FDA Adverse Event Injury Summary report: N

ASTRATECH IMPL EV 4.2S 11MM OS

MDR report key: 24632686 · Received March 18, 2026

Report

Report Number
3013111692-2026-08674
Event Type
Injury
Date Received
March 18, 2026
Date of Event
January 16, 2026
Report Date
March 18, 2026
Manufacturer
DENTSPLY IMPLANTS MANUFACTURING GMBH
Product Code
DZE
UDI-DI
07392532214271
PMA / PMN Number
K120414
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
GM
Reporter Occupation
DENTIST
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THEREFORE, BECAUSE A SERIOUS INJURY RESULTED, THIS EVENT IS REPORTABLE PER 21 CFR PART 803. THE DEVICE WAS NOT EVALUATED BECAUSE THE ISSUE IS A KNOWN INHERENT RISK OF THE DEVICE. WE WILL CONTINUE TO TRACK AND MONITOR THE TREND.

Description of Event or Problem · 0

CUSTOMER REPORTED AN IMPLANT LOSS - MOBILITY IMPLANT REGION 25 DID NOT HEAL, HAD TO BE REMOVED, IMPRESSION TAKEN BEFOREHAND AT HZA WHERE THE IMPLANT LOOSENED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
689729 ASTRATECH IMPL EV 4.2S 11MM OS IMPLANT, ENDOSSEOUS, ROOT-FORM DZE DENTSPLY IMPLANTS MANUFACTURING GMBH 526372 07392532214271

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown Required Intervention IMPLANT WITH GF.