off) Division of Anesthesiology, General Hospital Infection Control, Dental Devices

510(k) Number: K120627

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