Tuxedo Digital Dental Sensor

K153710 · Led Dental, Inc. · MQB · Mar 18, 2016 · Radiology

Device Facts

• Record ID: K153710
• Device Name: Tuxedo Digital Dental Sensor
• Applicant: Led Dental, Inc.
• Product Code: MQB · Radiology
• Decision Date: Mar 18, 2016
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 892.1680
• Device Class: Class 2

Intended Use

The Tuxedo Digital Dental Sensor is a CMOS sensor for the capturing of digital diagnostic x-ray images on a patient for evaluation by an appropriately trained oral healthcare professional. The Tuxedo sensor itself is a single piece comprised of the image capture components on one end, with a USB 2.0 plug on the other end. The sensor is designed to be used in conjunction with a disposable, single-use hygienic sheath as well as a positioning device to allow for proper alignment within the patient's mouth. Images are acquired with the Tuxedo sensor by plugging it into a USB port and properly placing it in the patient's mouth, while an operator exposes radiation toward the sensor from an approved intraoral x-ray generator.

Device Story

Tuxedo Digital Dental Sensor is a CMOS-based solid-state X-ray imager; captures intraoral X-ray radiation; converts radiation to visible light via scintillator; converts light to digital image via CMOS sensor. Device connects to PC/tablet via USB 2.0. Used by licensed dental practitioners in clinical settings; requires disposable hygienic sheath and positioning device. Output viewed in imaging software (e.g., LED Imaging Software). Assists practitioners in detecting dental anomalies and evaluating treatment. Benefits include immediate digital image acquisition for diagnostic assessment.

Clinical Evidence

Bench testing only. Performance evaluated via IEC standards for electrical safety (IEC 60601-1), electromagnetic compatibility (IEC 60601-1-2), and imaging performance (IEC 62220-1). Mechanical reliability (bending, pulling, dropping) and infection control (alcohol dipping) were tested. Clinical images were acquired using a DXTTR III human skull phantom to demonstrate diagnostic quality, contrast, and spatial resolution; no human clinical trials were performed.

Technological Characteristics

CMOS sensor with CsI scintillator; USB 2.0 interface. Two sizes: 39x25 mm and 41.9x30.4 mm. Thickness 5.3 ± 0.3 mm. Resolution 25 lp/mm. MTF >30% at 6 lp/mm; DQE >40% at 2.5 lp/mm. Compatible with Windows Vista/7/8 and Server 2003/2008/2012. Sterilization: liquid sterilization of mouth-placed portion. Standards: IEC 60601-1, IEC 60601-1-2, IEC 62220-1, ISO 14971.

Indications for Use

Indicated for capturing digital diagnostic x-ray images for evaluation by trained oral healthcare professionals. Used by general dental practitioners to detect dental anomalies and evaluate treatment, including carious lesions in dentin and enamel. Applicable to various patient sizes using two sensor sizes.

Regulatory Classification

Identification

A stationary x-ray system is a permanently installed diagnostic system intended to generate and control x-rays for examination of various anatomical regions. This generic type of device may include signal analysis and display equipment, patient and equipment supports, component parts, and accessories.

Special Controls

*Classification.* Class II (special controls). A radiographic contrast tray or radiology diagnostic kit intended for use with a stationary x-ray system only is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 892.9.

Predicate Devices

• RIO Sensor (RIS 500) (K143000)

Reference Devices

• TIDIShield (K132953)
• Apteryx, Inc. imaging software (K983111)

Submission Summary (Full Text)

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Image /page/0/Picture/1 description: The image shows the logo for the Department of Health & Human Services - USA. The logo features a stylized depiction of a human figure, represented by three curved lines, next to the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA". The text is arranged in a circular fashion around the figure.

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

March 18, 2016

LED Dental, Inc. % Mr. Daniel Kamm Principal Engineer Kamm and Associates 8870 Ravello Court NAPLES FL 34144

Re: K153710

Trade/Device Name: Tuxedo Digital Dental Sensor Regulation Number: 21 CFR 892.1680 Regulation Name: Stationary x-ray system Regulatory Class: II Product Code: MOB Dated: February 24, 2016 Received: February 26, 2016

Dear Mr. Kamm:

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.

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.

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If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please contact the Division of Industry and Consumer Education at its toll-free number [phone] or [phone] or at its Internet address

http://www.fda.gov/MedicalDevices/Resourcesfor You/Industry/default.htm. 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

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 Industry and Consumer Education at its toll-free number [phone] or [phone] or at its Internet address

http://www.fda.gov/MedicalDevices/ResourcesforYou/Industry/default.htm.

Sincerely yours.

Robert Ocks

Robert Ochs, Ph.D. Director Division of Radiological Health Office of In Vitro Diagnostics and Radiological Health Center for Devices and Radiological Health

Enclosure

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# Indications for Use

510(k) Number (if known) K153710

Device Name Tuxedo Digital Dental Sensor

### Indications for Use (Describe)

The Tuxedo Digital Dental Sensor is a CMOS sensor for the capturing of digital diagnostic x-ray images on a patient for evaluation by an appropriately trained oral healthcare professional. The Tuxedo sensor itself is a single piece comprised of the image capture components on one end, with a USB 2.0 plug on the other end. The sensor is designed to be used in conjunction with a disposable, single-use hygienic sheath as well as a positioning device to allow for proper alignment within the patient's mouth. Images are acquired with the Tuxedo sensor by plugging it into a USB port and properly placing it in the patient's mouth, while an operator exposes radiation toward the sensor from an approved intraoral x-ray generator.

Type of Use (Select one or both, as applicable)

| <span style="font-family: Arial, sans-serif;">☑</span> Prescription Use (Part 21 CER 801 Subpart D) |
|-----------------------------------------------------------------------------------------------------|
| <span style="font-family: Arial, sans-serif;">□</span> Over The Counter Use (21 CER 801 Subpart C) |

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Image /page/3/Picture/0 description: The image shows the logo for LED DENTAL. The logo features the company name in a stylized font, with "LED" in gray and "DENTAL" in blue. To the left of the name is a cluster of green and blue circles arranged in a pattern. Below the company name, in smaller font, is the text "A SUBSIDIARY OF LED MEDICAL DIAGNOSTICS INC."

# 510(k) Summarv: LED Dental INC. Tuxedo Dental Digital Sensor

This 510(k) summary of safety and effectiveness information is being submitted in accordance with the requirements of 21 CFR §807.92.

#### General Information 1.

Business Name: Address:

Phone Number: Contact Person: Date of 510(k) Preparation: LED Dental INC No. 235-5589 Byrne Rd. Burnaby, BC, CANADA V5J 3J1 404-432-2819 Weslev Newsom November 23, 2015

## 2. Device Name and Classification

Proprietary-Trade Name: "Tuxedo Digital Dental Sensor" Device: Solid State X-Ray Imager (Flat Panel/Digital Imager) Regulation Description: Stationary x-ray system Regulation Medical Specialty: Radiology Review Panel: Radiology Regulatory Class: Class II Product Code: MQB Regulation Number 892.1680

## 3. Equivalent legally marketed device: K143000

| Proprietary-Trade Name: | RIO Sensor (RIS 500) |
|-------------------------------|------------------------------------------------------|
| Device: | Solid State X-Ray Imager (Flat Panel/Digital Imager) |
| Regulation Description: | Stationary x-ray system |
| Regulation Medical Specialty: | Radiology |
| Review Panel: | Radiology |
| Regulatory Class: | Class II |
| Product Code: | MQB |
| Regulation Number | 892.1680 |

- 4. Indications for Use: The Tuxedo Digital Dental Sensor is a CMOS sensor for the capturing of digital diagnostic x-ray images on a patient for evaluation by an appropriately trained oral healthcare professional. The Tuxedo sensor itself is a single piece comprised of the image capture components on one end, with a USB 2.0 plug on the other end. The sensor is designed to be used in conjunction with a disposable, single-use hygienic sheath as well as a positioning device to allow for proper alignment within the patient's mouth. Images are acquired with the Tuxedo sensor by plugging it into a USB port and properly placing it in the patient's mouth. while an operator exposes radiation toward the sensor from an approved intraoral x-ray generator.
- 5. Device Description: The TUXEDO Dental Digital Sensor is used in the detection and diagnosis of anomalies in dental anatomy, as well as for the evaluation of performed treatment in dental care. The primary use is by general dental practitioners to detect the presence and extent of carious legions in the dentin and enamel of a tooth. Two different sized sensors (size 1 and size

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2) are utilized to image different anatomy and different patient sizes. The TUXEDO Dental Digital Sensor functions by being placed in a patient's mouth lingually by a licensed dental practitioner, and is designed to capture collimated radiation which is converted into a digital image for viewing by a licensed dental practitioner. The capturing of the radiation is done within the TUXEDO sensor casing which contains a scintillator used to convert the radiation into visible light, and this visible light is immediately captured by the internal CMOS sensor. The digital image is transferred to a computer via USB 2.0 and can be viewed in most common imaging software programs, including LED Imaging Software. A software driver is available from LED Dental which will allow the TUXEDO sensor to be used in these software programs. The software supplied with the Tuxedo Digital Dental Sensor was cleared separately by FDA by Apteryx, Inc. The sensor is intended to be used with a disposable barrier sheath that should be replaced between patients. This is to reduce cross contamination between patients. The sensor is also sealed in a way that the portion of the device that is placed in the patient's mouth can be sterilized with liquid without the device being damaged.

| Comparable<br>Properties | RIO Sensor (RIS 500), K143000 | "Tuxedo Digital Dental Sensor" | Comparison<br>Results |
|----------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|------------------------------------------------------------------|
| Indications<br>for Use | This system is intended to collect<br>dental x-ray photons and convert<br>them into electronic impulses that<br>may be stored, views and<br>manipulated for diagnostic use by<br>dentists. | The Tuxedo Digital Dental Sensor is a<br>CMOS sensor for the capturing of<br>digital diagnostic x-ray images on a<br>patient for evaluation by an<br>appropriately trained oral healthcare<br>professional. The Tuxedo sensor itself<br>is a single piece comprised of the<br>image capture components on one end,<br>with a USB 2.0 plug on the other end.<br>The sensor is designed to be used in<br>conjunction with a disposable, single-<br>use hygienic sheath as well as a<br>positioning device to allow for proper<br>alignment within the patient's mouth.<br>Images are acquired with the Tuxedo<br>sensor by plugging it into a USB port<br>and properly placing it in the patient's<br>mouth, while an operator exposes<br>radiation toward the sensor from an<br>approved intraoral x-ray generator. | These<br>statements<br>are<br>functionally<br>equivalent |
| Computer<br>Interface | USB 2 | USB 2 | Identical |
| Sizes | Size 1: 39x25<br>Size 2: 42x30 | Size 1 39 x 25 mm<br>Size 2 41.9 x 30.4 mm | Identical.<br>Predicate<br>rounded off<br>the numbers |
| Sensor<br>Thickness | 5.6 mm | 5.3 ± 0.3 mm | Essentially<br>identical |
| Imaging<br>Technology | CMOS | CMOS | Identical |
| Comparable<br>Properties | RIO Sensor (RIS 500), K143000 | "Tuxedo Digital Dental Sensor" | Comparison<br>Results |
| Pixel Size | 20.0 µm | 20.0 µm | Identical |
| Scintillator<br>Technology | Csl Scintillator | Csl Scintillator | Identical |
| Image Sizes | Size 1: 1000x1500 pixel<br>Size 2: 1300x1700 pixel | 1000 x 1500 pixels<br>1300 x 1700 pixels | Identical |
| Theoretical<br>Resolution | 25 lp/mm | 25 lp/mm | Identical |
| MTF | More than 30% at 6 lp/mm | More than 30% at 6 lp/mm | Identical |
| DQE | More than 40% at 2.5 lp/mm | More than 40% at 2.5 lp/mm | Identical |
| Computer | Not specified | PC or Tablet with Windows Vista®<br>SP2 or above, Windows® 7,<br>Windows® 8, Windows Server®<br>2003 R2, Windows Server® 2008,<br>and Windows Server® 2012<br>operating systems including<br>Terminal Services and Citrix®.<br>The software has been cleared by<br>FDA in a separate submission.<br>(Apteryx, Inc, K983111) | New device<br>covers a<br>wider range<br>of operating<br>systems |
| Infection<br>control | Requires a single patient use<br>FDA cleared hygienic barrier | Requires a single patient use FDA<br>cleared hygienic barrier, for<br>example TIDIShield™ K132953.<br>Sheaths:<br>Code # 21041 for Size 1<br>Code # 21040 for Size 2 | Identical |
| Photo | Image: Dental sensor with USB | Image: Dental sensor with USB | The same<br>sensor is<br>being used<br>by the<br>predicate. |

- 6. Substantial Equivalence

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- 7. Summary of Technological Characteristics of the Subject Device as Compared with the Predicate Device: The comparison results show essentially identical characteristics or negligible differences. We conclude that our Tuxedo device is substantially equivalent in terms of safety and effectiveness. Looking at the photo and the specification comparisons, it appears that the predicate is using the same exact sensor as ours.

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- 8. Performance Testing: Successful standards testing was done according to the following: Radiated Emission IEC60601-1-2: 2007, including Radiated Immunity EN61000-4-3, and Electrostatic Discharge (ESD) EN61000-4-2.
Dielectric strength and PATIENT LEAKAGE CURRENT and Temperature of APPLIED PARTS: IEC60601-1:2005.

Imaging performance tests were conducted according to IEC6220-1, Characteristics of digital X-ray imaging devices - Part 1: Determination of the detective quantum efficiency.

Other testing: The stability of sensitivity, dark output and offset value.

Mechanical Strength Testing: Bending and Pulling Test of Cable

Other Reliability Test Reporting: Dropping, Alcohol Dipping, Air leakage, Mechanical Strength of APPLIED PART, and Transport testing.

Although the device does not directly contact the patient, biomedical conformity was evaluated according to food utensil safety requirements of Japan.

We also conducted a risk analysis according to the recommendations of IEC 14971, Application of Risk Management to Medical Devices. There are three broad categories of risk: Broadly Acceptable Region; Marginal; countermeasure required to reduce risk to acceptable level (ALARP) and Intolerable; countermeasure required to reduce risk to acceptable level. After applying countermeasures, all risks were reduced to the BA (broadly acceptable) category. The application of the standards testing (above) was the main method of risk reduction, as well as relying on the use of FDA cleared components such as the sanitary barriers and the software. The sensor has been previously cleared as well.

- 9. Clinical Testing: Clinical images were provided using a Phantom equivalent to a 51 year old male. Phantom Utilized for Image Capture:
DXTTR III Dental X-Ray Phantom (Human Skull): A training phantom. With real skull and teeth with silicone face etc.

Intra-Oral X-Ray Generator Utilized: Gendex Expert DC

These images were not necessary to establish substantial equivalence based on the modifications to the device (note CMOS detector that is very similar to the predicate dental detector Rio), but they provide further evidence in addition to the laboratory performance data to show that the complete system works as intended. All images acquired demonstrated excellent diagnostic imaging quality on both the size #1 and the size #2 sensor. The sensors demonstrated a good latitude response from variations in generator settings. Contrast and spatial resolution on all images were good to excellent on all images acquired.

- 10. Conclusion as to Substantial Equivalence: In accordance with the federal Food, Drug and Cosmetic Act, 21 CFR Part 807 and based on the information provided in this premarket notification. LED Dental concludes that the Tuxedo Digital Dental Sensor is safe and effective to perform its intended use as well as substantially equivalent to the predicate device.