| Brand Name | BioHorizons, Inc. |
| Common Device Name | Dental Implant |
| Manufacturer (Section D) |
| BioHorizons, Inc. |
| 2300 riverchase center |
| birmingham AL 35244 |
|
| Manufacturer (Section G) |
| BioHorizons Inc. |
| 2300 riverchase center |
|
| birmingham AL 35244 |
|
| Manufacturer Contact |
|
anissa
smith
|
| 2300 riverchase center |
| birmingham, AL 35244
|
|
| MDR Report Key | 25773764 |
| Report Number | 1060818-2026-14067 |
| Device Sequence Number | 9625155 |
| Product Code |
DZE
|
| UDI-Device Identifier | 00847236021863 |
| UDI-Public | 00847236021863 |
| Combination Product (Y/N) | N |
| Initial Reporter State | OH |
| Initial Reporter Country | US |
| PMA/510(K) Number | K223697 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Device Implanted Year | 2025 |
| Device Explanted Year | 2026 |
| Serviced by Third Party (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Company Representative |
| Initial Reporter Occupation |
Dentist
|
| Type of Report
| Initial,Followup |
| Report Date (Section B) |
08/10/2026 |
| 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 Model Number | BTR4215 |
| Device Catalogue Number | BTR4215 |
| Device Lot Number | 2601013 |
| Was Device Available for Evaluation? |
Yes
|
| Is the Reporter a Health Professional? |
Yes
|
| Was the Report Sent to FDA? |
No
|
| Type of Report(Section G) | Thirty-Day |
| Initial Date Received by Manufacturer | 06/15/2026 |
| Supplement Date Received by Manufacturer | 06/18/2026
|
| Initial Report FDA Received Date | 07/09/2026 |
| Supplement Report FDA Received Date | 08/10/2026
|
| Was Device Evaluated by Manufacturer? (Y/N) |
Yes
|
| Date Device Manufactured | 02/17/2026 |
| Is the Device Labeled for Single Use? (Y/N) |
Yes
|
Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N) |
No
|
| Usage of Device |
Initial
|
| Patient Sequence Number | 1 |
| Outcome Attributed to Adverse Event |
Required Intervention;
|
| Patient Sex | Unknown |
|
|