Patent Publication Number: US-2007111159-A1

Title: Compressible Content Sac for Dental Prophylaxis Angle with Offset Rotational Axis

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS  
      This application is a continuation-in-part application of copending U.S. patent application Ser. No. 10/909,816, filed on Aug. 2, 2004, allowed, which is hereby incorporated in its entirety. 
    
    
     FIELD OF THE INVENTION  
      The present invention relates generally to the field of dental devices, and relates more specifically to a self-contained dental prophylaxis angle with an offset rotational axis and methods for use in cleaning, polishing, bleaching, bonding, etching, abrading, desensitizing, or otherwise treating teeth.  
     BACKGROUND OF THE INVENTION  
      The application of an abrasive dentifrice paste is generally known to clean and polish teeth. Similarly, other dentifrice compounds are applied to the surfaces of teeth in numerous other dental procedures to bleach, abrade, or otherwise treat a variety of dental conditions. Most commonly, such procedures are performed by a dentist, dental hygienist, or dental assistant using a motorized handpiece which receives what is commonly referred to in the art as a “prophylaxis angle” or “prophy angle.” Typically, the prophylaxis angle is mounted at a right angle to the handpiece, and has a rotating polishing surface that is rotated by the motorized action of the handpiece, and receives dentifrice as it rotates from a cup mounted on the prophylaxis angle. The dentifrice contained within the cup on the prophylaxis angle is replaced as needed by the operator, typically by dipping the prophylaxis angle into a container of dentifrice and scooping out additional dentifrice as desired.  
      As conventionally deployed, the dentifrice used in prophylaxis angles has been generally in a paste, cream, or other gummy amalgam form. Powdered dentifrices have also been commonly used, generally with sufficient moisture added to create a paste-like preparation for application.  
      Formerly, most prophylaxis angles were supplied and used as multi-use devices, requiring cleaning and/or sterilization between use for different patients. With the advent of cost-efficient, disposable manufacturing materials and techniques, and with the growing concern over the prevention of transmittable diseases during dental therapy, the use of single-use, disposable prophylaxis angles has become commonplace.  
      Although the development of disposable prophylaxis angles has had significant impact on dental practice, problems still exist relating to the application of dentifrice to a patient&#39;s teeth using an existing disposable prophylaxis angle. Conventional disposable prophylaxis angles may effectively prevent the spread of disease from patient to patient, but do not completely protect the dentist or other operator from potential exposure during use. The container of dentifrice is often held on the finger of the operator. Digital pressure must then be employed with the dentifrice to apply it to the cup of the prophylaxis angle, and such pressure may often stall the drive motor that drives the prophylaxis angle. As the digital pressure is released, the drive motor overcomes the stalling pressure, and the rotational speed of the prophylaxis cup may suddenly increase, potentially spraying buccal debris such as saliva, blood, and tissue particles into the surrounding work environment. This phenomenon is commonly referred to as “splatter,” and may occur even in the presence of a minimal amount of buccal debris. Exposure to such debris can pose a significant health risk to the dentist and/or other operators who are attending the patient.  
      Past attempts have been made to incorporate dispensable dentifrice within the prophylaxis angle device. However, these efforts have generally failed because of technical disadvantages that prevented their acceptance in the dental marketplace. Among other problems, early prophylaxis angles incorporating paste were not disposable. Additionally, other paste delivery mechanisms were relatively mechanically complex and therefore cost prohibitive.  
      For example, disposable prophylaxis angles having internal paste delivery systems using an auger-like structure of the type proposed in the related art must overcome problems associated with charging an internal reservoir with dentifrice material either before or after the auger is assembled into the prophylaxis angle. Either way, the helical blades of the auger, which typically extend for a substantial portion of the internal diameter of the fluid reservoir, make it difficult to fully charge the reservoir with the dentifrice material. Also, the auger blades make advancement of the dentifrice material dependent on the direction of rotation and rotational speed of the auger.  
      Prophylaxis angles as previously known in the related art are also too large to be practical or were generally more difficult to use and required retraining the practitioner before use on a patient.  
      Recent efforts to improve a prophylaxis angle are disclosed in U.S. Pat. No. 6,257,886 to Warner, U.S. Pat. No. 6,382,971 to Randolph, U.S. Pat. No. 5,692,901 to Roth et al., and U.S. Pat. No. 5,871,353 to Pierce et al. These cited prophylaxis angles, while they may represent improvements upon certain aspects of the preceding art, continue to be designed around a central rotational axis, which requires more complex engineering to allow for a pathway for dentifrice flow. Certain deficiencies also persist among existing prophylaxis angles, leaving a need for further improvement in the design, use, and applications for such devices.  
     SUMMARY OF THE INVENTION  
      A prophylaxis angle according to the present invention overcomes, or at least alleviates, one or more of the difficulties or deficiencies associated with prior art prophylaxis angles, employing an offset rotational axis which allows mechanically simpler and more reliable passage of dentifrice material during use.  
      A prophylaxis angle according to the present invention may or may not require a cup to receive dentifrice or other dental therapeutic material as is commonly employed in existing prophylaxis angles in cleaning or otherwise treating teeth. In a prophylaxis angle according to the present invention in which a modified cup is employed, a supply of dentifrice or other dental therapeutic material is delivered in the proximity of or through the cup through one or more channels parallel to the rotational axis of the power drive, which is offset from a central axis within the handle of the prophylaxis angle. In a prophylaxis angle according to the present invention in which no cup is required, a dentifrice or other dental therapeutic material is dispensed within the prophylaxis angle, and the dentifrice or other dental therapeutic material is dispensed in the proximity of or through the surface tip that cleans or otherwise contacts the teeth for the desired effect.  
      A prophylaxis angle according to the present invention may further incorporate a control device to start or stop rotational action of the prophylaxis angle for enhanced user control and convenience. Moreover, a prophylaxis angle according to the present invention may further incorporate an adjustable geared mechanism to allow user control of the rotational speed of the prophylaxis angle.  
      A prophylaxis angle according to the present invention may further provide a design that will not allow back flow of saliva or contaminated materials into the unused dentifrice supply.  
      A prophylaxis angle according to the present invention may be provided either as a single use, disposable device, or as a reusable device for various applications.  
      A prophylaxis angle according to the present invention may be provided for a variety of therapeutic applications in the fields of dentistry and oral hygiene. Such applications include, but are not limited to, the cleaning, polishing, etching, desensitization, bonding, abrading, fluoride treatment of teeth, gums, other intraoral structures, dental appliances, or other dental therapeutic or oral hygienic procedures.  
      A prophylaxis angle according to the present invention may be provided to mechanically interface with the nozzle connector piece of a standard dental gas-driven handpiece to provide power for use in dental therapeutic or oral hygienic procedures.  
      In alternate embodiments according to the present invention, a prophylaxis angle according to the present invention may be provided to incorporate a connection allowing direct connection to the motor unit of a standard dental gas-driven handpiece to provide power for use in dental therapeutic or oral hygienic procedures, thus eliminating the need to clean and re-sterilize conventional nozzle connectors for such headpieces.  
      A prophylaxis angle according to the present invention may be provided as a toothbrush for self use by patients.  
      A method of treating teeth using a self-contained dental prophylaxis angle according to the present invention by an operator or by a patient, in which a dental therapeutic material contained within the dental prophylaxis is delivered to the interface of a powered dental tip and the teeth while power is applied to rotate the dental tip through a drive mechanism which is offset from the mechanical center of the dental prophylaxis unit.  
      These and other features, aspects, and other advantages of the present invention will become better understood with regard to the following drawings, description, and appended claims. 
    
    
     BRIEF DESCRIPTION OF THE DRAWINGS  
       FIG. 1  provides a cross-sectional view of an exemplary self-contained dental prophylaxis angle with an offset rotational axis according to the present invention in which a contained pressurized gas is used to advance the flow of dentifrice within.  
       FIG. 2  provides a cross-sectional view of an exemplary self-contained dental prophylaxis angle with an offset rotational axis according to the present invention in which the mechanical action of the prophylaxis angle is used to advance the flow of dentifrice within.  
       FIG. 3  provides a cross-sectional view of an exemplary self-contained dental prophylaxis angle with an offset rotational axis according to the present invention in which an integral nozzle is provided to directly connect to a standard dental handpiece motor unit.  
       FIG. 4  provides a cross-sectional view of an exemplary self-contained dental prophylaxis angle with an offset rotational axis according to the present invention in which an integral nozzle and gas-driven motor unit is provided for direct connection to a standard dental compressed drive gas supply.  
       FIG. 5  provides a cross-sectional view of an exemplary self-contained dental prophylaxis angle with an offset rotational axis according to the present invention in which a spring biases the plunger distally.  
       FIG. 6  provides a cross-sectional view of an exemplary self-contained dental prophylaxis angle with an offset rotational axis according to the present invention in which a threaded control stem actuates the plunger distally.  
       FIG. 7  A-F provide lateral and end-on views of various exemplary dental tips for an self-contained dental prophylaxis angle with an offset rotational axis according to the present invention.  
    
    
     DETAILED DESCRIPTION OF THE INVENTION  
      The present invention may be understood more readily by reference to the following detailed description of the preferred embodiments of the invention and the Examples included herein However, before the preferred embodiments of the devices and methods according to the present invention are disclosed and described, it is to be understood that this invention is not limited to the exemplary embodiments described within this disclosure, and the numerous modifications and variations therein that will be apparent to those skilled in the art remain within the scope of the invention disclosed herein. It is also to be understood that the terminology used herein is for the purpose of describing specific embodiments only and is not intended to be limiting.  
      Unless otherwise noted, the terms used herein are to be understood according to conventional usage by those of ordinary skill in the relevant art. In addition to the definitions of terms provided below, it is to be understood that as used in the specification and in the claims. “a” or “an” can mean one or more, depending upon the context in which it is used.  
      The present invention is directed towards a self-contained dental prophylaxis angle with an offset rotational axis and methods for its use in performing dental therapeutic procedures. Such dental therapeutic procedures, as referred to herein, include, but are not limited to, the cleaning, polishing, etching, desensitization, bonding, abrading, fluoride treatment of teeth, gums, other intraoral structures, dental appliances, or other dental therapeutic or oral hygienic procedures  
      In an exemplary embodiment according to the present invention, a self-contained dental prophylaxis angle with an offset rotational axis is provided to dispense dentifrice or other therapeutic medicament contained therein as the prophylaxis angle is being used by an operator to clean or otherwise treat a patient&#39;s teeth An exemplary self-contained dental prophylaxis angle with an offset rotational axis according to the present invention is provided with an elongated tubular body with a length defining a central axis, a proximal end, a distal end, a content lumen containing a content in fluid communication with a distal content portal, and a drive lumen in communication with a distal drive portal. In addition, such a self-contained dental prophylaxis angle with an offset rotational axis according to the present invention is further provided with a dental tip rotatably mounted on the distal end that is turned by the action of one or more distal gears at the distal drive portal that are turned by a mechanical drive shaft within the drive lumen and with a length defining a longitudinal rotational axis. Finally, a self-contained dental prophylaxis angle with an offset rotational axis according to the present invention is provided with a content dispensing mechanism to selectively dispense content such as a dental therapeutic dentifrice or other material from the content lumen through the distal content portal into contact or proximity with the dental tip.  
      Referring now to the drawings, in which like numerals indicate like elements throughout the several views, one preferred embodiment of an exemplary prophylaxis angle according to the present invention is shown in  FIG. 1 . As shown in  FIG. 1 , an exemplary self-contained dental prophylaxis angle  100  is provided with a tubular body  105  with a proximal end  110  and a distal end  115 . In various embodiments according to the present invention, the external shape of the body  105  may be round, oblong, triangular, square, polygonal, or any other desired shape. In the example illustrated in  FIG. 1 , the body  105  contains at least two parallel lumens, a main lumen  118 , and a drive lumen  125 . The longitudinal axis of the main lumen  118  is referred to herein as the central axis, The drive lumen contains a drive shaft  130 . The longitudinal axis of the drive shaft  130  is referred to herein as the rotational axis. At the proximal end  110 , the drive shaft  130  is fitted with a geared connector  131  compatible to connect operably with a standard dental handpiece [not shown] to provide rotational power to said drive shaft  130 . The drive shaft  130  is further provided with a distal gear tip  135  which interfaces with a transitional gear  145  which interfaces with a geared tip  150  at a distal drive portal  138  to transfer rotational motion from the handpiece to the geared tip  150  thus rotating a cleaning tip  155  which is attached to said geared tip  150 .  
      In alternate embodiments according to the present invention, the distal gear tip  135  may interface directly with the geared tip  150  at a distal drive portal  138 , eliminating any transitional gears. The cleaning tip  155  and attached geared tip  150  are rotatably attached to the distal end  115  of the body  105 , which may be straight, or may be curved at an angle varying from 0 to 179 degrees with respect to the long axis of the body  105 . At or near the junction with the dental tip  155  and attached geared tip  150 , the body  105  terminates with a content portal  160  which contains one or more fenestrations  165  to allow egress of therapeutic content  170  from main lumen  118  onto or in proximity with the dental tip  155  for cleaning or other therapeutic purposes. Flow of said egress of contained dentifrice or other therapeutic content  170  from main lumen  118  is effected by compression by a plunger  175  with a distal face  176 . In various embodiments according to the present invention, the plunger  175  is sized and shaped to fit sealably, but slidably within the main lumen  118 . The distal face  176  of the plunger  175  may be flat, concave, convex, or otherwise shaped to fit the desired application. In the example shown in  FIG. 1 , the plunger  175  is advanced by the effect of gas pressure release from a pressurized gas container  180  located within the proximal aspect of main lumen  118 . Said pressurized gas container  180  has a gas portal  185  that connects to a gas valve  190  and a gas jet  195 . The gas valve  195  is operated by compression action of a control stem  196  which is spring loaded by a spring  193  which is housed in a control well  198 . The control stem  196  has a sealed traverse through said control well  198 , and exits through a sealed control well cap  197  to terminate in a control button  199 .  
      In various embodiments according to the present invention, the control button  199  may be provided further with a control latch  178  to permit continued opening of the gas valve  190  despite release of digital pressure by the operator. Such a control latch  178  would be immediately releasable upon a re-application of digital pressure to the control button  199  by the operator.  
      In use by an operator, the exemplary prophylaxis angle of  FIG. 1  is again attached to a standard dental handpiece. The rotary motion of the handpiece powers the motion of the drive shaft  130 , which is transferred to, and causes rotational motion of the dental tip  155 . When the operator desires to effect the dispensing of therapeutic content  170 , digital pressure on the control button  199  opens the gas valve  190  releasing compressed gas into the enclosed main lumen  118 , thus permitting the displacement of the plunger  175  and dispensing therapeutic content  170  through the fenestrations  165  in the end cap  160 . In various embodiments according to the present invention, the body  105  may further be provided with one or more transparent windows  169  that permit an operator to monitor the movement of the plunger  175  towards the distal end  115 , thus allowing the operator to determine how much content  170  remains to be dispensed. Graduations or other markers [not shown] may be provided on the windows  169  to allow the operator to quantitate the remaining content  170 .  
      In other alternate embodiments according to the present invention, a self-contained dental prophylaxis angle  100  may further be provided with a distal cap  177  removable by the operator, which may serve to provide a seal during storage, and to prevent inadvertent leakage of content  170  prior to use.  
      In yet other alternate embodiments according to the present invention, the distal end  115  may be covered by a membrane [not shown]. Such a membrane may be solid and removable or pierced by the operator prior to use, or may be semipermeable, and permit egress of content  170  through the membrane as the plunger  175  is advanced.  
      In yet other alternate embodiments according to the present invention, content is dispensed by action of a plunger which is advanced by the effect of gas pressure release from a pressurized gas located within the main lumen operable by a valve activated by a user in a manner similar to a conventional aerosol can. Alternately, content may be dispensed by direct action of a pressurized gas located within the main lumen operable by a valve activated by a user in a manner similar to a conventional aerosol can. Alternately still, a self-contained dental prophylaxis angle according to the present invention may be directly connected to an external source of compressed gas, such as that typically provided in a dental treatment unit, to dispense content either by advancing a plunger or by direct displacement effect on the content.  
      An alternate preferred embodiment of an exemplary prophylaxis angle according to the present invention is shown in  FIG. 2 . As shown in  FIG. 2 , an exemplary self-contained dental prophylaxis angle  200  is provided with an elongated tubular body  205  with a proximal end  210  and a distal end  215 . In various embodiments according to the present invention, the external shape of the body  205  may be round, oblong, triangular, square, polygonal, or any other desired shape In the example illustrated in  FIG. 2 , the body  205  contains at least two parallel lumens, a main lumen  220 , and a drive lumen  225 . The longitudinal axis of the main lumen  220  is referred to herein as the central axis. The drive lumen contains a turnable drive shaft  230  which contains drive shaft threads  233  along some or all its length. The longitudinal axis of the drive shaft  230  is referred to herein as the rotational axis. At the proximal end  210 , the drive shaft  230  is fitted with a geared connector  231  compatible to connect operably with a standard dental handpiece [not shown] to provide rotational power to said drive shaft  230 . The drive shaft  230  is further provided with a distal gear tip  235  which interfaces at a distal drive portal  238  with a transitional gear  240  which interfaces with a geared tip  245  to transfer rotational motion from the handpiece to the geared tip  245  thus rotating a cleaning tip  250  which is attached to said geared tip  245 . In alternate embodiments according to the present invention, the distal gear tip  235  may interface directly with the geared tip  245  at a distal drive portal  238 , eliminating any transitional gears. The cleaning tip  250  and attached geared tip  245  are rotatably attached to the distal end  215  of the body  205 , which may be straight, or may be curved at an angle varying from 0 to 179 degrees with respect to the long axis of the body  205 . At the junction with the dental tip  250  and attached geared tip  245 , the body  205  terminates with a content portal  255  which contains one or more fenestrations  260  to allow egress of therapeutic content  265  from main lumen  220  onto or in proximity with the dental tip  250  for cleaning or other therapeutic purposes. In various embodiments according to the present invention, the therapeutic content  265  may be contained within the main lumen  220  within a content sac  273  which may be attached to the content portal  255  such that content can only be expressed through the content portal  255  upon compression of the sac  273  and leakage of content  265  is otherwise avoided. Such a content sac  273  may be fabricated of any thin, flexible, and compressible material such as a plastic, rubber, or other natural or synthetic polymer that is chemically inert with respect to the nature of the therapeutic content  265 . Flow of said egress of contained dentifrice or other therapeutic content  265  from lumen  220  is effected by compression by a plunger  270  with a distal face  271 . In various embodiments according to the present invention, the plunger  270  is sized and shaped to fit sealably, but slidably within the main lumen  220  . The distal face  271  of the plunger  270  may be flat, concave, convex, or otherwise shaped to fit the desired application. In the example shown in  FIG. 2 , the plunger  270  is attached to a stem  275  to which an engagement arm  290  is attached at a first engagement pivot  280 . The engagement arm  290  is further provided with an engagement pin  285 . The engagement pin  285  is provided to engage the drive shaft threads  233  through an engagement slot  231  that connects lumens  220  and  225  within body  205 . The engagement  290  is further attached at a second engagement pivot  293  to a control stem  295 . The control stem  295  passes from main lumen  220  through the wall of the body  205  in a control well  261 . Within said control well  261 , a spring  262  between the body  20  and a control well cap  263  maintains tension on said control stem  295  and engagement arm  290 . For user convenience, the control stem  295  may be attached to a control button  268 . The control well  261  and its contained elements are slidably mounted in an advancement slot  267  that extends through said body  205  to allow advancement of said plunger  270  to dispense said therapeutic content  265 .  
      In use by an operator, the exemplary prophylaxis angle of  FIG. 2  is attached to a standard dental handpiece. The rotary motion of the handpiece powers the motion of the drive shaft  230 , which is transferred to, and causes rotational motion of the dental tip  250 . Also, the engagement of the engagement pin  285  by the drive shaft threads  233  allows the rotation of the drive shaft to effect movement of the plunger  270 , along with the attached engagement arm/control stem assembly as described above which slides within the advancement slot  267 . Should the operator desire to slow the dispensing of therapeutic content  265 , digital pressure on the control button  268  causes the engagement pin  285  to disengage from the drive shaft threads  233 , thus interrupting further displacement of the plunger  270  by handpiece rotational motion. When the operator desires to resume dispensing of therapeutic content  265 , release of digital pressure on the control button  268  causes the engagement pin  285  to re-engage the drive shaft threads  233 , thus permitting the renewed displacement of the plunger  270  by handpiece rotational motion. In various embodiments according to the present invention, the control button  268  may be provided further with a control latch  272  to permit continued engagement of the engagement pin  285  with the drive shaft threads  233  despite release of digital pressure by the operator. Such a control latch  272  would be immediately releasable upon a re-application of digital pressure to the control button  268  by the operator.  
      In various embodiments according to the present invention, the body  205  may further be provided with one or more transparent windows  269  that permit an operator to monitor the movement of the plunger  270  towards the distal end  215 , thus allowing the operator to determine how much content  265  remains to be dispensed. Graduations or other markers [not shown] may be provided on the windows  269  to allow the operator to quantitate the remaining content  265 .  
      In other alternate embodiments according to the present invention, a self-contained dental prophylaxis angle  200  may further be provided with a distal cap  297  removable by the operator, which may serve to provide a seal during storage, and to prevent inadvertent leakage of content  265  prior to use.  
      In yet other alternate embodiments according to the present invention, the distal end  215  may be covered by a membrane [not shown]. Such a membrane may be solid and removable or pierced by the operator prior to use, or may be semipermeable, and permit egress of content  265  through the membrane as the plunger  270  is advanced.  
      While the embodiment as described above has a separate main lumen  220  and drive lumen  225 , in alternate embodiments according to the present invention, a common single lumen accommodates both the drive shaft and content storage/delivery functions.  
      In an alternate embodiment according to the present invention as shown in  FIG. 3 , a self-contained dental prophylaxis unit  100  similar to the one described above and in  FIG. 1  is further provided with an attached or integrated nozzle segment  305 , including a tubular nozzle body  310  which may be straight or flared, and contains an extension of the drive shaft  130  and drive lumen  125 , with a drive gear  315  which directly interfaces with the motor gear of a standard dental handpiece motor [not shown]. Such alternate embodiments according to the present invention in which a nozzle segment  305  is provided as an attached or integral attachment to a self-contained dental prophylaxis unit  100  may include a self contained compressed gas tank, as shown previously above and in  FIG. 1 , to provide a mechanism to drive the dispensing of content. Alternately, when a self-contained dental prophylaxis unit  100  is provided with a nozzle segment  305  as shown in  FIG. 3 , a nozzle gas connector  320  may be provided with a tank connector  325  in gas flow continuity with the compressed gas tank  180 , and with a handpiece gas connector  335  sized and located to connect with the compressed gas connectors on a standard dental compressed gas handpiece motor [not shown].  
      Yet another alternate embodiment according to the present invention is shown in  FIG. 4 . In this example, a self-contained dental prophylaxis unit  100  similar to the one described above and in  FIG. 1  is provided with an attached or integrated nozzle segment  305  as described above and in  FIG. 3 , with the further attachment or integration of a motor segment  405  including a tubular or solid motor housing  410 , a commonly available compressed gas-driven motor  415  of conventional design for use in standard dental handpieces, and one or more gas supply connectors  425  sized and located to permit attachment of the entire motor segment  405 , nozzle segment  305 , and prophylaxis angle  100  to a conventional dental handpiece supply line [not shown]. Various embodiments according to the present invention may employ branching compress gas supply lines to drive both the motor  415  and to supply compressed gas to the nozzle gas connector  320  to supply a compressed gas tank  180  when an external supply is used to drive the content dispensing function. When a dental prophylaxis angle is provided with an integral or attached motor unit  415  according to the present invention, a motor speed control valve  430  may further be provided with an attached motor speed control device  435  which may be a lever  440  pivotably mounted  445  to a pivot mount  450 , such that pressure on the lever  440  may open the flow of compressed gas through the control valve  430 , allowing the motor  415  to turn with increased speed. The action of this lever  440  may be spring-loaded or otherwise controlled mechanically [not shown], such that release of pressure on the lever  440  by an operator causes the motor  415  to slow or stop. Alternately, other mechanical, electrical, or electromechanical speed control connections may be provided between the control lever  445  or alternate control interface and the control valve  430 , providing other conventional mechanisms to decrease or increase motor speed by adjusting the flow of compressed gas to the motor  415 . The action of the speed control device  435  thus allows an operator to regulate the flow of compressed gas to the motor  415  to control its operation and operating speed.  
      Yet another alternate embodiment according to the present invention is shown in  FIG. 5 . As shown in  FIG. 5 , an exemplary self-contained dental prophylaxis angle  500  is provided with a tubular body  505  with a proximal end  510  and a distal end  515 . In various embodiments according to the present invention, the external shape of the body  505  may be round, oblong, triangular, square, polygonal, or any other desired shape. In the example illustrated in  FIG. 5 , the body  505  contains at least two parallel lumens, a main content lumen  518 , and a separate drive lumen  525 . The longitudinal axis of the main lumen  518  is referred to herein as the central axis. The drive lumen contains a drive shaft  530 . The longitudinal axis of the drive shaft  530  is referred to herein as the rotational axis. At the proximal end  510 , the drive shaft  530  extends along at least the proximal end  510  of the body  505  and is fitted with a geared connector  531  which interfaces with a transitional gear  532  compatible to connect operably with a standard concentric drive dental handpiece [not shown] to provide rotational power to said drive shaft  530 . The drive shaft  530  is further provided with a distal gear tip  535  which interfaces with a geared tip  550  at a distal drive portal  538  to transfer rotational motion from the handpiece to the geared tip  550  thus rotating a cleaning tip  555  which is attached to said geared tip  550 .  
      In alternate embodiments according to the present invention, the cleaning tip  555  and attached geared tip  550  are rotatably attached to the distal end  515  of the body  505 , which may be straight, or may be curved at an angle varying from 0 to 179 degrees with respect to the long axis of the body  505 . At or near the junction with the dental tip  555  and attached geared tip  550 , the body  505  terminates with a content portal  560  which contains one or more fenestrations  565  to allow egress of therapeutic content  570  from main lumen  518  onto or in proximity with the dental tip  555  for cleaning or other therapeutic purposes. Flow of said egress of contained dentifrice or other therapeutic content  570  from main lumen  518  is effected by compression by a plunger  575  with a distal face  576 . In various embodiments according to the present invention, the plunger  575  is sized ad shaped to fit sealably, but slidably within the main lumen  518 . The distal face  576  of the plunger  575  may be flat, concave, convex, or otherwise shaped to fit the desired application. The therapeutic content  570  is shown contained within a content sac  573  in the main lumen  518 .  
      In the example shown in  FIG. 5 , the plunger  575  is advanced by the effect of a spring  580  within the proximal aspect of main lumen  518  loading pressure upon the plunger  575 . The plunger  575  is operated by compression action of a control stem  596  which disengages engagement pin  582  from anchoring to dispensing notches  584  on the tubular body  505  to provide pressure upon the therapeutic content  570  to exit the content portal  560 . The control stem  596  advances toward the distal end  515  of the content containing main lumen  518  along an advancement slot  586 , assisted by spring  580  pressure against the plunger  576 . The engagement pin  582  is immediately renegagable with successive dispensing notches  584  upon a release of digital pressure from the control stem  596  by the operator. The control stem  596  is optionally also spring loaded (not shown) to maximize re-engagement and cessation of pressure on the therapeutic content  565 .  
      Yet another alternate embodiment according to the present invention is shown in  FIG. 6  As shown in  FIG. 6 , an exemplary self-contained dental prophylaxis angle  600  is provided with a tubular body  605  with a proximal end  610  and a distal end  615 . In various embodiments according to the present invention, the external shape of the body  605  may be round, oblong, triangular, square, polygonal, or any other desired shape. In the example illustrated in  FIG. 6 , the body  605  contains at least two parallel lumens, a content containing main lumen  618 , and a separate drive lumen  625  The longitudinal axis of the main lumen  618  is referred to herein as the central axis. The drive lumen contains a drive shaft  630 . The longitudinal axis of the drive shaft  630  is referred to herein as the rotational axis. At the proximal end  610 , the drive shaft  630  extends along at least the proximal end  610  of the body  605  and is fitted with a geared connector  631  which interfaces with a transitional gear  632  compatible to connect operably with a standard concentric drive dental handpiece [not shown] to provide rotational power to said drive shaft  630 . The drive shaft  630  is further provided with a distal gear tip  635  which interfaces with a geared tip  650  at a distal drive portal  638  to transfer rotational motion from the handpiece to the geared tip  650  thus rotating a cleaning tip  655  which is attached to said geared tip  650 .  
      In alternate embodiments according to the present invention, the cleaning tip  655  and attached geared tip  650  are rotatably attached to the distal end  615  of the body  605 , which may be straight, or may be curved at an angle varying from 0 to 179 degrees with respect to the long axis of the body  605 . At or near the junction with the dental tip  655  and attached geared tip  650 , the body  605  terminates with a content portal  660  which contains one or more fenestrations  665  to allow egress of therapeutic content  670  from main lumen  618  onto or in proximity with the dental tip  655  for cleaning or other therapeutic purposes. Flow of said egress of contained dentifrice or other therapeutic content  670  from main lumen  618  is effected by compression by a plunger  675  with a distal face  676 . In various embodiments according to the present invention, the plunger  675  is sized and shaped to fit sealably, but slidably within the main lumen  618 . The distal face  676  of the plunger  675  may be flat, concave, convex, or otherwise shaped to fit the desired application. The therapeutic content  670  is shown contained within a content sac  673  in the content containing main lumen  618 .  
      In the example shown in  FIG. 6 , the plunger  675  is advanced by rotational action on a threaded control stem  696  which disengages engagement pin  682  from anchoring to dispensing notches  684  on the tubular body  605  to permit manual advancing pressure upon plunger  675  against the therapeutic content  670  to exit the content portal  660 . The control stem  696  advances toward the distal end  615  of the content containing main lumen  618  along an advancement slot  686 , assisted by manual pressure against the plunger  676 . The engagement pin  682  is immediately renegagable with successive dispensing notches  684  upon opposite turning of the threaded control stem  696  which engages engagement pin  682  with anchoring to dispensing notches  684 . The control stem  696  is alternatively spring loaded rather than threaded to effect disengagement and re-engagement of the engagement pin  682  with the dispensing notches  684 .  
      Prophylaxis angles according to the present invention as shown in  FIGS. 1-6  may be provided either as single use, disposable units or for multiple use applications. Such prophylaxis angles may be fabricated out of any biocompatible material, including but not limited to, plastics, high durometer rubbers, other polymers, aluminum, stainless steel, other metals, metal alloys, or combinations thereof.  
      Exemplary embodiments of various dental tips for a prophylaxis angle according to the present invention are shown in FIGS.  7 (A)- 7 (J). Such dental tips may be fabricated of plastic, natural or synthetic rubbers, other polymers, nylon, Teflon, plastic foam, metals, metal alloys, ceramics, natural bristles, or other synthetic or natural materials. Such dental tips may further be solid or of varying porosity. In addition, dental tips for a prophylaxis angle according to the present invention may be permanently attached to the prophylaxis angle, or may be removable for use of replacement or alternate form dental tips, as desired by the operator.  
      Dental tips for a prophylaxis angle according to the present invention may be provided with varying durometer material strength, yielding rigid, semi-rigid, or soft dental tips for various applications anticipated by the present invention. Similarly, the cross-sectional shape of various dental tips for a prophylaxis angle according to the present invention may vary for different applications. As shown in FIGS.  7 (A)- 7 (J), such dental tips may be square, round, triangular, stellate, heart-shaped, polygonal, or irregular in their various cross-sectional shapes. Such dental tips may also be uniform in their long axis dimensions or may be tapered, irregular, or otherwise shaped for optimal use in a given dental therapeutic application.  
      The dentifrice or therapeutic content contained within a prophylaxis angle according to the present invention may be a cleaning paste, a bleaching or etching agent, an antibacterial agent, topical fluoride or calcium treatment, desensitizing treatment, or any other desired therapeutic material or any combination thereof that may be prepared, contained, and delivered in a paste, gel, or other semisolid form. A dentrifrice or therapeutic content according to the present invention may also include a surfactant or other chemical, biological, or mechanical agent to aid in the performance of a variety of dental therapeutic procedures.  
      Location of the drive mechanism needed to power motion of the dental tip in a position that is offset from the longitudinal axis of the body is important to the proper function of a dental prophylaxis angle according to the present invention. This offset location permits a mechanical and operational separation in the functions of providing power to the rotating dental tip and of dispensing dentifrice or other therapeutic content.  
      Many additional mechanisms are anticipated by the present invention to provide a controllable dispensing system for dentifrice or therapeutic content contained within an inventive prophylaxis angle. These include, but are not limited to, the use of spring-loaded components, such as a small controllably releasable spring-loaded motor, to controllably apply pressure within or to the portion of the prophylaxis angle containing such materials to effect such dispensing, the use of a telescoping rod or tubing within the body of such a prophylaxis angle to mechanically express such content, or use of a screw-mounted movable disk to serve as a plunger to effect such expression of content.  
      In yet another alternate embodiment according to the present invention, a prophylaxis angle may be provided with an offset drive mechanism and a dispensing system for contained dentifrice or other therapeutic medicaments in the form of a motorized toothbrush or other personal dental therapeutic device, designed for use by an operator and/or self use by a patient. In such an application, the prophylaxis angle has either a removable connection from a separate motorized handpiece to provide power, or such a motorized handpiece may be integrated into the prophylaxis angle to provide power and an operating handle.  
      Finally, while there have been shown and described and pointed out fundamental novel features of the present invention as applied to preferred embodiments thereof it will be understood that various omissions and substitutions and changes in the form and details of the devices illustrated, and in their operation, and in the method illustrated and described, may be made by those skilled in the art without departing from the spirit of the invention as broadly disclosed herein. All of the above-discussed patents and publications are hereby expressly incorporated by reference as if they were written directly herein.