FDA Adverse Event Malfunction Summary report: N

EXCITE F DSC

MDR report key: 3873708 · Received September 23, 2013

Report

Report Number
9612352-2014-00007
Event Type
Malfunction
Date Received
September 23, 2013
Report Date
September 20, 2013
Manufacturer
IVOCLAR VIVADENT AG
Product Code
KLE
PMA / PMN Number
K093744
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
DENTIST

Narratives

Additional Manufacturer Narrative · 1

(B)(4). THERE IS NO RISK TO PATIENT HEALTH. EXCITE F DSC IS A DUAL CURING ADHESIVE AND THEREFORE USUALLY USED IN CLINICAL SITUATIONS WHERE THE RESTORATION IS SOMEWHAT OPAQUE. IN THESE CASES A POSSIBLE BLUE DISCOLORATION IS NOT VISIBLE AND DOES NOT AFFECT THE AESTHETICS OF THE RESTORATION. A BLUE DISCOLORATION CAN GE NOTICEABLE IN TRANSLUCENT RESTORATIONS (E.G. VENEERS) IN THE FRONT OF THE MOUTH. HOWEVER, EVEN HERE THE AESTHETICS ARE ONLY AFFECTED WHEN THE CERAMIC IS VERY THIN. AN ADDITIONAL QUALITY CONTROL MONITORING HAS BEEN INTRODUCED SO THAT EVERY BATCH IS CHECKED USING UV/VISUAL ANALYSIS. THE POSSIBILITY OF CHANGING THE MONOMER PRODUCTION PROCESS TO AVOID USING THIS STABILISER IS BEING INVESTIGATED. IT HAS BEEN DECIDED TO UNDERTAKE A FIELD SAFETY CORRECTION ACTION TO REMOVE BATCH R59595 FROM THE MARKET.

Description of Event or Problem · 1

THE DENTIST FOUND THAT THREE VENEERS WHICH HE CEMENTED WITH VARIOLINK II HAD A GREEN DISCOLORATION. IT IS NOT SPECIFICALLY REPORTED BUT THE PATIENT WOULD NEED THE VENEER TO BE REMOVED AND CEMENTED AGAIN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
480880 EXCITE F DSC DENTAL ADHESIVE, PRODUCT CODE: KLE KLE IVOCLAR VIVADENT AG 630378AN R59595

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention