MAUDE Adverse Event Report: ALIGN TECHNOLOGY, INC. INVISALIGN SYSTEM; ALIGNER, SEQUENTIAL

Model Number INVISALIGN GO PLUS

Device Problem Appropriate Term/Code Not Available (3191)

Patient Problem Tooth Fracture (2428)

Event Date 07/01/2023

Event Type  Injury  

Manufacturer Narrative

The current instructions for use (ifu) contains the following: "precautions - a tooth that has been previously traumatized or significantly restored may be aggravated.In rare instances, the useful life of the tooth may be reduced, the tooth may require additional dental treatment such as endodontic and/or additional restorative work, and/or the tooth may be lost," "the health of the bone and gums which support the teeth may be impaired or aggravated" and "the length of the roots of the teeth may be shortened during orthodontic treatment, which may become a threat to the longevity of the teeth." the treating doctor shared that the potential root cause could be related to the treatment.This event is being filed as an mdr as the patient reported tooth loss (serious injury) and the invisalign product was being used.

Event Description

The patient reported fracture and extraction of tooth 2.5.The patient was prescribed antibiotic clavuli to alleviate the reported symptoms.The patient is continuing the use of the aligners and is currently asymptomatic.

• Brand Name: INVISALIGN SYSTEM
• Type of Device: ALIGNER, SEQUENTIAL
• Manufacturer (Section D): ALIGN TECHNOLOGY, INC.; 2820 orchard parkway; san jose CA 95134
• Manufacturer (Section G): ALIGN TECHNOLOGY, INC.; 2820 orchard parkway; san jose CA 95134
• Manufacturer Contact: aaheli poddar ; 100 queens quay e; toronto, ontario M5E1Z-2 ; CA M5E1Z2
• MDR Report Key: 17397268
• MDR Text Key: 319803209
• Report Number: 2953749-2023-02281
• Device Sequence Number: 1
• Product Code: NXC
• UDI-Device Identifier: 00816063020479
• UDI-Public: (01)00816063020479(10)0151006971(13)230522(91)2009212602N
• Combination Product (y/n): N
• Reporter Country Code: IT
• PMA/PMN Number: K220287
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: Foreign,Health Professional
• Reporter Occupation: Physician
• Type of Report: Initial
• Report Date: 07/26/2023

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Is this an Adverse Event Report?: Yes
• Is this a Product Problem Report?: No
• Device Operator: Lay User/Patient
• Device Model Number: INVISALIGN GO PLUS
• Device Catalogue Number: 9012
• Device Lot Number: 151006971
• Was Device Available for Evaluation?: No
• Is the Reporter a Health Professional?: Yes
• Initial Date Manufacturer Received: 07/12/2023
• Initial Date FDA Received: 07/26/2023
• Was Device Evaluated by Manufacturer?: Device Not Returned to Manufacturer
• Date Device Manufactured: 05/22/2023
• Is the Device Single Use?: No
• Is This a Reprocessed and Reused Single-Use Device?: No
• Type of Device Usage: Initial
• Patient Sequence Number: 1
• Patient Outcome(s): Disability
• Patient Age: 36 YR
• Patient Sex: Male