Who is the manufacturer of DeltaFil, DeltaFil Conditioner?

DMG Chemisch-Pharmazeutische Fabrik GmbH filed the 510(k) submission for DeltaFil, DeltaFil Conditioner (K213201).

What is the FDA product code for DeltaFil, DeltaFil Conditioner?

EMA. It is classified under 21 CFR 872.3275 as a Class 2 device in the Dental panel.

What is the regulatory pathway for DeltaFil, DeltaFil Conditioner?

510(k) clearance (submission type: Traditional).

What are the predicate devices for DeltaFil, DeltaFil Conditioner?

Fuji IX GP (K961448); Ketac Conditioner (K872984).

Who can help prepare an FDA 510(k) submission like DeltaFil, DeltaFil Conditioner?

Innolitics — a medical-device software consultancy — provides regulatory and engineering support for FDA 510(k) submissions. See https://innolitics.com/services/510ks/ or contact https://innolitics.com/contact.

DeltaFil, DeltaFil Conditioner

K213201 · DMG Chemisch-Pharmazeutische Fabrik GmbH · EMA · Jun 1, 2022 · Dental

Device Facts

Record ID	K213201
Device Name	DeltaFil, DeltaFil Conditioner
Applicant	DMG Chemisch-Pharmazeutische Fabrik GmbH
Product Code	EMA · Dental
Decision Date	Jun 1, 2022
Decision	SESE
Submission Type	Traditional
Regulation	21 CFR 872.3275
Device Class	Class 2
Attributes	Therapeutic, Pediatric

Intended Use

DeltaFil (in capsule) is used for geriative filling procedures. The procedures. The product is designed for use in final restorations of Class I, II, III, and V of deciduous teeth and as a long - term restorative in non-load bearing areas of Class I and II carious lesions. It is also used as a restorative and sandwich material for heavy stress in Class I and II cavities. DeltaFil can also be used as a core build-up material. DeltaFil Conditioner: - Treatment of the smear layer · Conditioning of the cavity

Device Story

DeltaFil is a radiopaque glass ionomer restorative material supplied in disposable capsules; used with a compatible 10% aqueous polyacrylic acid conditioner. The conditioner is applied to the prepared tooth surface to remove the smear layer and condition the cavity, improving the adhesive bond between tooth tissue and the restorative cement. The restorative material is a two-part powder/liquid glass polyalkenoate cement mixed in a standard dental capsule dispenser. Used in dental offices/clinics by dental professionals for permanent or temporary restorations. The device provides a restorative filling or core build-up, benefiting patients by restoring tooth structure and function in carious lesions or cavities. The healthcare provider applies the conditioner, then the mixed cement, to the prepared cavity.

Clinical Evidence

Bench testing only. Performance data confirmed compliance with ISO 9917-1:2007 for water-based cements, including compressive strength (≥ 180 MPa), radiopacity (200 %Al), acid erosion (≤ 0.1 mm), and acid-soluble lead content (≤ 100 ppm). Shear bond strength on dentin (4.9 ± 1.3 MPa) and enamel (13.6 ± 2.4 MPa) was evaluated. Biocompatibility was assessed per ISO 10993.

Technological Characteristics

Two-part powder/liquid glass polyalkenoate restorative cement (ISO 9917-1:2007) and 10% aqueous polyacrylic acid conditioner. Supplied in disposable 'Applicap' capsules for use with a mechanical capsule dispenser. Radiopaque. Non-sterile. No software or electrical components.

Indications for Use

Indicated for geriatric and pediatric restorative filling procedures, including final restorations of Class I, II, III, and V of deciduous teeth, long-term restoration of non-load bearing Class I and II carious lesions, heavy stress Class I and II cavities (as restorative/sandwich material), and core build-ups.

Regulatory Classification

Identification

Zinc oxide-eugenol is a device composed of zinc oxide-eugenol intended to serve as a temporary tooth filling or as a base cement to affix a temporary tooth filling, to affix dental devices such as crowns or bridges, or to be applied to a tooth to protect the tooth pulp. Dental cement other than zinc oxide-eugenol is a device composed of various materials other than zinc oxide-eugenol intended to serve as a temporary tooth filling or as a base cement to affix a temporary tooth filling, to affix dental devices such as crowns or bridges, or to be applied to a tooth to protect the tooth pulp.

Predicate Devices

Fuji IX GP (K961448)
Ketac Conditioner (K872984)

Reference Devices

DiaEtch (K192273)

Related Devices

K153174 — Ketac Universal Aplicap · 3M Deutschland GmbH · Apr 13, 2016
K973262 — KETAC-FIL APLICAP PLUS · Espe GmbH & Co. Kg. · Nov 17, 1997
K152652 — PackFil Dual Cured Resin Modified Glass Ionomer Restorative Cement · Gaia Dental Products, Inc. · Apr 5, 2016
K031467 — GLASIONOMER FX-II · Shofu Dental Corp. · Jul 17, 2003
K020376 — AHL GENERIC GLASS IONOMER AESTHETIC RESTORATIVE · Advanced Healthcare , Ltd. · Apr 9, 2002

Submission Summary (Full Text)

{0}------------------------------------------------ Image /page/0/Picture/0 description: The image shows the logo of the U.S. Food and Drug Administration (FDA). The logo consists of two parts: the Department of Health & Human Services logo on the left and the FDA text logo on the right. The text logo has the FDA acronym in a blue square, followed by the words "U.S. FOOD & DRUG ADMINISTRATION" in blue. DMG Chemisch-Pharmazeutische Fabrik GmbH Pamela Papineau Consultant Delphi Medical Device Consulting, Inc. 5 Whitcomb Ave Ayer, Massachusetts 01432 ## Re: K213201 Trade/Device Name: DeltaFil, DeltaFil Conditioner Regulation Number: 21 CFR 872.3275 Regulation Name: Dental Cement Regulatory Class: Class II Product Code: EMA Dated: April 21, 2022 Received: April 27, 2022 ## Dear Pamela Papineau: 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. Although this letter refers to your product as a device, please be aware that some cleared products may instead be combination products. The 510(k) Premarket Notification Database located at https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm identifies combination product submissions. 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. 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 {1}------------------------------------------------ 801); medical device reporting of medical device-related adverse events) (21 CFR 803) for devices or postmarketing safety reporting (21 CFR 4, Subpart B) for combination products (see https://www.fda.gov/combination-products/guidance-regulatory-information/postmarketing-safety-reportingcombination-products); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820) for devices or current good manufacturing practices (21 CFR 4. Subpart A) for combination products; and, if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to https://www.fda.gov/medical-device-safety/medical-device-reportingmdr-how-report-medical-device-problems. For comprehensive regulatory information about mediation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/medicaldevices/device-advice-comprehensive-regulatory-assistance) and CDRH Learn (https://www.fda.gov/training-and-continuing-education/cdrh-learn). Additionally, you may contact the Division of Industry and Consumer Education (DICE) to ask a question about a specific regulatory topic. See the DICE website (https://www.fda.gov/medical-device-advice-comprehensive-regulatoryassistance/contact-us-division-industry-and-consumer-education-dice) for more information or contact DICE by email (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100). Sincerely, For Michael E. Adjodha, M.ChE. Assistant Director DHT1B: Division of Dental and ENT Devices OHT1: Office of Ophthalmic, Anesthesia, Respiratory, ENT and Dental Devices Office of Product Evaluation and Quality Center for Devices and Radiological Health Enclosure {2}------------------------------------------------ # Indications for Use 510(k) Number (if known) K213201 Device Name DeltaFil, DeltaFil Conditioner #### Indications for Use (Describe) DeltaFil (in capsule) is used for geriative filling procedures. The procedures. The product is designed for use in final restorations of Class I, II, III, and V of deciduous teeth and as a long - term restorative in non-load bearing areas of Class I and II carious lesions. It is also used as a restorative and sandwich material for heavy stress in Class I and II cavities. DeltaFil can also be used as a core build-up material. DeltaFil Conditioner: - Treatment of the smear layer · Conditioning of the cavity | Type of Use (Select one or both, as applicable) | <div> <input type="checkbox"/> </div> <div> <input type="checkbox"/> </div> | |-------------------------------------------------|-----------------------------------------------------------------------------| |-------------------------------------------------|-----------------------------------------------------------------------------| > Prescription Use (Part 21 CFR 801 Subpart D) __ Over-The-Counter Use (21 CFR 801 Subpart C) #### CONTINUE ON A SEPARATE PAGE IF NEEDED. This section applies only to requirements of the Paperwork Reduction Act of 1995. #### *DO NOT SEND YOUR COMPLETED FORM TO THE PRA STAFF EMAIL ADDRESS BELOW.* The burden time for this collection of information is estimated to average 79 hours per response, including the time to review instructions, search existing data sources, gather and maintain the data needed and complete and review the collection of information. Send comments regarding this burden estimate or any other aspect of this information collection, including suggestions for reducing this burden, to: > Department of Health and Human Services Food and Drug Administration Office of Chief Information Officer Paperwork Reduction Act (PRA) Staff PRAStaff(@fda.hhs.gov "An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB number." {3}------------------------------------------------ ## K213201 ## DeltaFil 510(k) Summary (revised) | General Information | | |-------------------------|------------------------------------------------------------------------| | Preparation date: | 31 May 2022 | | Owner's Name: | DMG Chemisch-Pharmazeutische Fabrik GmbH (FDA Registration 8044164) | | Address: | Elbgaustrasse 248 22547 Hamburg Germany | | Telephone Number: | 011-49-40-84006-0 | | Fax Number: | 011-49-40-84006-222 | | Contact Person: | Stephan Schaefer | | Subject Device Name: | DeltaFil | | Trade Name: | DeltaFil, DeltaFil Conditioner | | Common/Usual Name: | Dental Cement and Conditioner | | Product Codes: | EMA | | Regulations: | 21 CFR 872.3275 (Dental Cement) | | Device Classification: | II | | Predicate Devices: | | | Trade Name: | Fuji IX GP (GC America, Inc.) | | Common/Usual Name: | Dental Cement | | Product Code: | EMA | | Regulation: | 21 CFR 872.3275 (Dental Cement) | | Device Classification: | II | | Premarket Notification: | K961448 | | Trade Name: | Ketac Conditioner (3M ESPE GmbH) | | Common/Usual Name: | Tooth Conditioner | | Product Code: | EMA | | Regulation: | 21 CFR 872.3275 (Dental Cement) | | Device Classification: | II | | Premarket Notification: | K872984 | | Reference Device: | | | Trade Name: | DiaEtch (Diadent Group International) | | Common/Usual Name: | Resin Tooth Bonding Agent | | Product Code: | KLE | | Regulation: | 21 CFR 872.3200 (Resin Tooth Bonding Agent) | | Device Classification: | II | | Premarket Notification: | K192273 | | Device Description | | DeltaFil consists of a radiopaque glass ionomer restorative material supplied in capsule form (DeltaFil in capsule), and a compatible tooth conditioner (DeltaFil Conditioner). DeltaFil Conditioner {4}------------------------------------------------ and DeltaFil (in capsule) are used together for the creation of permanent or temporary dental restorations as described in the device labelling. DeltaFil is available in Vita shades A1, A2, A3, A3.5, and A4. DeltaFil (in capsule) is a two-part powder/liguid glass polyalkenoate restorative cement as defined in ISO 9917-1:2006 Dentistry - Water-Based Cements - Part 1: powder/liquid acid-base cements. The powder and liquid components are supplied in the correct mixing ratio in disposable "Applicap" capsules for use with the DMG Applicap Dispenser. DeltaFil Conditioner is a 10% aqueous polyacrylic acid solution, which is applied to the prepared tooth surface prior to placement of the mixed DeltaFil (in capsule) material. DeltaFil Conditioner improves the adhesive bond between the tooth tissue and the restorative cement material by treating the smear layer and conditioning the prepared cavity. ## Indications for Use DeltaFil (in capsule) is used for geriatric and pediatric restorative filling procedures. The product is designed for use in final restorations of Class I, II, III, and V of deciduous teeth and as a long - term restorative in non-load bearing areas of Class I and II carious lesions. It is also used as a restorative and sandwich material for heavy stress in Class I and II cavities. DeltaFil can also be used as a core build-up material. DeltaFil Conditioner: - Treatment of the smear layer ● - . Conditioning of the cavity Substantial Equivalence / Comparison of Technical Characteristics with the Predicate Device The predicate devices are the GC Fuji IX GP cleared in K961448, and the 3M Espe Ketac Conditioner cleared in K872984. A summary comparison of the subject and predicate device systems is provided in the substantial equivalence table below. | Attribute | Proposed Device DMG DeltaFil (in capsule) (current submission) | Predicate Device GC Fuji IX GP (K961448) | Similarities and Differences | |--------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------------------------| | Common Name | Restorative Dental Cement and Tooth Conditioner | Restorative Dental Cement and Tooth Conditioner | Same | | Classification Name | Dental Cement | Dental Cement | Same | | Device Class | II | II | Same | | Regulation | 21 CFR 872.3275 | 21 CFR 872.3275 | Same | | Regulation Name | Dental Cement | Dental Cement | Same | | Product Code | EMA | EMA | Same | | Attribute | Proposed Device DMG DeltaFil (in capsule) (current submission) | Predicate Device GC Fuji IX GP (K961448) | Similarities and Differences | | Indications for Use | DeltaFil (in capsule) is used for geriatric and pediatric restorative filling procedures. The product is designed for use in final restorations of Class I, II, III, and V of deciduous teeth and as a long - term restorative in non-load bearing areas of Class I and II carious lesions. It is also used as a restorative and sandwich material for heavy stress in Class I and II cavities. DeltaFil can also be used as a core build-up material. | GC Fuji IX GP is used for geriatric and pediatric restorative filling procedures. The product is designed for use in final restorations of Class I, II, III, and V of deciduous teeth and as a long - term restorative in non-load bearing areas of Class I and II carious lesions. It is also used as an immediate restorative and sandwich material for heavy stress in Class I and II cavities. FUJI IX GP can also be used as a core build-up material. | Same | | Use Environment | Dental office/clinic | Dental office/clinic | Same | | Material Composition | Radiopaque glass ionomer cement supplied in capsules | Radiopaque glass ionomer cement supplied in capsules | Same | | Principle of Operation | DeltaFil (in capsule) is a two-part powder-liquid glass ionomer polyalkenoate restorative dental cement as defined in ISO 9917-1:2007 Dentistry – Water-Based Cements – Part 1: powder/liquid acid-base cements. DeltaFil Conditioner is applied to condition the prepared tooth surface prior to placement of the mixed DeltaFil Capsule material. | GC Fuji IX GP is a two-part powder-liquid glass ionomer polyalkenoate restorative dental cement as defined in ISO 9917-1:2007 Dentistry – Water-Based Cements – Part 1: powder/liquid acid-base cements. | Same | | Supplied in Mixing Capsules? | Yes | Yes | Same | | Capsule Dispenser Available? | Yes | Yes | Same | | Powder:Liquid Ratio | 4.96:1 | 0.40:0.11 | Similar | | Mixing Time (sec) | 10 | 10 | Same | | Attribute | Proposed Device DMG DeltaFil (in capsule) (current submission) | Predicate Device GC Fuji IX GP (K961448) | Similarities and Differences | | Working Time (min.) at 23°C, inclusive of mixing time (sec) | 120 | 120 | Same | | Net Setting Time (max.) at 37°C, exclusive of mixing time (sec) | 240 | 140 | Similar | | Compressive Strength (MPa) (after 24 hrs) | $\ge$ 180 | 220 | Similar; both meet ISO 9917-1 requirement ( $\ge$ 100 MPa) | | Radiopacity | 200 %Al | 3.7 mm | Similar; both meet ISO 9917-1 requirement (200 %Al = 2 mm) | | Acid Erosion (mm) | $\le$ 0.1 | 0.21 | Similar; DeltaFil meets ISO 9917-1 requirement ( $\le$ 0.17 mm) | | Shear Bond Strength on Dentin (MPa) (after 24 hrs) | 4.9 ± 1.3 | 5.1 ± 2.1 | Similar for samples prepared with compatible Conditioner; no applicable ISO 9917-1 requirement | | Shear Bond Strength on Enamel (MPa) (after 24 hrs) | 13.6 ± 2.4 | 11.8 ± 7.7 | Similar for samples prepared with compatible Conditioner; no applicable ISO 9917-1 requirement | | Acid Soluble Lead Content (ppm) | $\le$ 100 | unknown | Similar; DMG material meets ISO 9917-1 requirement ( $\le$ 100 ppm) | | Opacity C0,70 (%) | 0.35 – 0.9 | unknown | Similar; DMG material meets ISO 9917-1 requirement (0.35 – 0.9 %) | | Biocompatibility | ISO 10993 | ISO 10993 | Same | | Single Use / Reusable | Single Use | Single Use | Same | | Sterilization / Reprocessing Software | Non-sterile device; no reprocessing requirements Device does not contain software | Non-sterile device; no reprocessing requirements Device does not contain software | Same | | Attribute | Proposed Device DMG DeltaFil (in capsule) (current submission) | Predicate Device GC Fuji IX GP (K961448) | Similarities and Differences | | Electrical Safety & EMC | Not applicable | Not applicable | Same | ## Substantial Equivalence Comparison Table: DeltaFil (in capsules) {5}------------------------------------------------ {6}------------------------------------------------ {7}------------------------------------------------ ## Substantial Equivalence Comparison Table: DeltaFil Conditioner | | Proposed Device | Predicate Device | Similarities and | |-----------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------| | Attribute | DeltaFil Conditioner (current submission) | 3M Espe Ketac Conditioner (K872984) | Differences | | Common Name | Tooth Conditioner | Tooth Conditioner | Same | | Classification Name | Dental Cement | Dental Cement | Same | | Device Class | II | II | Same | | Regulation | 21 CFR 872.3275 | 21 CFR 872.3275 | Same | | Regulation Name | Dental Cement | Dental Cement | Same | | Product Code | EMA | EMA | Same | | Indications for Use | • Treatment of the smear layer • Conditioning of the cavity | Dentin pretreatment prior to filling with glass ionomer cement | Same | | Use Environment | Dental office/clinic | Dental office/clinic | Same | | Material Composition | 10% aqueous polyacrylic acid Blue colorant | 20 - 30% aqueous polyacrylic acid Blue colorant | Same | | Principle of Operation | DeltaFil Conditioner improves the adhesive bond between the tooth tissue and the restorative cement material by treating the smear layer and conditioning the prepared cavity. | Ketac Conditioner improves the adhesive bond between the tooth tissue and the restorative cement material by treating the smear layer and conditioning the prepared cavity. | Same | | Technological Characteristics | Mild PAA acid solution applied to the prepared tooth surface removes the smear layer, thereby improving direct contact between the restorative material and intact dentin structure. Evidence is demonstrated through increased bond strength for finished DeltaFil restorations using DeltaFil Conditioner. | Mild PAA acid solution applied to the prepared tooth surface removes the smear layer, thereby improving direct contact between the restorative material and intact dentin structure. | Same | | Shear Bond Strength on Dentin* | $4.9 \pm 1.3$ (with Conditioner) $4.4\pm 3.7$ (without Conditioner) | $5.1 \pm 2.1$ (with Conditioner*) $6.5 \pm 1.5$ (without Conditioner) | Similar | | | Proposed Device | Predicate Device | Similarities and Differences | | Attribute | DeltaFil Conditioner (current submission) | 3M Espe Ketac Conditioner (K872984) | | | Shear Bond Strength on Enamel* | $13.6 \pm 2.4$ (with Conditioner) $13.6 \pm 6.5$ (without Conditioner) | $11.8 \pm 7.7$ (with Conditioner*) $10.6 \pm 4.5$ (without Conditioner) | Similar | | Biocompatibility | ISO 10993 | ISO 10993 | Same except for blue colorant. Reference device K192273 (Diadent DiaEtch) used to confirm biological safety of methylene blue colorant. | | Single Use / Reusable | Single Use | Single Use | Same | | Sterilization / Reprocessing | Non-sterile device; no reprocessing requirements | Non-sterile device; no reprocessing requirements | Same | | Software | Device does not contain software | Device does not contain software | Same | | Electrical Safety & EMC | Not applicable | Not applicable | Same | {8}------------------------------------------------ * Predicate SBS data for GC Fuji IX GP with and without the compatible GC Cavity Conditioner ## Non-clinical Performance Testing Performance data demonstrated that DeltaFil (in capsule) and DeltaFil Conditioner meet all predetermined acceptance criteria contained in the product specification and are suitable for their intended use. The risks associated with the use of the new devices were found acceptable when evaluated in accordance with ISO 14971. Risks and benefits associated with the proposed and the predicate device are the same. Design verification and validation activities consisted of physical testing, biocompatibility evaluation, and stability (shelf life) validation. ## Comparison of Technological Characteristics with the Predicate Devices The general material type, intended use, and performance specifications of DeltaFil (in capsule) and DeltaFil Conditioner are substantially equivalent to the predicate devices, GC Fuji IX GP and 3M Espe Ketac Conditioner. DeltaFil (in capsule) and GC Fuji IX GP are two-part powder-liquid glass ionomer polyalkenoate restorative dental cement as defined in ISO 9917-1:2007 Dentistry - Water-Based Cements – Part 1: powder/liquid acid-base cements. Both DeltaFil (in capsule) and GC Fuji IX GP are supplied in capsules that are briefly mixed by the user in a standard dental capsule mixer prior to dispensing. DeltaFil Conditioner and 3M Espe Ketac Conditioner are both mild, blue-tinted aqueous solutions of polyacrylic acid intended to enhance the bond between the glass ionomer restorative cement and the tooth surface by treating the smear layer to condition the cavity. DeltaFil Conditioner is intended for use prior to the application of DeltaFil (in capsule). The Diadent DiaEtch cleared in K192273 is cited {9}------------------------------------------------ as a reference device to confirm biological safety for methlylene blue pigment used to enhance the visibility of dental cavity pretreatments. ## Conclusion The DMG Chemisch-Pharmazeutische Fabrik GmbH DeltaFil (in capsule) and DeltaFil Conditioner meet all pre-determined acceptance criteria of the testing performed to confirm substantial equivalence to the predicate devices.