510(k) Summary. Dentsply Implants. April 30, 2013



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5 1 0(k) Summary AtlantisTM Straumann Bone Level Abutment 510(k) Summary Dentsply Implants MAY 1 2013 ADMINISTRATIVE INFORMATION AtlantisTM Straumann Bone Level Abutment K130216 April 30, 2013 Manufacturer Name Official Contact: Representative/Consultant Dentsply Implants Aminogatan 1, P.O. Box 14 M6IndaI, Sweden SE-431-21 Telephone: +46 31 776 30 00 Fax: +46 31 776 30 10 Christina Lewing Head of Regulatory Affairs Linda K. Schulz Floyd G. Larson PaxMed International, LLC 12264 El Camino Real, Suite 400 San Diego, CA 92130 Telephone: +1 (858) 792-1235 Fax: +1 (858) 792-1236 Email: LSchulz@paxmed.com FLarson@paxmed.com DEVICE NAME AND CLASSIFICATION Trade/Proprietary Name AtlantisuM Straumann Bone Level Abutment Common Name Dental implant abutment Classification Name Endosseous dental implant abutment Classification Regulation Class 11, 21 CFR 872.3630 Product Code NRA Classification Panel Dental Products Panel Reviewing Branch Dental Devices Branch

5 1 0(k) Summary AtlantisTM Straumann Bone Level Abutment INTENDED USE The AtlantiSTM Abutment is intended for use with an endosseous implant to support a prosthetic device in a partially or completely edentulous patient. It is intended for use to support single and multiple tooth prosthesis, in the mandible or maxilla. The prosthesis can be cemented or screw retained to the abutment. The abutment screw is intended to secure the abutment to the endosseous implant. The AtlantisTM Crown Abutment is intended for use with an endosseous implant to function as a substructure that also serves as the final restoration, in partially or completely edentulous patients. The abutment screw is intended to secure the crown abutment to the endosseous implant. AtlantiSTM Straumann Bone Level Abutment in Zirconia is compatible with the 03.3 mm Straumann Bone Level Implant. DEVICE DESCRIPTION Atlantis Straumann Bone Level Abutment is a patient specific dental implant abutment for screw-retained, cement-retained or friction fit restorations. Atlantis Straumann Bone Level Abutment is provided in one diameter (03.3 mm) and two designs: Atlantis Straumann Bone Level Abutment and Atlantis Straumann Bone Level Crown Abutment. The coronal portion of Atlantis Abutment is fabricated as a patient specific abutment for prosthesis attachment. The coronal portion of Atlantis Crown Abutment is fabricated as a single tooth final restoration and is shaped in the design of the final prosthesis onto which porcelain is added. Both designs are compatible with the Straumann Bone Level implant 03.3 mm. Atlantis abutments are made from yttria-stabilized zirconia (Y-TZP) conforming to ISO 13356 Implants for surgery-ceramic materials based on yttria-stabilized tetragonal zirconia (Y-TZP) and are used with a titanium alloy abutment screw. EQUIVALENCE TO MARKETED DEVICE Dentsply Implants submits the following information in this Premarket Notification to demonstrate that for the purposes of FDA's regulation of medical devices AtlantisTM Straumann Bone Level Abutment is substantially equivalent in indications and design principles to the following legally marketed predicate devices: AtlantisTM Straumann Bone Level Abutment - K083871I AtlantiSTM Crown Abutment in Zirconia - KI 110356 Straumann Dental Implant System - K083550 13.004 Implants - K062 129 Non-clinical testing data submitted, referenced, or relied upon to demonstrate substantial equivalence included: engineering analysis, dimensional analysis, and static and dynamic

5 1 0(k) Summary AtlantisTM Straumann Bone Level Abutment testing according to ISO 14801 Dental-implants Dynamic Fatigue Test for Endosseous Dental Implants. -compression-bending Any differences in the technological characteristics between the subject and predicate devices do not raise new issues of safety or efficacy. The data included in this submission demonstrates substantial equivalence to the predicate devices listed above. Overall, AtlantiSTM Straumann Bone Level Abutment has the following similarities to the predicate devices: * has the same intended use, " uses the same operating principle, * incorporates the same basic design, * incorporates the same or very similar materials, and * has similar packaging and is sterilized using the same materials and processes.

DEPARTMENT OF HEALTH & HUMAN SERVICES Public Health Service Food and Drug Administration 10903 New Hampshire Avenue Document Control Center - W066-G609 Silver Spring, MD 20993-0002 May 1, 2013 Dentsply Implants C/O Ms. Linda K. Schulz PaxMed International, Limited Liability Company 12264 El Camino Real, Suite 400 SAN DIEGO CA 92130 Re: K130216 *Trade/Device Name: Atlantis TMStraumann Bone Level Abutment Regulation Number: 21 CFR 872.3630 Regulation Name: Endosseous Dental Implant Abutment Regulatory Class: 11 * Product Code: NHA Dated: January 30, 2013 Received: January 31, 2013 Dear Ms. Schulz: We have reviewed your Section 5 10(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 Cosfietic Act (Act) that do not require approval of a premarket approval application (PMIA). 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 11 (Special Controls) or class I11 (PMA), it may be subject to additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 2 1, Pants 800 to 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.

Page 2 - Ms. Schulz 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 CER Part 801); medical device reporting (reporting of medical devicerelated adverse events) (21 CFR 803); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CER Part 820); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050. If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please contact the Division of Small Manufacturers, International and Consumer Assistance at its tollfree number (800) 638-2041 or (301) 796-7 100 or at its Internet address http://www.fda.gov/medicaldevices/resourcesforyou/industrv/default.htm. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (2I1CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to http:f//www.fda.gzov/medicaldevices/safetv/reportaproblem /default.htm for the CDRI-'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 Small Manufacturers, International and Consumer Assistance at its toll-free number (800) 63 8-2041 or (301) 796-7100 or at its Internet address http)://nvww.fda.2ov/medicaldevices/resotircesforyou/induistrv/default.htm. Sincerely yours, Kwam:OI I e for Anthony D. Watson, B.S., M.S., M.B.A. Director Division of Anesthesiology, General Hospital, Respiratory, Infection Control and Dental Devices Office of Device Evaluation Center for Devices and Radiological Health Enclosure

51 0(k) Summary AtlantisTM Stiraumann Bone Level Abutment 5 10(k) Number: M3ZL Indications for Use Device Name: AtlantisTm Straumann Bone Level Abutment Indications for Use: The Atlantis~h Abutment is intended for use with an endosseous implant to support a prosthetic device in a partially or completely edentulous patient. It is intended for use to support single and multiple tooth prosthesis, in the mandible or maxilla. The prosthesis can be cemented or screw retained to the abutment. The abutment screw is intended to secure the abutment to the endosseous implant. The AtlantisThi Crown Abutment is intended for use with an endosseous implant to function as a substructure that also serves as the final restoration, in partially or completely edentulous patients. The abutment screw is intended to secure the crown abutment to the endosseous implant. AtlantisTh Straumann Bone Level Abutment in Zirconia is compatible with the 03.3 mm Straumann Bone Level Implant. Prescription Use X N/l Over-The-Counter Use (Part 21 CFR 801 Subpart D) AN/R(21 CFR 801 Subpart C) (PLEASE DO NOT WRITE BELOW TIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of Device Evaluation (ODE) Page 1 of I /OI 29 1001. 13000g9 (Division Slgn.Off) Division of Anesthesioogy, General Hospital Infecton Control, Dential Devices 51O(k)Numbonhe3-/ Page 41 of 166