The High Retention Attachment System is designed to support fixed, partial or full arch restorations on endosseous dental implants in the mandible or maxilla for the purpose of restory function. It is used in fixed hybrid restorations that can be attached with a snap-in system.
Device Story
System provides rigid connection of fixed/detachable hybrid dentures to endosseous dental implants; consists of titanium alloy abutments (TiN coated), attachment housings, PEEK inserts, and seating/removal tools. Used in dental clinics by clinicians. Abutments connect to specific OEM implants; accommodates path of insertion divergence up to 20° per implant and 40° between implants. Snap-in mechanism secures prosthesis to abutment. Output is mechanical retention of dental restoration; aids in restoring masticatory function for patients with dental implants.
Clinical Evidence
No clinical data. Bench testing only. Fatigue testing per ISO 14801:2016 and MR safety assessment (displacement force/torque) leveraged from previous submissions (K120198, K203701, K213391).
Technological Characteristics
Abutments: Ti-6Al-4V ELI titanium alloy (ASTM F136) with TiN coating. Retention component: PEEK insert. Interface: Conical, External Hex, Internal Hex, Internal Multi Lobe. Divergence allowance: 20°/40°. Supplied non-sterile.
Indications for Use
Indicated for patients requiring fixed, partial, or full arch restorations on endosseous dental implants in the mandible or maxilla to restore masticatory function using a snap-in attachment system.
Regulatory Classification
Identification
An endosseous dental implant abutment is a premanufactured prosthetic component directly connected to the endosseous dental implant and is intended for use as an aid in prosthetic rehabilitation.
Special Controls
*Classification.* Class II (special controls). The guidance document entitled “Class II Special Controls Guidance Document: Root-Form Endosseous Dental Implants and Endosseous Dental Implant Abutments” will serve as the special control. (See § 872.1(e) for the availability of this guidance document.)
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Zest Anchors, LLC Richard Hines Regulatory Affairs Manager 2875 Loker East Carlsbad, California 92026
Re: K220252
Trade/Device Name: High Retention Attachment System Regulation Number: 21 CFR 872.3630 Regulation Name: Endosseous Dental Implant Abutment Regulatory Class: Class II Product Code: NHA Dated: March 24, 2022 Received: March 28, 2022
Dear Richard Hines:
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.
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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); 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 medical devices and radiation-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.
Andrew I. Steen Assistant Director DHT1B: Division of Dental and ENT Devices OHT1: Office of Ophthalmic, Anesthesia, Respiratory, ENT and Dental Devices Office of Product Evaluation and Ouality Center for Devices and Radiological Health
Enclosure
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# Indications for Use
510(k) Number (if known)
## K220252
Device Name
### High Retention Attachment System
## Indications for Use (Describe)
The High Retention Attachment System is designed to support fixed, partial or full arch restorations on endosseous dental implants in the mandible or maxilla for the purpose of restory function. It is used in fixed hybrid restorations that can be attached with a snap-in system. The High Retention Attachment System is compatible with the following implants:
| Implant Manufacturer | Implant System | Implant Diameter |
|-----------------------|-------------------------------------------------------------|--------------------------------------------------|
| Ace Surgical | Infinity OCTAGON | 3.3, 4.1, 4.8 |
| | Infinity TRI-CAM | 3.5, 4.3, 5.0 |
| | Infinity Internal Hex | 3.7, 4.1, 4.7, 5.1 |
| BioHorizons | Tapered Internal | 3.0 |
| | Tapered Plus | 3.8 |
| | Laser-Lok | 3.0 |
| Biomet 3i | 3iT3, NanoTite, OSSEOTITE | 3.25, 3.75, 4.0 |
| Blue Sky Bio | Quattro | 3.3, 4.1, 4.8 |
| | One Stage | 3.3, 4.1, 4.8 |
| Camlog | SCREW-LINE ROOT-LINE 2 | 3.3, 3.8, 4.3, 5.0 |
| | SCREW-LINE | 3.3, 3.8, 4.3, 5.0 |
| Dentsply | Astra Tech OsseoSpeed EV | 3.6, 4.2, 4.8 |
| | Xive Frialit-2 | 3.4, 3.8, 4.5, 5.5 |
| | Ankylos C/X | 3.5 |
| | Astra Tech OsseoSpeed TX | 3.5, 4.0, 4.5, 5.0 |
| Hiossen, Inc. | SS | 3.5, 4.0, 4.5 |
| | ET, TS | 3.5, 4.0, 4.5, 5.0, 6.0, 7.0 |
| | US | 3.5, 3.3, 4.5, 4.0, 5.0, 6.0, 7.0 |
| Implant Direct | Swish Plus | 4.1, 4.8 |
| | SwishTapered | 4.1, 4.8 |
| | InterActive | 3.2, 3.7, 4.3, 5.0 |
| | ReActive | 3.7, 4.2, 4.7, 5.7 |
| | RePlant | 3.5, 4.3, 5.0 |
| | Legacy 1, 2, 3, 4 | 3.7, 4.2 |
| | Legacy 2, 3, 4 | 3.2, 4.7, 5.2 |
| | Legacy 1, 3 | 5.7 |
| | Legacy 2, 4 | 5.7, 7.0 |
| | Legacy 1 | 4.7 |
| IDS | MegaGen Any Ridge | 3.5, 4.0, 4.5, 5.0, 5.5, 6.0, 6.5, 7.0, 7.5, 8.0 |
| Keystone | PrimaConnex | 3.5, 4.1, 5.0 |
| | Genesis | 3.5 |
| | TILOBEMAXX | 7.0, 8.0, 9.0 |
| MIS | C1 | 3.3, 3.75, 4.2 |
| | V3 | 3.3, 3.9, 4.3, 5.0 |
| | SEVEN | 3.3 |
| | M4 | 3.3 |
| Nobel | Replace, Replace Select, Nobel Speedy | 3.5, 4.3, 5.0 |
| | NobelActive, NobelParallel CC, NobelReplace CC | 3.5, 4.3, 5.5 |
| | Branemark, Nobel Speedy, Groovy | 3.3, 3.75, 4.0, 5.0 |
| OCO Biomedical | Engage | 3.25, 4.0, 5.0 |
| Southern Implants | Tri-Nex | 3.5, 4.3, 5.0 |
| | Tri-MAX7 | 7.0 |
| Straumann | Roxolid SLActive, Roxolid SLA | 3.3, 4.1, 4.8 |
| Zest Dental Solutions | Locator Overdenture Implant System | 2.4, 2.9, 3.5, 3.9, 4.4, 4.9 |
| Zimmer Dental | Trabecular Metal, Tapered Screw-Vent, Screw-Vent,<br>Advent | 3.7, 4.1, 4.7, 6.0 |
| | Spline Reliance Cylinder | 3.25, 4.0, 5.0 |
| | Spline Twist | 3.75 |
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Type of Use (Select one or both, as applicable)
> Prescription Use (Part 21 CFR 801 Subpart D)
__ Over-The-Counter Use (21 CFR 801 Subpart C)
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Image /page/4/Picture/0 description: The image shows the logo for Zest Dental Solutions. The logo has the letters "ZD" in a bold, teal font on the left side. To the right of the letters, the words "ZEST DENTAL" are written in a bold, dark teal font, with the word "SOLUTIONS" written in a lighter teal font below it. The logo is simple and modern, and the colors are clean and professional.
# 510(K) Summary – K220252 High Retention Attachment System
#### i. General Information on Submitter
| Applicant: | Zest Anchors, LLC |
|-----------------------------|---------------------------------------------------|
| Address: | 2875 Loker Avenue, East<br>Carlsbad, CA 92010 USA |
| Telephone: | 442-244-4835, ext. 480 |
| Cellphone: | 949-395-8795 |
| Contact Person: | Richard Hines |
| Contact Title: | Regulatory Affairs Manager |
| Email: | richard.hines@zestdent.com |
| Date Prepared: | April 13, 2022 |
| Establishment Registration: | 3006796211 |
#### ii. General Information on Device
| Proprietary Name: | High Retention Attachment System |
|----------------------|---------------------------------------------------------|
| Common Name: | Dental Implant Abutment |
| Classification Name: | Endosseous dental implant abutment<br>(21 CFR 872.3630) |
| Regulatory Class: | II |
| Product Code: | NHA (Abutment, Implant, Dental, Endosseous) |
- iii. Predicate Device
| Predicate Device | 510(k) Number |
|-------------------------------------------------------|---------------|
| High Retention Attachment System: Zest Anchors, LLC | K213391 |
| Reference Devices | 510(k) Number |
| Locator Overdenture Implant System, Zest Anchors, LLC | K120198 |
| Locator Overdenture Implant System, Zest Anchors, LLC | K203701 |
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Image /page/5/Picture/0 description: The image shows the logo for Zest Dental Solutions. The logo has the letters "ZD" on the left side in a blue gradient color. To the right of the letters is the text "ZEST DENTAL" in a bold, sans-serif font, with the word "SOLUTIONS" underneath in a smaller font.
#### iv. Description of Device
The High Retention Attachment System is a system that provides rigid connection of fixed, partial, and full arch restorations (fixed/detachable hybrid dentures) to endosseous dental implants. It consists of abutments, attachment housings, inserts and seating and removal tools. The abutments are provided in various cuff heights with the implant and abutment connection specific to the Zest Anchors, LLC or OEM implant. The subject device abutments are made of titanium alloy conforming to ASTM F136 Standard Specification for Wrought Titanium-6Aluminum-4Vanadium ELI (Extra Low Interstitial) Alloy for Surgical Implant Applications (UNS R56401) and are TiN (titanium nitride) coated.
The High Retention Attachment System is as provided with an abutment (LOCATOR Attachment) and the surgical instrumentation necessary to place the implant.
The High Retention Attachment System is designed to accommodate a path of insertion diverqence of up to 20° per implant and no more than 40° of divergence between implants.
The abutments are identical to the High Retention Attachment System devices cleared in the predicate. K213391, with the main difference being an additional implant system compatibility. The additional compatible implant system, Zest Anchors, LLC's Locator Overdenture Implant (LODI) implants, were previously cleared in K120198 and K203701 and are included as reference devices, in the K220252 submission.
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Image /page/6/Picture/0 description: The image is a logo for Zest Dental Solutions. The logo features the letters "ZD" in a bold, blue font on the left side. To the right of the letters, the words "ZEST DENTAL" are written in a dark blue, sans-serif font. Below "ZEST DENTAL", the word "SOLUTIONS" is written in a smaller, light blue font.
#### Indication for Use V.
The High Retention System is designed to support fixed, partial or full arch restorations on endosseous dental implants in the mandible or maxilla for the purpose of restoring masticatory function. It is used in fixed hybrid restorations that can be attached with a snap-in system. The High Retention Attachment System is compatible with the following implants:
| Implant Manufacturer | Implant System | Implant Diameter |
|-----------------------|--------------------------------------------------------------|--------------------------------------------------|
| Ace Surgical | Infinity OCTAGON | 3.3, 4.1, 4.8 |
| | Infinity TRI-CAM | 3.5, 4.3, 5.0 |
| | Infinity Internal Hex | 3.7, 4.1, 4.7, 5.1 |
| BioHorizons | Tapered Internal | 3.0 |
| | Tapered Plus | 3.8 |
| | Laser-Lok | 3.0 |
| Biomet 3i | 3iT3, NanoTite, OSSEOTITE | 3.25, 3.75, 4.0 |
| Blue Sky Bio | Quattro | 3.3, 4.1, 4.8 |
| | One Stage | 3.3, 4.1, 4.8 |
| Camlog | SCREW-LINE ROOT-LINE 2 | 3.3, 3.8, 4.3, 5.0 |
| | SCREW-LINE | 3.3, 3.8, 4.3, 5.0 |
| Dentsply | Astra Tech OsseoSpeed EV | 3.6, 4.2, 4.8 |
| | Xive Frialit-2 | 3.4, 3.8, 4.5, 5.5 |
| | Ankylos C/X | 3.5 |
| | Astra Tech OsseoSpeed TX | 3.5, 4.0, 4.5, 5.0 |
| Hiossen, Inc. | SS | 3.5, 4.0, 4.5 |
| | ET, TS | 3.5, 4.0, 4.5, 5.0, 6.0, 7.0 |
| | US | 3.5, 3.3, 4.5, 4.0, 5.0, 6.0, 7.0 |
| Implant Direct | Swish Plus | 4.1, 4.8 |
| | SwishTapered | 4.1, 4.8 |
| | InterActive | 3.2, 3.7, 4.3, 5.0 |
| | ReActive | 3.7, 4.2, 4.7, 5.7 |
| | RePlant | 3.5, 4.3, 5.0 |
| | Legacy 1, 2, 3, 4 | 3.7, 4.2 |
| | Legacy 2, 3, 4 | 3.2, 4.7, 5.2 |
| | Legacy 1, 3 | 5.7 |
| | Legacy 2, 4 | 5.7, 7.0 |
| | Legacy 1 | 4.7 |
| IDS | MegaGen Any Ridge | 3.5, 4.0, 4.5, 5.0, 5.5, 6.0, 6.5, 7.0, 7.5, 8.0 |
| Keystone | PrimaConnex | 3.5, 4.1, 5.0 |
| | Genesis | 3.5 |
| | TILOBEMAXX | 7.0, 8.0, 9.0 |
| MIS | C1 | 3.3, 3.75, 4.2 |
| | V3 | 3.3, 3.9, 4.3, 5.0 |
| | SEVEN | 3.3 |
| | M4 | 3.3 |
| Nobel | Replace, Replace Select, NobelSpeedy | 3.5, 4.3, 5.0 |
| | NobelActive, NobelParallel CC, NobelReplace CC | 3.5, 4.3, 5.5 |
| | Branemark, Nobel Speedy, Groovy | 3.3, 3.75, 4.0, 5.0 |
| OCO Biomedical | Engage | 3.25, 4.0, 5.0 |
| Southern Implants | Tri-Nex | 3.5, 4.3, 5.0 |
| | Tri-MAX7 | 7.0 |
| Straumann | Roxolid SLActive, Roxolid SLA | 3.3, 4.1, 4.8 |
| Zest Dental Solutions | Locator Overdenture Implant System | 2.4, 2.9, 3.5, 3.9, 4.4, 4.9 |
| Zimmer Dental | Trabecular Metal, Tapered Screw-Vent, Screw-<br>Vent, Advent | 3.7, 4.1, 4.7, 6.0 |
| | Spline Reliance Cylinder | 3.25, 4.0, 5.0 |
| | Spline Twist | 3.75 |
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Image /page/7/Picture/0 description: The image contains the logo for Zest Dental Solutions. The logo features the letters "ZD" in a bold, blue font on the left side. To the right of the letters, the words "ZEST DENTAL" are stacked on top of the word "SOLUTIONS" in a smaller, blue font. The logo is simple and professional, and it is likely used to represent the company's brand.
#### vi. Predicate Device Comparison
The following table compares the Indications for Use and key technological
characteristics of the subject and predicate device:
| Characteristic<br>/ Feature | High Retention<br>Attachment System<br>(Subject Device) | High Retention<br>Attachment<br>System<br>(Predicate Device<br>- K213391) | Locator<br>Overdenture<br>Implant System<br>(Reference<br>Device #1 -<br>K120198) | The Locator<br>Overdenture<br>Implant System<br>(Reference<br>Device #2 -<br>K203701) | Comparison |
|--------------------------------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Reason for<br>predicate or<br>reference | n/a | Indications, function,<br>material of insert,<br>mechanical (retention)<br>performance | Design of implant added to compatibility table | | Predicate is unchanged and<br>reference device is added to<br>cleared compatibility table |
| Indication<br>for use | Locator High<br>Retention<br>Attachment System<br>is designed to<br>support fixed, partial<br>or full arch<br>restorations on<br>endosseous dental<br>implants in the<br>mandible or maxilla<br>for the purpose of<br>restoring masticatory<br>function. It is used in<br>fixed hybrid<br>restorations that can<br>be attached with a<br>snap-in system. | High Retention<br>Attachment System is<br>designed to support<br>fixed, partial or full arch<br>restorations on<br>endosseous dental<br>implants in the mandible<br>or maxilla for the purpose<br>of restoring masticatory<br>function. It is used in<br>fixed hybrid restorations<br>that can be attached with<br>a snap-in system. | Locator<br>Overdenture<br>Implant System is<br>designed to retain<br>overdentures or<br>partial dentures in<br>the mandible or<br>maxilla. | The Locator<br>Overdenture<br>Implant System is<br>designed to retain<br>overdentures or<br>partial dentures in<br>the mandible or<br>maxilla.<br>Immediate loading is<br>indicated when good<br>primary stability has<br>been achieved and with<br>appropriate occlusal<br>loading. | Similar:<br>The subject and the primary<br>predicate K223391 have identical<br>indications for use, with the<br>exception of an additional implant<br>system compatibility for the subject<br>devices.<br>The additional compatible implant<br>system, Zest Anchors, LLC's<br>Locator Overdenture Implant<br>(LODI) implants, were previously<br>cleared in K120198 and K203701,<br>and are included as reference<br>devices. |
| FDA<br>Product<br>Code | NHA (Abutment, Implant,<br>Dental, Endosseous) 21 CFR<br>872.3630 | NHA (Abutment,<br>Implant, Dental,<br>Endosseous) 21<br>CFR 872.3630 | DZE (Implant,<br>Endossesous,<br>Root-Form) 21<br>CFR 872.3640 | DZE (Implant,<br>Endossesous, Root-<br>Form) 21 CFR<br>872.3640 | Substantially Equivalent:<br>The subject device have<br>demonstrated substantial<br>equivalence to the primary<br>predicate device, K213391, in that<br>they utilize identical materials,<br>fundamental designs, intended<br>use and principles of operation.<br>The reference devices, K120198<br>and K203701, are only included<br>as reference devices for additional<br>implant system compatibilities. |
| | | | DESIGN | | |
| Abutment<br>platform<br>diameter | 2.3 mm to 7.0 mm,<br>multiple systems | 2.3 mm to 7.0<br>mm, multiple<br>systems | N/A | N/A | Substantially Equivalent.<br>Predicate and subject<br>abutment platform<br>diameters are identical. |
| Abutment<br>angle | Straight | Straight | N/A | N/A | Substantially Equivalent.<br>Predicate and subject abutment<br>angles are identical |
| Abutment /<br>implant<br>interface | Conical, External Hex,<br>Internal Hex, Internal<br>Multi Lobe | Conical,<br>External Hex,<br>Internal Hex,<br>Internal Multi<br>Lobe | External Hex | External Hex | Substantially Equivalent.<br>Predicate and subject device<br>abutment/implant interfaces are<br>identical. |
| | | | | | |
| Divergence<br>Allowance | 20°/40° (except when<br>not allowed by the<br>implant manufacturer) | 20°/40° (except<br>when not allowed<br>by the implant<br>manufacturer) | N/A | N/A | Substantially Equivalent.<br>Divergence allowance is<br>unchanged from the predicate<br>device. |
| Prosthesis<br>attachment<br>type | PEEK insert retained<br>in denture attachment<br>housing | PEEK insert<br>retained in<br>denture<br>attachment<br>housing | N/A | N/A | Substantially Equivalent.<br>Predicate and subject device<br>prosthesis attachment type are<br>identical. |
| Materials | | | | | |
| Abutment<br>or Implant<br>Material | Abutment: Ti-6AI-4V<br>ELI | Abutment: Ti-<br>6AI-4V ELI | Implant: Ti<br>6AI-4V ELI | Implant: Ti<br>6AI-4V ELI | Substantially Equivalent.<br>both the abutment and the<br>implants in the subject,<br>predicate, and reference<br>devices are made from the<br>same titanium alloy (Ti-6Al-<br>4V ELI). |
| Device<br>Material<br>Surface<br>Treatment | Abutment: TiN | Abutment: TiN | Implant:<br>Resorbable<br>Blast Media<br>(RBM) using<br>MCD Apatatic<br>Abrasive | Implant:<br>Resorbable<br>Blast Media<br>(RBM) using<br>MCD Apatatic<br>Abrasive | Substantially Equivalent.<br>Predicate and subject device use<br>identical surface treatment<br>process. |
| Prosthetic<br>retention<br>component | PEEK | PEEK | N/A | N/A | Substantially Equivalent.<br>Predicate and subject device<br>retention components are<br>identical. |
| Reference<br>Implant<br>Size | N/A | N/A | 2.4mm, 2.9mm | 3.5mm, 3.9mm,<br>4.4mm, 4.9mm | Reference Devices are cleared<br>for implants of 2.4mm to 4.9mm<br>in diameter |
| Sterilization | | | | | |
| Sterile | No | No | Yes | Yes | Substantially Equivalent.<br>Predicate and subject device are<br>both supplied non-sterile. |
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Image /page/8/Picture/0 description: The image shows the logo for Zest Dental Solutions. The logo has the letters "ZD" in a bold, blue font on the left side. To the right of the letters are the words "ZEST DENTAL" in a smaller, blue font, with the word "SOLUTIONS" underneath in a lighter blue. The logo is simple and modern, and the use of blue gives it a professional and trustworthy feel.
As noted in the table above, the subject and predicate devices are identical. Fatigue testing according to ISO 14801: 2016 was performed for Zest Anchors, LLC's Locator Overdenture Implant (LODI) implants (K120198/K203701) and leveraged to support modifications to the K213391 compatibility table.
#### Summary of Non-Clinical Performance Testing vii.
No new testing was performed as a part of this submission for the determination of substantial equivalence.
Fatigue testing, sterilization, and biocompatibility testing are all leveraged from previous submissions
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Image /page/9/Picture/0 description: The image shows the logo for Zest Dental Solutions. The logo features the letters "ZD" in a bold, blue font on the left side. To the right of the letters, the words "ZEST DENTAL" are written in a similar bold, blue font. Below "ZEST DENTAL", the word "SOLUTIONS" is written in a lighter blue color.
MR safety for the subject device system was based on the "worst-case" of the entire system including all variations (all compatible implant bodies, dental abutments, and fixation screws) and material composition. The "worst-case" assessment includes an evaluation of the High Retention Attachment System devices in the MRI environment using scientific rationale and published literature (i.e., Woods, Terry O., Jana G. Delfino, and Sunder Rajan. "Assessment of Magnetically Induced Displacement Force and Torque on Metal Alloys Used in Medical Devices." Journal of Testing and Evaluation 49.2 (2019): 783-795).
In addition, the "worst-case" MR Safety rationale addressed parameters per the FDA guidance, "Testing and Labeling Medical Devices for Safety in the Magnetic Resonance (MR) Environment," including magnetically induced displacement force and torque.
#### viii. Substantial Equivalence
The risk management activities and results of the other activities described above provide reasonable assurance that the subject devices have demonstrated substantial equivalence to the predicate devices in the that they utilize the same materials and fundamental designs and also have the same intended use and principles of operation.
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Part 2 — Embeddings: the galaxy map 3 min
1. Search: exact and fuzzy
Type a phrase like "coronary artery calcification" into the search box. You get two kinds of results. Exact results match the literal phrase — prefix searches work ("coronary artery calcificati") but suffix searches do not. Fuzzy results match on the meaning and intent of your phrase rather than the exact words, and are sorted by relevance score. Hover over the Exact or Fuzzy badge on any row to see exactly why it matched.
Use the checkboxes above the results to narrow: SaMD keeps only software-only devices, AI / ML keeps only devices with AI.
Exact vs. fuzzy search: what's the difference?
Exact matches on the literal phrase (prefix search works, suffix does not). Fuzzy matches on the meaning and intent of the phrase rather than the exact words. Hover over the badge on any row to see why it matched.
You search "coronary artery calcification" and want only software devices with AI. What two filters do you apply?
Narrow by SaMD (software-only devices), then narrow by AI/ML (devices with AI).
2. The results table
Scroll right in the results table. The intended use is extracted for you — no need to open the PDF. The device story gives a high-level snapshot of what the device does and how it's used. The AI Performance sub-table shows each output name, acceptance criteria, observed values, and development/test dataset descriptions — the same format Innolitics uses for regulatory strategy outputs, and the fastest high-level fingerprint of an AI device. It is AI-generated but has been very reliable in practice.
Where do you find a device's intended use without opening the PDF?
Scroll right in the search results table. The intended use column is extracted for you; no need to dig into the 510(k) summary PDF.
What does the AI Performance sub-table show, and why is it useful?
Output name, acceptance criteria, observed values, development dataset description, and test dataset description. It's the same format we use for regulatory strategy output and Fast 510(k) input, and the fastest high-level fingerprint of an AI device. AI-generated but reliable in practice.
3. Judging fuzzy relevance
Fuzzy results trail off in relevance as you scroll. Use three signals to decide how far down to go: the fuzzy badge explanations, the intended use column, and whether your target output (e.g., Cobb angle) still appears in the AI Performance sub-table. Once it stops appearing, you're past the relevant zone. A top hit with a low score (~0.4) and a stretched explanation is a hint the closest predicates are far away — the project may be headed for De Novo. Note the fuzzy search is a pattern match: it doesn't handle negation ("not") well, and hardware devices can appear — filter by SaMD/AI ML to cut them.
How do you judge how far down fuzzy search results to go?
Use the relevancy signals: the fuzzy badge explanations, the intended use column, and whether the target output (e.g., Cobb angle) still appears in the AI Performance sub-table. Once it stops appearing, results are trailing off in relevancy.
4. Device detail page: chat and citations
Click a device name to open its detail page: device facts on the left, a chat window on the right. Ask something like "Describe the training data". The answer carries little citation bubbles — click one to jump to the highlighted passage in the source PDF, so you can verify every AI answer against the document. There's also a Download PDF button for sharing.
How do you verify an AI chat answer on the device detail page?
Click the citation bubbles to jump to the relevant highlight in the source document.
Reading rule for every project: how many summaries do you read in full?
At least the three most relevant 510(k) or De Novo summaries, in full. After that, use targeted chat questions to confirm your memory quickly. The tool supports this professional habit — it doesn't replace it.
5. Side-by-side comparison
Select multiple rows in the results table (aim for under ~10), then open the PDF Viewer tab. Ask one question — it goes to all selected devices in parallel, each with citations. This is the fastest way to compare and contrast devices: training data, PCCP scope, how they handled adding new scanners, and so on.
What does the side-by-side PDF viewer mode do?
Select multiple devices, open the PDF viewer tab, and ask one question (e.g., "Describe the training data"). It queries all selected devices simultaneously with citations, so you can compare and contrast quickly.
6. Collections
With rows selected, go to the Collections tab and create a labeled collection (e.g., "Cobb Angle Project"). Reload that selection any time — before a client call, pull up the collection and ask questions across all of its devices at once.
How do you save a set of selected devices for later use?
Select the rows, go to the Collections tab, and create a labeled collection (e.g., "Cobb Angle Project"). You can reload the selection anytime and carry it into the PDF viewer and other tabs that support selections.
7. Product codes and the regulations tree
Click a product code in the results to jump to it in the regulations tree — identification text, sibling product codes, and devices you can open in a PDF viewer on the right. Click a regulation number to see its identification, special controls, and related product codes. You can also search by product code or regulation number at the top of the tree. Always read the special controls if any exist for your device — it broadens your search and sharpens pre-kickoff research.
What can you do from the regulations tree view?
Browse product codes and regulation numbers, read the identification text and special controls, browse sibling product codes, open device PDFs on the right, and search by product code or regulation number at the top of the tree.
8. Chart view
Click Show Chart and segment by regulation number (or product code) to see which regulations dominate your result set. Clicking a regulation takes you into the regulations tree. Great for spotting that most matches are, say, hardware laparoscopic devices — a cue to go back and filter.
How do you see which regulations dominate a search result set?
Click "Show Chart" and segment by Regulation Number. Clicking a regulation takes you to the regulations tree.
9. The predicate graph
Open the Predicates tab for a family-tree view of predicate relationships. Click a node to trace its parents and children; selections from search carry over pre-selected. Commonly predicated devices are worth reading — a lot of people predicated them for a reason. The visual lineage is also handy on client calls, e.g. to show how a predicate family evolved and justify why your predicate still holds.
In the predicate graph, why are commonly predicated devices worth reading?
A lot of people predicated them for a reason. Clicking a node traces parents and children, and selections from search carry over pre-selected.
10. Embeddings: the galaxy map
The Embeddings tab plots every matching document in a 2-D "galaxy map" where semantically similar devices cluster together. Hover or click clusters to explore, and let AI label the clusters for you. Embeddings beat product codes for grouping: two devices can carry different product codes (LLZ vs. QIH) yet do the same thing — the embedding captures the meaning of the intended use and device story. This is also exactly how retrieval-augmented generation (RAG) works under the hood, and it makes a great visual on client calls.
Try it yourself
Head to the search page and work through a few of these AI/ML fuzzy searches to build intuition: perivascular fat on CT · aortic valve calcification opportunistic screening on noncontrast CT · breast cancer prediction on digital pathology slides · autism detection · gestational age prediction · a hearing aid that can also detect a pulse · foundation model based analysis of ECG · large language models · penetration test. Watch how the relevance scores, intended use, and AI Performance tables tell you when results stop being meaningful.