阅读说明：本技术 一种牙科氧化锆陶瓷桩核及其制作方法 (Dental zirconia ceramic pile core and manufacturing method thereof ) 是由 沈志坚 于 2020-11-25 设计创作，主要内容包括：本发明公开了一种牙科氧化锆陶瓷桩核及其制作方法,包括个性化设计的一体化桩核,所述桩核由粘固于牙髓腔内的桩(1)和暴露在牙髓腔外的核(2)两部分组成,所述核的底部设有核底平台(3),所述桩的顶部设有固位突(4),核底平台与固位突相连。本发明能够确保稳定固位,避免因核在侧向咬合力作用下产生径向微移动而给桩尖传递过大的侧向力,导致桩断裂和牙根折裂的风险。(The invention discloses a dental zirconia ceramic pile core and a manufacturing method thereof, the dental zirconia ceramic pile core comprises an integrated pile core with personalized design, the pile core consists of a pile (1) adhered in a dental pulp cavity and a core (2) exposed outside the dental pulp cavity, the bottom of the core is provided with a core bottom platform (3), the top of the pile is provided with a retention projection (4), and the core bottom platform is connected with the retention projection. The invention can ensure stable retention and avoid the risk of pile fracture and root fracture caused by excessive lateral force transferred to the pile tip due to radial micro-movement of the nucleus under the action of lateral occlusal force.)

1. The dental zirconia ceramic post core comprises an integrated post core with personalized design, and is characterized in that the post core consists of a post (1) which is cemented in a dental pulp cavity and a core (2) which is exposed out of the dental pulp cavity (5), wherein the bottom of the core is provided with a core bottom platform (3), the top of the post is provided with a retention projection (4), and the core bottom platform is connected with the retention projection.

2. The dental zirconia ceramic post core according to claim 1, wherein the surface of the post core is micro-nano modified.

3. The dental zirconia ceramic post core according to claim 1, wherein the edge of the core bottom platform is provided with a hoop part (7) surrounding the defective tooth body (6), and the core bottom platform is matched with the tooth preparation surface of the defective tooth body.

4. The dental zirconia ceramic post core according to claim 1, wherein the retention protrusion is made into a ring shape or an irregular shape according to the available tooth volume, and the bottom of the retention protrusion is provided with a protruding bottom platform (8) which is perpendicular to the axis of the post.

5. The ceramic post core according to claim 1, wherein the core is in a truncated cone shape with a small top and a large bottom, the edge line of the core is matched with the edge line of the defective tooth preparation body, and the core and the defective tooth preparation body are fused into an abutment body with a retaining form, which plays a role of supporting a dental crown.

6. The dental zirconia ceramic post core according to claim 1, wherein the core is in a shape of a crown of a tooth, and the edge of the core is matched with the edge of the prepared tooth to form a post core crown of an integrated structure of the post core and the crown.

7. The dental zirconia ceramic post core of claim 1, wherein the post core has a fracture toughness of greater than 8mpa.m^1/2The zirconia ceramic or zirconia-based ceramic composite material.

8. The method of claim 1, wherein the method comprises the steps of:

(1) the pulp cavity of the retention pile core is trimmed, and an expansion hole is prepared for embedding the retention projection at the pulp cavity opening;

(2) acquiring an impression of the trimmed endodontic cavity of the retention pile core by using silica gel, and then optically scanning the silica gel impression to prepare a digital impression which is used as a basis for designing and manufacturing a personalized pile core;

(3) designing a pile-core digital model, preparing a pile-core biscuit by using a zirconium oxide block formed by cold isostatic pressing or gel injection molding or a partially sintered zirconium oxide block through numerical control milling, and then preparing a pile-core sintered body through sintering; or designing a pile core digital model, manufacturing a biscuit of the personalized pile core by photocuring additive manufacturing, and then forming a pile core sintered body by glue removal and sintering;

(4) the surface of the sintered body of the pile core is subjected to micro-nano modification to form a surface secondary groove and pit structure with the length of 5-20 micrometers, the width of 2-5 micrometers, the depth of 2-5 micrometers, the diameter of 30-300 nanometers and the depth of 10-200 nanometers, so that the physical bonding strength with a tooth body is enhanced.

9. The method of claim 8, wherein the diameter of the hole is 1 to 2 mm deep, the diameter of the hole is 1 mm or more larger than the diameter of the pulp chamber, and the bottom of the hole is perpendicular to the axis of the post.

10. The method of claim 8, wherein the post-core is white, pink, or dentin.

Technical Field

The invention relates to the field of manufacturing of dental restorations, in particular to a dental zirconia ceramic post core and a manufacturing method thereof.

Background

In the process of repairing the damaged residual root and the residual crown of a serious tooth body by adopting the crown bridge, when the quantity of the residual teeth is not enough to support the crown bridge, a pile can be cemented in a pulp cavity after root canal therapy to improve the resistance behavior of an affected tooth, and a core is added on the pile to restore partial form of the damaged tooth body, thereby creating retention and bearing conditions for further crown bridge repair or movable false tooth repair of the affected tooth. The pile and core may be formed as two separate parts or may be formed as a unitary structure, the former being typically joined by adhesive bonding. The technology for repairing the defective pile and core of the tooth has been known for hundreds of years and is a well-known important means for retaining and recovering the functions of the defective and diseased tooth. Conventionally, the core [1] is usually made of metal. The core cast from non-precious metals, which typically contains the sensitizing metals nickel and chromium, will cause allergic reactions in about 10% of the population. In the long-term use process, metal ions are dissolved out due to metal corrosion and diffused into the tooth body and the gum tissue, so that the neck of the tooth is stained and the gum tissue is grayed. When the high-transparency full-ceramic crown is used for restoration in the anterior dental area, the gray color of the metal post core can penetrate through the full-ceramic crown due to color shading failure, so that the aesthetic effect of the full-ceramic restoration is influenced.

One method for solving the problems of biocompatibility and aesthetics of the pile core is to adopt non-metal fiber reinforced resin matrix composite materials to manufacture the pile, and the pile is clinically and customarily called a fiber pile [2 ]. This technology started to prevail in europe and the united states since the 1990 s, and is now widely used in oral cavity restoration practice. Because the fiber pile does not contain metal, the biocompatibility problem caused by metal corrosion and metal ion dissolution is avoided. The fiber post can be made to be similar to the teeth in color, thereby being more in line with the aesthetic characteristics of the human body. In addition, the elastic modulus of the fiber pile is closer to that of dentin, so that the fiber pile can bear large elastic deformation and is not easy to break. In the initial fiber post solution, the post and the core are manufactured separately, and the post-formed fiber post with a certain taper is manufactured by firstly adhering the post-formed fiber post in the trimmed pulp cavity to obtain retention, and then further stacking a core on the post-formed fiber post by using light-cured resin. As the matrix of the fiber pile is mostly highly cross-linked epoxy resin, and the core resin takes photo-cured bisphenol A Bis glycidyl methacrylate (Bis-GMA) as the main matrix, the chemical compositions of the two are different, so that the fiber pile is difficult to form firm chemical bonding with the core resin [3 ]. Further, polymerization shrinkage of the core resin also generates stress at the bonding interface [4 ]. The bonding interface between the nuclear resin and the fiber post has obvious influence on the strength of the restoration, and the lack of bonding force and interface stress concentration between the nuclear resin and the fiber post often cause the failure of the restoration mode of stacking the pre-formed straight fiber post and the light-cured resin.

In order to solve the problems, Chinese patent CN101803958A discloses a technology for directly preparing an integrated pile core by cutting a fiber reinforced resin matrix composite blank by a CAD/CAM technology by manufacturing a non-metal fiber reinforced resin matrix composite pile core into a personalized integrated structure [5 ]. The integrated pile core can be designed according to the individual needs of each affected tooth, and better adapts to the shape of the tooth root, because the pile core is integrated, the operation of plastic resin core piling at the head of the pile is omitted, and the risk of fracture of the interface between the pile core is avoided. Whether the fiber pile core is of an integral structure or a two-section structure, the common problem is the chemical durability. The resin high polymer material can be degraded after long-term use in the oral cavity environment to release small molecules, so that the strength of the pile core is reduced, and peculiar smell is easily generated to cause discomfort of patients.

The other method for solving the problems of biocompatibility and aesthetics of the pile core is to manufacture the pile core by using the zirconia ceramic material, wherein the zirconia ceramic material is chemically stable, and the durability of the pile core can be ensured. A preformed zirconia ceramic post with both good aesthetics and biocompatibility was first introduced in 1995 by Meyeberg et al in the field of dental restorations [6], and ten years of clinical follow-up studies demonstrated a high success rate of treatment [7 ]. At present, various types of zirconia pile cores are available on the market, the piles are designed into tapered columns, the cores are simple in design and can be generally regarded as the prolongation of the piles (figure 2A), and light-cured resin is required to be further added on the cores to manufacture the abutment before crown repair. Because the bonding strength of the resin and the zirconia is low, interface separation easily occurs, and the repair fails. With further machining of the nucleus to form a platform at the nucleus bottom (fig. 2B), there is the problem that the nucleus undergoes radial micromotion under the action of lateral occlusal forces to transfer excessive lateral forces to the post tip, resulting in the risk of post fracture and root fracture.

In order to solve the problems, Chinese patent CN101803958A discloses a technology for directly scanning dentition and defective teeth in a patient's mouth by a high-precision optical scanner, further adopting computer-aided design software to combine the characteristics of the affected teeth, selecting proper crown data from a database to form a pile crown matched with the affected teeth, adopting a back-cutting method of full-ceramic crown restoration, generating an integrated pile-core three-dimensional data model capable of being guided into an open computer-aided manufacturing numerical control center by manual-aided adjustment, and then adopting a computer-aided processing technology to cut full-ceramic materials to manufacture an integrated full-ceramic pile core [8 ]. The integrated pile core avoids the interface between the pile cores, and the axis inclination of the full-ceramic crown repair can be changed. The invention has the advantages that the manufacturing method of the personalized integrated all-ceramic post core is provided, the manufacturing time and the repairing material can be saved, the high-precision repairing body can be obtained, the patient diagnosis period is shortened, and the clinical all-ceramic post core repairing cost is reduced. The invention extends the design scheme of the tapered columnar pile known in the industry in the aspect of the pile-core structure, and does not relate to innovation.

From the analysis of the background art, the zirconium oxide ceramic used for manufacturing the pile core has obvious advantages in the aspects of aesthetic texture, biocompatibility and chemical durability. By means of the existing mature computer aided design and processing technology, the technical bottleneck does not exist any more when the personalized zirconium oxide integrated pile core is manufactured. However, until now, the zirconia integral pile core is not widely used in clinic, and has another reason. In general, the high hardness and high elastic modulus of zirconia ceramics are still worried in the industry that the tooth body is easy to fracture, and the zirconia ceramic pile is worried that the zirconia ceramic pile is easier to fracture due to brittleness.

Disclosure of Invention

The invention aims to provide a dental zirconia ceramic pile core and a manufacturing method thereof, which can ensure stable retention and avoid the risk of pile fracture and tooth root fracture caused by excessive lateral force transferred to a pile tip due to radial micro-movement of the core under the action of lateral occlusal force.

The technical scheme adopted by the invention for solving the technical problems is as follows:

the dental zirconia ceramic post core comprises an integrated post core with personalized design, wherein the post core consists of a post (1) which is cemented in an endodontic cavity and a core (2) which is exposed out of the endodontic cavity, a core bottom platform (3) is arranged at the bottom of the core, a retention projection (4) is arranged at the top of the post, and the core bottom platform is connected with the retention projection.

The key point of the invention is to recognize that the main reason which may cause the fracture of the tooth body and the fracture of the pile is not the elastic mismatch of the zirconia ceramics and the tooth body, but the radial micro-displacement of the core under the action of the lateral occlusal force can transmit a warping force to the inner wall of the tooth root through the pile tip due to the unstable retention of the pile core. In view of this, the key technology of the present invention involves the following three aspects: (1) a secondary retention platform structure (a core bottom platform and a retention projection) is designed between a pile fixedly attached to the pulp cavity and a core exposed out of the pulp cavity so as to disperse the buckling force and improve the bearing stability; (2) the method comprises the following steps of (1) manufacturing a pile core by adopting zirconia ceramics with higher fracture toughness; (3) and carrying out micro-nano modification on the surface of the zirconia ceramic pile core to strengthen the physical bonding strength with the tooth body.

The size of the post in the invention is matched with the size of the trimmed dental pulp cavity, and the size of the core is individually designed according to the damage degree of the defective tooth.

Preferably, the surface of the pile core is subjected to micro-nano modification.

Preferably, the edge of the nucleus bottom platform is provided with a hoop-shaped part surrounding the defective tooth body, and the nucleus bottom platform is matched with the prepared tooth surface of the defective tooth body.

Preferably, the retention process is made into a ring shape or an irregular shape according to the available tooth volume, and the bottom of the retention process is provided with a protruding bottom platform which is perpendicular to the axis of the pile.

Preferably, the core has a truncated cone shape with a small top and a large bottom, and an edge line of the core fits with an edge line of the defective tooth preparation, and the core and the defective tooth preparation are fused into an abutment having a retaining form, which serves to support the crown.

Preferably, the core is in a shape of a dental crown, and the edge of the core is matched with the edge of the prepared tooth to form the post-core crown with an integrated structure of the post-core and the crown.

Preferably, the fracture toughness of the pile core is more than 8MPa^1/2The zirconia ceramic or zirconia-based ceramic composite material. Fracture toughness is more than 8MPa.m^1/2The zirconia ceramic is added with Y₂O₃、 Er₂O₃、 Sm₂O₃、 Nd₂O₃、Pr₂O₅、 Nb₂O₅One or more of the zirconia ceramics is used as a stabilizing agent, and the total content of the stabilizing agent is 1-15 mol%. Oxygen gasThe zirconium-based ceramic composite material has fracture toughness of more than 8MPa^1/2One or more of alumina, silicate, aluminate and aluminosilicate is further added to the zirconia ceramic composite material as a second phase, and the dosage of the second phase is less than 20 percent of the volume fraction of the zirconia ceramic.

A manufacturing method of a dental zirconia ceramic pile core comprises the following steps:

(1) the pulp cavity of the retention pile core is trimmed, and an expansion hole is prepared for embedding the retention projection at the pulp cavity opening;

(2) acquiring an impression of the trimmed endodontic cavity of the retention pile core by using silica gel, and then optically scanning the silica gel impression to prepare a digital impression which is used as a basis for designing and manufacturing a personalized pile core;

(3) designing a pile-core digital model, preparing a pile-core biscuit by using a zirconium oxide block formed by cold isostatic pressing or gel injection molding or a partially sintered zirconium oxide block through numerical control milling, and then preparing a pile-core sintered body through sintering; or designing a pile core digital model, manufacturing a biscuit of the personalized pile core by photocuring additive manufacturing, and then forming a pile core sintered body by glue removal and sintering;

(4) the surface of the sintered body of the pile core is subjected to micro-nano modification to form a surface secondary groove and pit structure with the length of 5-20 micrometers, the width of 2-5 micrometers, the depth of 2-5 micrometers, the diameter of 30-300 nanometers and the depth of 10-200 nanometers, so that the physical bonding strength with a tooth body is enhanced.

Preferably, the diameter of the diameter-expanding hole is 1 to 2 mm deep, the diameter of the diameter-expanding hole is more than 1 mm larger than the diameter of the dental pulp cavity, and the bottom surface of the hole is perpendicular to the axis of the pile.

Preferably, the post-core is white, pink or dentin.

The invention has the beneficial effects that:

the zirconia ceramic integrated pile core for dental restoration disclosed by the invention is structurally superior to the existing product, is made of zirconia ceramic with high fracture toughness, and is subjected to micro-nano modification on the surface to strengthen the physical bonding strength with a tooth body. Because the stable retention is ensured, the radial micro-movement of the core is avoided, the stress distribution of the pile, the core and the tooth body is optimized, and the fracture of the tooth body and the pile caused by the warping force in clinical application is avoided. Compared with the common preformed zirconia ceramic pile, the integral zirconia ceramic pile core reduces the possibility that the core is damaged due to the influence of external force, and the crown bridge can be directly bonded on the head core part of the integral zirconia ceramic pile core in the clinical application operation, thereby simplifying the operation steps.

The zirconium oxide ceramic integrated pile core is manufactured in a numerical control pure shape by adopting a computer aided design and processing technology, the processing technology is mature, the error is small, the consistency is extremely high, the batch customization can be realized, and the requirements of digital and personalized treatment are met. The invention improves the microstructure and performance of the zirconia ceramic, and the fracture toughness is more than 8MPa.m by multi-element doping^1/2The oxygen zirconium ceramic has the advantages of high strength, toughness and biocompatibility, and can be white, pink, dentin and other colors.

Drawings

FIG. 1: the invention discloses a structural schematic diagram of a dental zirconia ceramic integrated pile core.

FIG. 2: the structure of the prior art is schematic.

FIG. 3: the invention discloses a schematic diagram of a dental zirconia ceramic integrated pile-core crown structure.

FIG. 4: the invention discloses a bonding surface local structure schematic diagram of a dental zirconia ceramic integrated pile core subjected to micro-nano modification, wherein a is a groove and b is a pit.

Detailed Description

The technical solution of the present invention will be further specifically described below by way of specific examples.

In the present invention, the raw materials and equipment used are commercially available or commonly used in the art, unless otherwise specified. The methods in the following examples are conventional in the art unless otherwise specified.

Example 1:

and (3) preparing the conventional teeth for the full-ceramic post-core treatment of the large-area defective maxillary middle incisor row zirconium oxide, and preparing the shoulder collar. Dental pulp cavity after drilling root canal therapyThe pulp cavity is trimmed to form a deep hole with taper, the depth of the hole is 8 mm, an expanded hole with the depth of 2 mm is arranged at the pulp cavity opening, the diameter of the expanded hole is 1 mm larger than that of the pulp cavity, and the bottom surface of the hole is vertical to the pile axis. Taking the impression of dental pulp cavity hole with silica gel, optically scanning the silica gel impression to make digital impression, and intraoral scanning to obtain digital impression of dentition and occlusion relation. Designing a pile-core digital model, wherein the surface of a core bottom platform is matched with the tooth preparation surface of a defective tooth body, the edge of the core bottom platform is in a hoop shape surrounding the tooth body, the height of a lower retention projection is 2 mm, and the included angle between the retention projection bottom platform and a pile axis clamp is 90 DEG^o. The core at the upper part of the pile core is in a round table shape with big top and big bottom and conicity, and the edge line of the core is matched with the edge line of the defected tooth preparation body. According to the digital model, the cold isostatic pressing is carried out after the numerical control milling processing at 1000^oC partially sintered for 1 hour with additional addition of 5% volume fraction Al₂O₃3mol% Y of second phase particles₂O₃The partially stabilized ZrO2 block is used for making a biscuit of a pile core, and then the biscuit is passed through 1500 ℃ in an air atmosphere^oC sintering for 1 hour to prepare a sintered body of the pile core, wherein the zirconia pile core has the three-point bending strength of 1200MPa and the fracture toughness of 10MPa^1/2. Then, the surface of the zirconia pile core is subjected to local scribing and plastic deformation in a micro-nano scale through sand blasting, and micro-nano modification is carried out to form a surface secondary groove and pit structure (shown in figure 4) with the length of 5-20 micrometers, the width of 2-5 micrometers, the depth of 2-5 micrometers, the diameter of 30-300 nanometers and the depth of 10-200 nanometers. 3M ESPE RelyXTM Unicem self-adhesive resin cement is used for cementing a zirconium oxide all-ceramic pile core, the pile is cemented with the medullary cavity wall, and the core and the defective tooth preparation body are cemented and fused into an abutment whole body with a retaining form (as shown in figure 1).

Example 2:

and (3) preparing the shoulder collar by conventional tooth preparation for the zirconium oxide all-ceramic post-core treatment of the first molar row with the undersize occlusion gap and the larger crown defect area. Drilling pulp cavities after root canal treatment, trimming one pulp cavity into a deep hole with taper, wherein the depth of the hole is 7 mm, trimming the other pulp cavity into a shallow hole, the depth of the hole is 3 mm, an expanded hole with the depth of 2 mm is arranged at the mouth of the pulp cavity of the deep hole, the diameter of the expanded hole is 1 mm larger than that of the pulp cavity, and the bottom surface of the hole is vertical to the axis of the pile. Obtaining dental pulp cavity with silica gelThe silica gel impression is optically scanned to make a digital impression, and the digital impression of the dentition and the occlusion relation is obtained by intraoral scanning. Designing a pile-core digital model, wherein the surface of a core bottom platform is matched with the tooth preparation surface of a defective tooth body, the edge of the core bottom platform is in a hoop shape surrounding the tooth body, the height of a retention projection below the core bottom platform is 2 mm, and the retention projection bottom platform is vertical to the pile axis. The core at the upper part of the pile core is in a round table shape with big top and big bottom and conicity, and the edge line of the core is matched with the edge line of the defected tooth preparation body. According to a digital model, 10% of Al with volume fraction is added for gel injection molding by numerical control milling₂O₃10mol% of CeO₂The partially stabilized ZrO2 block is used to make the biscuit of pile core, and then the biscuit is passed through 800^oC removing the gel for 5 hours and in air at 1530^oC sintering for 1 hour to obtain a sintered body of the pile core, wherein the zirconia pile core has three-point bending strength of 800MPa and fracture toughness of 12MPa^1/2. And then, performing local scribing and plastic deformation on the surface of the zirconia pile core in a micro-nano scale through sand blasting, and performing micro-nano modification to form a surface secondary groove and pit structure with the length of 5-20 micrometers, the width of 2-5 micrometers, the depth of 2-5 micrometers, the diameter of 30-300 nanometers and the depth of 10-200 nanometers. The zirconium oxide full-ceramic pile core is cemented by zinc phosphate cement, the pile is cemented with the wall of the marrow cavity, and the core and the defective tooth preparation body are cemented and fused into an abutment whole with a fixed shape.

Example 3:

for the cuspid tooth row zirconium oxide all-ceramic pile-core treatment which is not possible to be used as a shoulder collar, the conventional tooth preparation is carried out, a pulp cavity after the root canal treatment is drilled, a pulp cavity is trimmed to form a deep hole with taper, the depth of the hole is 7 mm, an expanding hole with the depth of 2 mm is arranged at the mouth of the pulp cavity, the diameter of the expanding hole is 1 mm larger than that of the pulp cavity, and the bottom surface of the hole is vertical to the pile axis. Taking an impression of a medullary cavity hole by silica gel, optically scanning the silica gel impression to prepare a digital impression, and scanning in the mouth to obtain the digital impression of dentition and occlusion relation of the dentition. Designing a pile-core digital model, wherein the surface of a core bottom platform is matched with the tooth preparation surface of a defective tooth body, the edge of the core bottom platform is in a hoop shape surrounding the tooth body, the height of a retention projection below the core bottom platform is 2 mm, and the retention projection bottom platform is vertical to the pile axis. The core on the upper part of the pile core is in a dental crown shape, and the edge of the core is matched with the edge of the prepared tooth to form the pile core crown with the pile core and the crown integrated structure. Photocuring additive material according to digital modelThe method comprises the following steps of: procurement of Al from Tosoh of Japan₂O₃ZrO of type TZ-3Y20A₂The powder (evenly mixed with PMMA resin monomer and photosensitizer to prepare composite slurry with zirconia content of 40 weight percent, and the composite slurry is manufactured into a biscuit of a personalized zirconia ceramic pile core on a CeraFab 7500 photocuring 3D printer manufactured by Lithoz company through a photocuring material increasing process, and then the biscuit is processed through 700 steps^oC removing glue for 15 hours and in air atmosphere at 1500^oC, sintering for 1 hour to obtain a sintered body of the pile core. Then, the surface of the zirconia pile core is subjected to micro-nano modification through local scribing and plastic deformation on a micro-nano scale by adopting sand blasting, and a surface secondary groove and pit structure with the length of 5-20 micrometers, the width of 2-5 micrometers, the depth of 2-5 micrometers, the diameter of 30-300 nanometers and the depth of 10-200 nanometers are formed. 3M ESPE RelyXTM Unicem self-adhesive resin cement is used for cementing the zirconia all-ceramic post-core pile and the medullary cavity wall, and the nuclear crown and the defective tooth preparation body are cemented and fused to form a post-core crown (as shown in figure 3).

Compared with the existing product, the dental zirconia ceramic pile core ensures stable retention, avoids excessive lateral force from being transmitted to the pile tip due to radial micro-movement of the core under the action of the lateral occlusal force, can reduce the failure rate of interface stripping of the existing product due to micro-movement by more than 30 percent, and improves the success rate of pile core repair by more than 10 percent.

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The above-described embodiments are only preferred embodiments of the present invention, and are not intended to limit the present invention in any way, and other variations and modifications may be made without departing from the spirit of the invention as set forth in the claims.