LINGUAL POSITIONING DEVICE FOR SLEEP, BREATHING, JAW AND AIRWAY DISORDERS
20220362051 · 2022-11-17
Inventors
Cpc classification
A61M16/0493
HUMAN NECESSITIES
A61C7/08
HUMAN NECESSITIES
International classification
Abstract
Oral appliances that may include a supporting shell member having concave geometry for receiving at least a portion of a dental arch of a wearer into the concave geometry; and, a tongue guide member extending from said supporting shell member and into contact with an underside of a tongue of said wearer when the portion of the dental arch is received into the concave geometry. This oral appliance may be utilized in methods for treating various sleep and breathing disorders (“SBD”), for treating sleep apnea, treating airway obstruction, for upper and/or lower jaw reshaping, for airway reshaping, for mandibular advancement, for tongue-retaining, and for providing myofunctional therapy to encourage and help train the tongue to have the proper tongue posture for nasal breathing and discourage mouth breathing.
Claims
1. An oral appliance comprising: a supporting shell member having concave geometry for receiving at least a portion of a dental arch of a wearer into the concave geometry; and, a tongue guide member extending from said supporting shell member and into contact with an underside of a tongue of said wearer when the portion of the dental arch is received into the concave geometry, wherein the portion of said arch has an arch geometry, and wherein the concave geometry fits over the arch and comprises a negative of at least a portion of the arch geometry.
2. The appliance of claim 2, wherein the arch comprises teeth, with each of the teeth having a unique tooth geometry, and wherein the concave geometry comprises a negative geometry corresponding to the unique tooth geometry of at least one of said teeth.
3. The appliance of claim 3, wherein the tongue guide member comprises a shape that will urge, and is positioned to urge, the tongue upwards toward a roof of a mouth of the wearer.
4. The appliance of claim 4, wherein the teeth have a lingual side, and the tongue guide member will extend away from the lingual side of the teeth.
5. The appliance of claim 5, wherein the teeth comprise one or more incisors, and wherein the tongue guide extends away from the lingual side of incisors.
6. The appliance of claim 5, wherein the teeth comprise one or more incisors and one or more canines, and wherein the tongue guide extends away from the lingual side of the incisors and canines.
7. The appliance of claim 5, wherein the teeth comprise one or more incisors, one or more canines, and one or more premolars, and wherein the tongue guide extends away from the lingual side of the one or more incisors, one or more canines, and one or more premolars.
8. The appliance of claim 5, wherein the teeth comprise one or more incisors, one or more canines, one or more premolars, and one or more molars and wherein the tongue guide extends away from the lingual side of the incisors, canines, premolars, and molars.
9. The appliance of claim 5, wherein the tongue guide defines a concave region into which a frenulum of the wearer is received.
10. The appliance of claim 5, wherein tongue guide comprises a first extension extending from the lingual side of the teeth toward a left side of a frenulum of the wearer and comprises a second extension extending from the lingual side of the teeth toward a right side of the frenulum.
11. The appliance of claim 5, wherein the dental arch comprises a right half and a left half, wherein the tongue guide extends from the left half to the right half.
12. The appliance of claim 5, comprising two of the tongue guides.
13. The appliance of claim 5, wherein the dental arch comprises a right half and a left half, wherein the tongue guide extends from the left half to the right half.
14. The appliance of claim 5, comprising two of the tongue guides, wherein the dental arch comprises a right half and a left half, and wherein one of the tongue guides extends from the right half, and the other tongue guide extends from the left half.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0069] The following drawings illustrate some of the many possible embodiments of this disclosure in order to provide a basic understanding of this disclosure. These drawings do not provide an extensive overview of all embodiments of this disclosure. These drawings are not intended to identify key or critical elements of the disclosure or to delineate or otherwise limit the scope of the claims. The following drawings merely present some concepts of the disclosure in a general form. Thus, for a detailed understanding of this disclosure, reference should be made to the following detailed description, taken in conjunction with the accompanying drawings, in which like elements have been given like numerals.
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DETAILED DESCRIPTION OF THE INVENTION
[0119] It is to be understood that the following disclosure provides many different non-limiting embodiments, or examples, for implementing different features of various non-limiting embodiments. Specific examples of compositions are described below to simplify the disclosure and are not intended to limit the scope of the claims. These are, of course, merely examples and are not intended to be limiting of the scope of the claims. The section headings used herein are for organizational purposes and are not to be construed as limiting the subject matter described.
[0120] Non-Limiting Apparatus of the Present Invention
[0121] The present invention provides, among other things, a lingual positioning device. Some non-limiting embodiments of the tongue guiding apparatus of the present invention are for guiding the tongue into a desired position. In even other non-limiting embodiments of the present invention, a tongue guiding apparatus is provided that urges the tongue upward toward the roof of the mouth. In still other non-limiting embodiments of the present invention, multifunction equipment is provided that will not only provide for jaw expansion, but at the same time urge/move the teeth into or toward their desired position, that is, from an initial tooth arrangement to a desired (i.e. final) tooth arrangement.
[0122] Some non-limiting embodiments of the tongue guiding apparatus of the present invention may include a supporting shell member that comprises a member that engages the lower set of teeth in a human mouth, and another member that engages and guides the tongue.
[0123] Some non-limiting embodiments of the present invention provide appliances for bite block and/or lingual positioning, to parts thereof, to systems thereof including such appliances, such appliances for repositioning teeth and/or positioning the tongue, and to methods of making and using such appliances, parts and systems, with such appliances including a supporting shell member that engages the lower set of teeth in a human mouth, a tongue guide member supported by the shell member, and at least one bite block supported by the supporting shell member.
[0124] It should be understood any of the embodiments shown herein as having a tongue guide and/or bite block, may be provided with or without the tongue guide and/or bite block.
[0125] Some non-limiting embodiments of the present invention comprise systems that comprise an orthodontic appliance for moving teeth that is worn during a time period, and that comprise a lingual positioning appliance that is worn during an alternate time period. These systems may comprise a series of orthodontic appliances, and a series of lingual positioning appliances. Most conveniently, orthodontic appliance is an aligner, most likely a clear aligner. Such aligners are well known in the dental arts. As non-limiting examples, any of the aligners as shown in any of the prior art publications and patents cited herein are incorporated by reference. Further, any of the many commercially available clear aligners are believed to be suitable for use as the orthodontic appliance in the present invention. An example of a suitable commercially available aligner useful in the present invention includes CLEARCORRECT® clear aligners, available from the Straumann Group.
[0126] The methods, apparatus, and products of the present invention are suitable for various sleep and breathing disorders (“SBD”), sleep apnea, airway obstruction, upper and/or lower jaw reshape, airway reshaping, mandibular advancement, and tongue-retaining. Some embodiments of the present invention may be used with myofunctional therapy to encourage and help train the tongue to have the proper tongue posture for nasal breathing and discourage mouth breathing.
[0127] The tongue guide device of the present invention is designed to be worn by a patient, causing the tongue to be urged toward the roof of the mouth. Without being limited/bound by theory, the inventor believes that this causes the tongue to press against the lingual side of the incisors on the upper arch. The inventor also believes that this helps with breathing, because the tongue against the top of the mouth causes a seal encouraging/helping the patient to breathe through the nose. The inventor also believes this pressing against those incisors will cause the teeth to move forward, reshaping/moving the upper jaw in the process, subsequently allowing the lower jaw more room to move forward. The inventor also believes that this in turn will reshape/enlarge the airway.
[0128] It's probably most convenient for most patients to wear the apparatus of the present invention at night when sleep and breathing disorders are a problem. The present device may also be worn during the day. It is also believed that intermittent wearing will elicit the most movement from the teeth/jaw. For most patients wearing the device at night and allowing daytime for rest will work sufficiently.
[0129] Referring now to
[0130] While guide member 14 is shown in
[0131] It should be understood that for some non-limiting embodiments of the present invention, the tongue guiding apparatus of the present invention is designed for a specific patient, in particular, for that patient's lower set of teeth. That is, the apparatus will comprise geometry that is the negative of the geometry of the patient's teeth. It should also be understood, that for other non-limiting embodiments of the present invention, the tongue guiding apparatus of the present invention may be designed to be one size fits many or perhaps all patients. That is, such a device is more of a general device that comprises for generalized geometry to be able to accommodate a number of patients having a wide range of tooth arrangements more along the idea of an athletic mouthpiece.
[0132] Supporting shell member 12 may comprise a shell having at least one tooth-receiving cavity 21 formed therein. Supporting shell member 12 is designed to fit over one or more teeth 15 of the lower set of teeth 18. More specifically, supporting shell member 12 is designed to fit over 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, or 15 or more of the teeth 15 of the lower set of teeth 18. Some non-limiting embodiments of supporting shell member 12 are designed to fit over all of a patient's teeth 15 of the lower set of teeth 18 (which number “all” may vary according to any specific patient).
[0133] Supporting shell member 12 will also comprise one or more tooth receiving concave cavities 21, having geometries that conform to the teeth that are to be received within those cavities. Specifically, those geometries are negative geometries of the teeth that are to be received therein. Those cavities 21 will generally snuggly receive its corresponding tooth 15, generally forming a friction fit. More specifically, Supporting shell member 12 will also comprise 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, or 15 or more tooth receiving concave cavities 21, having geometries that conform to the teeth that are received within those cavities.
[0134] Supporting shell member 12 will generally be made of a suitable polymeric material as are well known in the dental arts. Any suitable thermoplastic or thermoset material may be utilized.
[0135] As can be noticed in
[0136] The human anatomy includes the frenulum which is a small fold of mucous membrane extending from the floor of the mouth to the midline of the underside of the tongue. It should be understood, that the position and extent of the frenulum varies from patient to patient, and representations of the frenulum in any of the drawings should be understood as a representative position and that the exact position for any given patent may or may not correspond as shown in any of these drawings. It should also be understood that while the frenulum is shown as a point F in some of the drawings, it has a curvilinear shape from the floor of the mouth to the midline of the underside of the tongue.
[0137] In most embodiments, it should be understood the design/shape of the tooth guide is determined by the shape of the lingual side of the teeth and the position of the frenulum.
[0138] As a non-limiting example, in some non-limiting embodiments, the tooth guide will extend away from the lingual side of the teeth toward the frenulum but not past the frenulum. See,
[0139] As another non-limiting example, in some non-limiting embodiments, the tooth guide will extend away from the lingual side of the teeth toward the frenulum but not past the frenulum. As non-limiting examples, see,
[0140] Specifically, referring now to
[0141] Specifically, referring now to
[0142] Specifically, referring now to
[0143] Specifically, referring now to
[0144] Specifically, referring now to
[0145] Specifically, referring now to
[0146] Specifically, referring now to
[0147] As another non-limiting example, in some non-limiting embodiments, the tooth guide will extend away from the lingual side of the teeth toward the frenulum, with some of the tooth guide extending past but not impinging upon the frenulum. As non-limiting examples, see,
[0148] Specifically, referring now to
[0149] Specifically, referring now to
[0150] Specifically, referring now to
[0151] Specifically, referring now to
[0152] Specifically, referring now to
[0153] It should be understood that any of the shapes shown in
[0154] It should also be understood that the shape of tongue guide 14 is not to be limited to any of those as show in
[0155] Referring again to
[0156] Specifically,
[0157] Specifically,
[0158] Specifically,
[0159] Specifically,
[0160] Specifically,
[0161] Specifically,
[0162] Specifically,
[0163] It should also be understood that tongue guide 15 will raise the tongue to various heights relative to the incisors, for example, ¼, ½, ¾ the height of the incisors, as well as incisor height, or even over the incisor.
[0164] See,
[0165] Specifically,
[0166] Specifically,
[0167] Specifically,
[0168] Specifically,
[0169] In some non-limiting embodiments, tongue guiding apparatus 10 is designed not only to position the tongue but is further designed to also reposition at least one of the patient's teeth. Specifically, supporting shell member 12 may also comprise at least one concave cavity 21 that is designed to reposition a tooth. Thus, supporting shell member 12 may comprise tooth receiving geometry to reposition the teeth to a different tooth arrangement.
[0170] In such a tooth repositioning embodiment, the tongue guiding appliance 10 will be configured to have at least one tooth-receiving cavity has a geometry causing a tooth to move to a new position relative to its current position. Is should be understood that in treatment, not all teeth are moved at each step of treatment. Generally, when such an appliance is first worn by the patient, one or more of the teeth will be misaligned relative to an undeformed geometry of the appliance cavity. The appliance, however, is sufficiently resilient to accommodate or conform to the misaligned teeth, and will apply sufficient resilient force against such misaligned teeth in order to reposition the teeth to the new position for that treatment step (be it an intermediate or final positioning).
[0171] Thus, such tooth moving tongue guiding systems according to the present invention may include one or more such tongue guiding appliances 10 having a geometry selected to reposition a patient's teeth to a new position for that treatment step. Such systems may include 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15 or more tongue guiding appliances 10 to incrementally reposition teeth. Thus, it should be understood such systems of tongue guiding appliances 10 may incrementally reposition teeth from an initial tooth arrangement to a desired/final tooth arrangement.
[0172] Referring now to
[0173] Some non-limiting embodiments of the apparatus of the present invention may include at least one bite block, and may or may not also include a tongue guide member Referring now to
[0174] The various apparatus of the present invention as disclosed herein may also include bite blocks 35 on each side of the apparatus. In fact, observing that an appliance my consist of both upper and lower arch members, any combination of one, two, three, four, or more bite blocks on the left/right side of the upper/lower arch members is contemplated. As non-limiting examples, a bite block on the upper right only, upper left only, lower right only, lower left only, or a bite block on only one of the upper right, upper left, lower right or lower left, in combination with a bite block on one, two or three of the following of lower right, lower left, and upper left. Any of these combinations may or may not be paired with a tongue guide.
[0175] Referring now to
[0176] It should be understood that the bite blocks utilized herein may be any suitable shape that is desirable and/or practical, include any regular geometric shape, any n-sided geometric side where n may be 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, or more, any irregular geometric shape, any shape having linear sides, any shape having curvilinear sides, any shape having convex sides, any shape having convex sides, and combinations of the foregoing.
[0177] Bite blocks utilized in the present invention will also comprise side walls that urge the bite block to stay affixed to a supporting shell member that has been vacuum formed around the bite block. Referring now to
[0178] Referring now to
[0179] Referring now to
[0180] Referring now to
[0181] Referring now to
[0182]
[0183] Appliance suite 100 may include only one bite block on bottom supporting shell 14, only one bite block on top supporting shell 14T, bite blocks on bottom supporting shell 14, more bite blocks on top supporting shell 14T, bite blocks on both shell 14 and shell 14T, bite blocks on both sides of bottom supporting shell 14, bite blocks on both sides of bottom supporting shell 14T, at least one bite block on both bottom supporting shell 14 and top supporting shell 14T, only one bite block on bottom supporting shell 14 and bite blocks on top supporting shell 14T, bite blocks on bottom supporting shell 14 and only one bite block on top supporting shell 14T, or bites block on both bottom supporting shell 14 and top supporting shell 14T.
[0184] Referring now to
[0185] Referring now to
[0186] Referring now to
[0187] Referring now to
[0188] Referring now to
[0189] Referring now to
[0190] Referring now to
[0191] Referring now to
[0192] Referring now to
[0193] Referring now to
[0194] Referring now to
[0195] In some non-limiting embodiments of the present invention, systems are provided in which the tongue positioning device is paired with an orthodontic device. In particular, the tongue positioning device and the orthodontic device are each worn during different/alternate time periods. As a non-limiting example, the tongue positioning device may be worn during nighttime/sleeping, and the orthodontic device is worn during the day. As another non-limiting example, both the tongue positioning device and the orthodontic device may be worn at different times of the day. Given that the tongue positioning device is useful for sleep/breathing disorders, it is most likely that the tongue positioning device is worn during sleep, however, it is possible that the orthodontic device could also be worn at night too, either exclusively, or both could be worn alternatively.
[0196] In some embodiments where the tongue positioning device is paired with an orthodontic device, the tongue positioning device will have the same tooth receiving geometry as the bottom orthodontic device, that is, both the tongue positioning device and the bottom orthodontic device will urge/guide/position the bottom teeth to a certain position/configuration. Thus, the bottom orthodontic device will urge/guide/position the bottom teeth to a certain position during a given time period, and when the tongue positioning device is subsequently worn during a different time period it will not only position the tongue it will also urge/guide/position the bottom teeth to that same certain position/configuration.
[0197] In some non-limiting embodiments of the present invention, there is provided a system comprising a series of incremental systems each comprising a tongue positioning device paired with an orthodontic device. This series of incremental systems of paired devices is designed to incrementally reposition teeth from an initial tooth arrangement to a final tooth arrangement. Such systems may comprise a series of 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15 or more incremental systems of paired devices.
[0198] In these systems for repositioning teeth from an initial tooth arrangement to a final tooth arrangement, repositioning is accomplished with a series of paired appliances configured to receive the teeth in a cavity and incrementally reposition individual teeth in a series of successive steps. The successive use of a number of such appliances permits each appliance to be configured to move individual teeth in small increments, typically less than 2 mm, preferably less than 1 mm, and more preferably less than 0.5 mm. These values refer to the maximum linear translation of any point on a tooth as a result of using a single appliance. The movements provided by successive appliances, of course, will usually not be the same for any specific tooth. Thus, one point on a tooth may be moved by a different distance as a result of the use of one appliance and thereafter moved by a different distance and/or in a different direction by a later appliance.
[0199] The individual orthodontic appliances and tongue positioning device preferably comprise a polymeric shell having the teeth-receiving cavity formed therein. Each individual appliance is configured so that its tooth-receiving cavity has a geometry corresponding to the next desired tooth arrangement intended for that appliance. That is, when an appliance is first worn by the patient, certain of the teeth will be misaligned relative to an undeformed geometry of the appliance cavity. The appliance, however, is sufficiently resilient to accommodate or conform to the misaligned teeth and will apply sufficient resilient force against such misaligned teeth in order to reposition the teeth to next tooth arrangement desired for that treatment step.
[0200] Referring now to
[0201] Two or more of these systems 210 may form a system 200 to incrementally move teeth. This system 200 may comprise a series of systems 210. In such a system 200, there are a series of orthodontic appliances 201, and a series of tongue positioning appliances. Most conveniently, orthodontic appliance is an aligner, most likely a clear aligner. Such aligners are well known in the dental arts. As non-limiting examples, any of the aligners as shown in any of the prior art publications and patents cited herein are incorporated by reference. Further, any of the many commercially available clear aligners are believed to be suitable for use as the orthodontic appliance in the present invention. An example of a suitable commercially available aligner useful in the present invention includes CLEARCORRECT® clear aligners, available from the Straumann Group.
[0202] Non-Limiting Methods of Making the Present Invention
[0203] Any of the apparatus as described herein, including the orthodontic device and tongue guide, may be manufactured by any suitable method utilizing any suitable machinery and/or tools as are well known in the dental arts.
[0204] As a non-limiting example, part or all of the orthodontic device and/or tongue guiding apparatus may be manufactured completely utilizing techniques that are well known in the dental and manufacturing arts, including but not limited to manual techniques, vacuum forming, molding methods, subtractive methods (milling as a non-limiting example), additive methods (3D printing as a non-limiting example), or combinations thereof.
[0205] In various methods of making part or all of the tongue guide apparatus of the present invention, the tongue guide member and the supporting shell member may be made by same or different methods, and at the same or different times.
[0206] As a non-limiting example, tongue guide member and supporting shell member can be made unassembled, with the two then assembled together using couplings, adhesives, friction fit, interlocking members, mating members, and the like.
[0207] As another non-limiting example, tongue guide member can be made first, with supporting shell member then formed around and affixed to the tongue guide member. As a non-limiting example, vacuum forming or molding the supporting shell member onto/around the tongue guide member. The tongue guide member may have a geometric configuration, surface characteristic, shape, undercut, protrusion, and/or indention, that will allow for supporting shell member to be affixed to the tongue guide member. For example, when the supporting member is vacuum formed around the tongue guide member, the polymer utilized to form the supporting shell member may or may not sufficiently adhere to the tongue guide member. Thus, a mechanical connection must be utilized to affix the two together. Alternatively, part of the supporting shell member may wrap around part of the tongue guide member. Alternatively, the tongue guide member may have a geometric configuration, surface characteristic, shape, undercut, protrusion, that will allow for supporting shell member to be affixed to the tongue guide member. Alternatively, an adhesive may be utilized between the tongue guide member and the supporting shell member.
[0208] As even another non-limiting embodiment, the tongue guide member and supporting shell member can be formed together, as non-limiting examples, by additive techniques (as a non-limiting example, 3-D printing the device having both the shell member and the guide member), subtractive techniques (as a non-limiting example, milling the device), and/or molding the device. Any of these techniques may be utilized for making the orthodontic devices of the present invention.
[0209] Both the tongue guide member and the supportive shell member, as well as the orthodontic devices, are designed based on a physical and/or digital model (negative or positive) of the patient's teeth. Thus, it is generally desired to obtain digital and/or physical models of the patient's mouth. Various techniques include taking a mold, picture, X-ray, or scan of a patient's teeth, and from that, making a physical and/or digital model of the model of the patient's teeth. Of course, the mold is a negative tooth model from which a positive tooth model may be obtained.
[0210] For embodiments in which teeth are to be repositioned in a series of incremental steps form initial tooth positions to final tooth positions, a series of treatment models providing for movement from initial tooth positions to final tooth positions, either physical or most conveniently digital, are obtained from which the systems are made.
[0211] The tooth guiding member and/or orthodontic device can then be made from the obtained model of the patient's teeth. It should be understood that the tongue guide member and/or orthodontic device can be digitally designed fully within an information handling system (for example, a computer), or physically designed directly upon a physical model. Methods for obtaining the tongue guide member and/or orthodontic device include designing a digital version of the tooth guiding member (or orthodontic device) and then creating a physical tooth guiding member (or orthodontic device) therefrom, and can also include creating a physical tooth guiding member and/or orthodontic device using a physical model of the teeth.
[0212] Referring now to
[0213] Referring now to
[0214] For the method as shown in
[0215] For the method 30 as shown in
[0216] Bite blocks 35 are shown as being positioned underneath supporting shell member 14. However, regarding bite block embodiment of the tongue guiding apparatus of the present invention, it should be understood, that one or more of the various bite blocks 35 may actually be positioned on top of supporting shell member 14. Rather than the bite block and the supporting shell member being vacuum formed together, the two can be affixed together using methods well known, including using an adhesive, connectors, interlocking members, mating members, friction fit, mechanical fit, and the like,
[0217] As another non-limiting example, it is believed that part or all of the tongue guiding apparatus of the present invention may be constructed utilizing rapid prototyping technology. In general, rapid prototyping is a group of techniques used to quickly fabricate a scale model of a physical part or assembly using three-dimensional computer aided design (CAD) data. Construction of part or all of the tongue guiding apparatus of the present invention may be manufactured utilizing one or more additive technologies and/or one or more subtractive technologies, generally computer implemented. Such methods includes, but are not limited to 3D printing (3DP), Ballistic particle manufacturing (BPM), Directed light fabrication (DLF), Direct-shell production casting (DSPC), Fused deposition modeling (FDM), Laminated object manufacturing (LOM), Laminated resin printing (LRP), Shape deposition manufacturing (SDM) (and Mold SDM), Solid ground curing (SGC), Selective laser sintering (SLS), Selective laser melting (SLM), Stereo lithography (SLA), Multi Jet Fusion (MJF), and CNC subtractive technology.
[0218] Without further elaboration, it is believed that one skilled in the art can, using the description herein, utilize the present disclosure to its fullest extent. The embodiments described herein are to be construed as illustrative and not as constraining the remainder of the disclosure in any way whatsoever. While the embodiments have been shown and described, many variations and modifications thereof can be made by one skilled in the art without departing from the spirit and teachings of the present disclosure as set forth herein. Accordingly, the scope of protection is not limited by the description set out above, but is only limited by the claims, including all equivalents of the subject matter of the claims.
[0219] The foregoing outlines several embodiments with numerous features so that those skilled in the art may better understand the aspects of the disclosure. Those skilled in the art should appreciate that they may readily use the disclosure as a basis for designing or modifying other processes and compositions for carrying out the same purposes and/or achieving the same advantages of the embodiments introduced herein. Those skilled in the art should also realize that such equivalent constructions do not depart from the spirit and scope of the disclosure, and that they may make various changes, substitutions, and alterations herein without departing from the spirit and scope of the disclosure. The scope of the invention should be determined only by the language of the claims that follow. The term “comprising” within the claims is intended to mean “including at least” such that the recited listing of elements in a claim are an open group. The terms “a,” “an,” and other singular terms are intended to include the plural forms thereof unless specifically excluded.
[0220] All materials described, cited and/or referenced herein, including patents, patent publications, provisional patent applications, books, journals, articles, websites/pages, and any publications, are incorporated by reference for all that they disclose or teach.