[Federal Register: November 12, 2002 (Volume 67, Number 218)]

[Rules and Regulations]               

[Page 68510-68512]

From the Federal Register Online via GPO Access [wais.access.gpo.gov]

[DOCID:fr12no02-6]                         



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DEPARTMENT OF HEALTH AND HUMAN SERVICES



Food and Drug Administration



21 CFR Part 872



[Docket No. 02N-0010]



 

Dental Devices; Classification for Intraoral Devices for Snoring 

and/or Obstructive Sleep Apnea



AGENCY: Food and Drug Administration, HHS.



ACTION: Final rule.



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SUMMARY: The Food and Drug Administration (FDA) is classifying the 

intraoral devices for snoring and/or obstructive sleep apnea into class 

II (special controls). These devices are used to control or treat 

simple snoring and/or obstructive sleep apnea. This classification is 

based on the recommendations of the Dental Devices Panel (the Panel), 

and is being taken to establish sufficient regulatory controls that 

will provide reasonable assurance of the safety and effectiveness of 

these devices. This action is being taken under the Federal Food, Drug, 

and Cosmetic Act (the act), as amended by the Medical Device Amendments 

of 1976 (the 1976 amendments), the Safe Medical Devices Act of 1990 

(the SMDA), and the Food and Drug Administration Modernization Act of 

1997 (FDAMA). Elsewhere in this issue of the Federal Register, FDA is 

publishing a notice of availability of the guidance document that will 

serve as the special control for this final rule.



DATES: This rule is effective December 12, 2002.



FOR FURTHER INFORMATION CONTACT: Susan Runner, Center for Devices and 

Radiological Health (HFZ-480), Food and Drug Administration, 9200 

Corporate Blvd., Rockville, MD 20850, 301-827-5283.



SUPPLEMENTARY INFORMATION:



I. Background



    The act (21 U.S.C. 301 et seq.), as amended by the 1976 amendments 

(Public Law 94-295), the SMDA (Public Law 101-629), and the FDAMA 

(Public Law 105-115), established a comprehensive system for the 

regulation of medical devices intended for human use. Section 513 of 

the act (21 U.S.C. 360c) established three categories (classes) of 

devices, depending on the regulatory controls needed to provide 

reasonable assurance of their safety and effectiveness. The three 

categories of devices are class I (general controls), class II (special 

controls), and class III (premarket approval).

    Under section 513 of the act, devices that were in commercial 

distribution before May 28, 1976 (the date of enactment of the 1976 

amendments), are generally referred to as preamendments devices, and 

are classified after FDA has: (1) Received a recommendation from a 

device classification panel (an FDA advisory committee); (2) published 

the panel's recommendation for comment, along with a proposed 

regulation classifying the device; and (3) published a final regulation 

classifying the device. FDA has classified most preamendments devices 

under these procedures.



[[Page 68511]]



    Devices that were not in commercial distribution prior to May 28, 

1976, are generally referred to as postamendments devices, and are 

classified automatically by statute (section 513(f) of the act) into 

class III without any FDA rulemaking process. Those devices remain in 

class III and require premarket approval, unless and until: (1) The 

device is reclassified into class I or II; (2) FDA issues an order 

classifying the device into class I or II in accordance with new 

section 513(f)(2) of the act), as amended by the FDAMA; or (3) FDA 

issues an order finding the device to be substantially equivalent, 

under section 513(i) of the act, to a predicate device that does not 

require premarket approval.

    The agency determines whether new devices are substantially 

equivalent to previously offered devices by means of premarket 

notification procedures in section 510(k) of the act (21 U.S.C. 360(k)) 

and 21 CFR part 807 of the regulations.

    A preamendments device that has been classified into class III may 

be marketed, by means of premarket notification procedures, without 

submission of a premarket approval application (PMA) until FDA issues a 

final regulation under section 515(b) of the act (21 U.S.C. 360e(b)) 

requiring premarket approval.

    Consistent with the act and the regulations, FDA consulted with the 

Panel, an FDA advisory committee, regarding the classification of these 

devices.



II. Regulatory History of the Device



    In the Federal Register of April 5, 2002 (67 FR 16338), FDA issued 

a proposed rule to classify the intraoral devices for snoring and/or 

obstructive sleep apnea, used to control or treat simple snoring and/or 

obstructive sleep apnea into class II. The agency also issued a 

guidance document as the special control. Interested persons were given 

until July 5, 2002, to comment on the proposed regulation and guidance 

document.

    FDA received one comment from the National Association of Dental 

Laboratories.



III. Summary of Final Rule



    As required by 21 CFR 860.84(g)(2) of the regulations, FDA is 

classifying intraoral devices for snoring and/or obstructive sleep 

apnea into class II with the guidance document ``Class II Special 

Controls Guidance Document: Intraoral Devices for Snoring and/or 

Obstructive Sleep Apnea'' (Ref. 1), as the special control.



IV. Analysis of Comment and FDA's Response



    The one comment FDA received expressed concerns about the effect 

the guidance document would have on dental laboratories. FDA has 

concluded that the guidance document does not change the regulatory 

requirements for dental laboratories.

    Therefore, under section 513 of the act, FDA is adopting the 

summary of reasons for the Panel's recommendation and the summary of 

data upon which the Panel's recommendation is based, in their entirety. 

FDA also agrees with the Panel's assessment of the risks to public 

health stated in the proposed rule published on April 5, 2002. FDA is 

issuing this final rule, which classifies these generic type of 

intraoral devices for snoring and obstructive sleep apnea into class 

II.



V. Environmental Impact



    The agency has determined under 21 CFR 25.34(b) that this action is 

of a type that does not individually or cumulatively have a significant 

effect on the human environment. Therefore, neither an environment 

assessment nor an environmental impact statement is required.



VI. Analysis of Impacts



    FDA has examined the impacts of the final rule under Executive 

Order 12866 and the Regulatory Flexibility Act (5 U.S.C. 601-612), and 

the Unfunded Mandates Reform Act of 1995 (Public Law 104-4). Executive 

Order 12866 directs agencies to assess all costs and benefits of 

available regulatory alternatives and, when regulation is necessary, to 

select regulatory approaches that maximize net benefits (including 

potential economic, environmental, public health and safety, and other 

advantages; distributive impacts; and equity). The agency believes that 

this final rule is consistent with the regulatory philosophy and 

principles identified in the Executive order. In addition, the final 

rule is not a significant regulatory action as defined by the Executive 

order and so is not subject to review under the Executive order.

    The Regulatory Flexibility Act requires agencies to analyze 

regulatory options that would minimize any significant impact of a rule 

on small entities. The classification of these devices into class II is 

not adding any additional burden to manufacturers, because most 

manufacturers, including small manufacturers, are already substantially 

in compliance with the recommendations of the guidance document that is 

the special control for the devices. The agency, therefore, certifies 

that this final rule will not have a significant economic impact on a 

substantial number of small entities. In addition, this final rule will 

not impose costs of $100 million or more on either the private sector 

or State, local, and tribal governments in the aggregate, and, 

therefore, a summary statement of analysis under section 202(a) of the 

Unfunded Mandates Reform Act of 1995 is not required.



VII. Federalism



    FDA has analyzed this final rule in accordance with the principles 

set forth in Executive Order 13132. FDA has determined that the rule 

does not contain policies that have substantial direct effects on the 

States, on the relationship between the National Government and the 

States, or on the distribution of power and responsibilities among the 

various levels of government. Accordingly, the agency has concluded 

that the rule does not contain policies that have federalism 

implications as defined in the Executive order and, consequently, a 

federalism summary impact statement is not required.



VIII. Paperwork Reduction Act of 1995



    FDA concludes that this final rule contains no collections of 

information. Therefore, clearance by the Office of Management and 

Budget under the Paperwork Reduction Act of 1995 (44 U.S.C. 3501-3520) 

is not required.



IX. Reference



    The following reference has been placed on display in the Dockets 

Management Branch (HFA-305), 5630 Fishers Lane, rm. 1061, Rockville, MD 

20852, and may be seen by interested persons between 9 a.m. and 4 p.m., 

Monday through Friday.

    1. FDA, Center for Devices and Radiological Health, Office of 

Device Evaluation, ``Class II Special Controls Guidance Document: 

Intraoral Devices for Snoring and/or Obstructive Sleep Apnea; 

Guidance for Industry and FDA,'' April 5, 2002.



List of Subjects in 21 CFR Part 872



    Medical devices.



    Therefore, under the Federal Food, Drug, and Cosmetic Act and under 

authority delegated to the Commissioner of Food and Drugs, 21 CFR part 

872 in subpart F is amended as follows:



PART 872--DENTAL DEVICES



    1. The authority citation for 21 CFR part 872 continues to read as 

follows:





[[Page 68512]]





    Authority: 21 U.S.C. 351, 360, 360c, 360e, 360j, 371.



    2. Section 872.5570 is added to subpart F to read as follows:





Sec.  872.5570  Intraoral devices for snoring and intraoral devices for 

snoring and obstructive sleep apnea.



    (a) Identification. Intraoral devices for snoring and intraoral 

devices for snoring and obstructive sleep apnea are devices that are 

worn during sleep to reduce the incidence of snoring and to treat 

obstructive sleep apnea. The devices are designed to increase the 

patency of the airway and to decrease air turbulence and airway 

obstruction. The classification includes palatal lifting devices, 

tongue retaining devices, and mandibular repositioning devices.

    (b) Classification. Class II (special controls). The special 

control for these devices is the FDA guidance document entitled ``Class 

II Special Controls Guidance Document: Intraoral Devices for Snoring 

and/or Obstructive Sleep Apnea; Guidance for Industry and FDA.''



    Dated: October 28, 2002.

Linda S. Kahan,

Deputy Director, Center for Devices and Radiological Health.

[FR Doc. 02-28549 Filed 11-8-02; 8:45 am]



BILLING CODE 4160-01-S