MAUDE Adverse Event Report: NOBEL BIOCARE AB GÖTEBORG NOBELACTIVE S TIULTRA NP 4.3X18MM; ENDOSSEOUS DENTAL IMPLANT

Catalog Number	302284
Medical Device Problem Code	Loss of Osseointegration (2408)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	04/27/2026
Type of Reportable Event	Serious Injury
Event or Problem Description
Loss of osseointegration.
Event or Problem Description
Loss of osseointegration.The initial report did have a wrong date of occurrence, however we have received correct information and the qn has been updated.Hence this updated report.

• Brand Name: NOBELACTIVE S TIULTRA NP 4.3X18MM
• Common Device Name: ENDOSSEOUS DENTAL IMPLANT
• Manufacturer (Section D): NOBEL BIOCARE AB GÖTEBORG; västra hamngatan 1; göteborg 41117 ; SW 41117
• MDR Report Key: 25118482
• Report Number: 2027971-2026-077338
• Device Sequence Number: 10272208
• Product Code: DZE
• UDI-Device Identifier: 07332747222050
• UDI-Public: (01)07332747222050(10)12284956(17)310114
• Combination Product (Y/N): N
• Initial Reporter Country: US
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Device Implanted Year: 2026
• Device Explanted Year: 2026
• Serviced by Third Party (Y/N): Unknown
• Reporter Type: Importer
• Initial Reporter Occupation: Dentist
• Type of Report: Initial,Followup
• Report Date (Section F): 05/07/2026

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
• Operator of Device: Health Professional
• Device Catalogue Number: 302284
• Device Lot Number: 12284956
• Was Device Available for Evaluation?: No
• Is the Reporter a Health Professional?: Yes
• Was the Report Sent to FDA?: No
• Distributor Facility Aware Date: 05/21/2026
• Event Location: Outpatient Treatment Facility
• Type of Report(Section G): Follow-Up
• Initial Date Received by Manufacturer: Not provided
• Supplement Date Received by Manufacturer: Not provided
• Initial Report FDA Received Date: 05/07/2026
• Supplement Report FDA Received Date: 05/27/2026
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• Usage of Device: A
• Patient Sequence Number: 1
• Outcome Attributed to Adverse Event: Required Intervention
• Patient Age: 62 YR
• Patient Sex: Female
• Date Report Sent to FDA: 05/07/2026