FINAL VARNISH LC

K030844 · Voco GmbH · KLE · Jun 13, 2003 · Dental

Device Facts

• Record ID: K030844
• Device Name: FINAL VARNISH LC
• Applicant: Voco GmbH
• Product Code: KLE · Dental
• Decision Date: Jun 13, 2003
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 872.3200
• Device Class: Class 2
• Attributes: Therapeutic

Indications for Use

Protection of glass ionomer cement surfaces against both humidity and drying immediately after placing the filling Sealing and smoothing of glass ionomer cement surfaces after polishing Sealing of cervical margin of cementations immediately after removal of excess

Device Story

Final Varnish LC is a light-cured resin-based dental material used by dentists in clinical settings. It functions as a protective sealant for glass ionomer cement surfaces. Applied immediately after filling placement or polishing, it prevents moisture contamination or dehydration of the cement. It also seals cervical margins following excess removal. The device is applied topically to the dental restoration and cured via light activation to form a protective barrier, enhancing the longevity and surface finish of the glass ionomer restoration.

Clinical Evidence

No clinical data provided; bench testing only.

Technological Characteristics

Resin-based dental bonding agent; light-cured; intended for surface sealing and protection of glass ionomer cements. Class II device (Product Code: KLE).

Indications for Use

Indicated for protection of glass ionomer cement surfaces from humidity/drying post-placement, sealing/smoothing of glass ionomer surfaces post-polishing, and sealing cervical margins of cementations post-excess removal.

Regulatory Classification

Identification

A resin tooth bonding agent is a device material, such as methylmethacrylate, intended to be painted on the interior of a prepared cavity of a tooth to improve retention of a restoration, such as a filling.

Submission Summary (Full Text)

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Image /page/0/Picture/1 description: The image shows the seal of the Department of Health & Human Services (HHS). The seal features a stylized eagle with three lines forming its body and wings. The words "DEPARTMENT OF HEALTH & HUMAN SERVICES • USA" are arranged in a circular pattern around the eagle. The seal is black and white.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

JUN 1 3 2003

Voco GmbH C/O Gerald Shipps Cascades Device Consulting Associates 19379 Blue Lake Loop Bend, Oregon 97702

Re: K030844

Trade/Device Name: Final Varnish LC Regulation Number: 872.3200 Regulation Name: Resin Tooth Bonding Agent Regulatory Class: II Product Code: KLE Dated: March 14, 2003 Received: March 17, 2003

Dear Mr. Shipps:

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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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 vours.

Susan Runoer

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

Enclosure

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## Indications for Use Statement

i10(k) Number: _ 长0 30844

Device Name: Final Varnish LC_________________________________________________________________________________________________________________________________________________

Indications for Use:

Protection of glass ionomer cement surfaces against both humidity and drying immediately after placing the filling

Sealing and smoothing of glass ionomer cement surfaces after polishing

Sealing of cervical margin of cementations immediately after removal of excess

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

| Prescription Use | X |
|----------------------|---|
| OR | |
| Over-The-Counter Use | |

Ken Muly for MsR

(Division Sign-Off)

Division of Anesthesiology, General Hospital, Infection Control, Dental Devices

| 510(k) Number: | K030844 |
|----------------|---------|
|----------------|---------|

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