HYDROGUM

K974704 · Zhermack S.P.A. · ELW · Jan 29, 1998 · Dental

Device Facts

• Record ID: K974704
• Device Name: HYDROGUM
• Applicant: Zhermack S.P.A.
• Product Code: ELW · Dental
• Decision Date: Jan 29, 1998
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 872.3660
• Device Class: Class 2

Intended Use

Hydrogum is an alginate dental impression material that is intended to be used to make dental impressions. The resulting impressions are used to make plaster models of the teeth.

Device Story

Hydrogum is an alginate-based dental impression material. It is used by dental professionals in a clinical setting to capture the anatomical structure of a patient's teeth and oral cavity. The material is mixed and placed into an impression tray, which is then inserted into the patient's mouth to set. Once set, the impression is removed and used as a negative mold to cast plaster models of the teeth. These models serve as diagnostic or restorative aids for the clinician. The device facilitates the creation of accurate physical replicas of the patient's dentition for treatment planning and prosthetic fabrication.

Clinical Evidence

No clinical data provided; bench testing only.

Technological Characteristics

Alginate-based dental impression material. Formulated for manual mixing and setting to create physical dental impressions. No electronic, software, or active components.

Indications for Use

Indicated for use as an alginate dental impression material to create dental impressions for the fabrication of plaster dental models.

Regulatory Classification

Identification

Impression material is a device composed of materials such as alginate or polysulfide intended to be placed on a preformed impression tray and used to reproduce the structure of a patient's teeth and gums. The device is intended to provide models for study and for production of restorative prosthetic devices, such as gold inlays and dentures.

Special Controls

*Classification.* Class II (Special Controls).

Submission Summary (Full Text)

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Public Health Service

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

FEB - 9 2005

Zhermack S.P.A. C/O Mr. Gerald Shipps Regulatory Affairs Consultant Cascades Device Consulting Associates 19379 Blue Lake Loop Bend, Oregon 97702

Re: K974704 Trade/Device Name: Hydrogum Regulatory Class: II Product Code: ELW Dated: December 16, 1997 Received: December 16, 1997

Dear Mr. Shipps:

This letter corrects our substantially equivalent letter of January 29, 1998 regarding the Indications for Use form.

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 (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 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. Shipps

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 continue 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 vours.

Clue

Chiu Lin, Ph.D. 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 STATEMENT

510(k) Number:

K974704

Device Name:

Hydrogum

Indications For Use:

Hydrogum is an alginate dental impression material that is intended to be used to make dental impressions.

The resulting impressions are used to make plaster models of the teeth.

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Concurrence of CDRH, Office of Device Evaluation (ODE) 20000 (Division Sign-Off) Division of Dental, Infection Control, and General Hospit 12 VC 510(k) Number Prescription Use, OR Over-The-Counter Use (per 21 CFR 801.109) (Optional Formst 1-2-96)