MAUDE Adverse Event Report: ADIN DENTAL IMPLANTS LTD. ADIN DENTAL IMPLANTS,; ISPS1042

Catalog Number	ISPS1042
Medical Device Problem Code	Loss of Osseointegration (2408)
Health Effect - Clinical Code	Inadequate Osseointegration (2646)
Date of Event	06/11/2026
Type of Reportable Event	Serious Injury
Event or Problem Description
Bone loss 5 years and 10 months after implantation.

• Brand Name: ADIN DENTAL IMPLANTS,
• Common Device Name: ISPS1042
• Manufacturer (Section D): ADIN DENTAL IMPLANTS LTD.; industrial zone alon tavor; pob 1128; afula, isr, 18111 01; IS 1811101
• MDR Report Key: 25734809
• Report Number: 3013143972-2026-00539
• Device Sequence Number: 21471174
• Product Code: DZE
• UDI-Device Identifier: 07290105151827
• UDI-Public: 7290105151827
• Combination Product (Y/N): N
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Device Implanted Year: 2019
• Device Explanted Year: 2026
• Serviced by Third Party (Y/N): N
• Reporter Type: Importer
• Initial Reporter Occupation: Dentist
• Type of Report: Initial
• Report Date (Section B): 07/07/2026

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
• Device Catalogue Number: ISPS1042
• Device Lot Number: 74952129
• Was Device Available for Evaluation?: Yes
• Is the Reporter a Health Professional?: Yes
• Distributor Facility Aware Date: 07/07/2026
• Event Location: Outpatient Treatment Facility
• Initial Date Received by Manufacturer: Not provided
• Initial Report FDA Received Date: 07/07/2026
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• Patient Sequence Number: 1
• Outcome Attributed to Adverse Event: Required Intervention
• Patient Sex: Male