Mandibular Implants (published 1977)   Dr. Leonard I. Linkow

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When Dr. Linkow asked me to review his new book on Oral Implants I was complimented, of course, but somewhat dumbfounded. What could I contribute to a field about which I knew practically nothing? Yet the compliment of being asked plus a long standing family interest in dentistry encouraged me to comply with the request. My father, Dr. Ralph C. Cooley, of Houston was an outstanding and innovative dentist who specialized mostly in restorative dentistry for some 50 years. He would have been fascinated by the breadth of Dr. Linkow's knowledge of his subject.

After perusing the book it occurred to me that oral implantology was concerned with many of the same problems and obstacles which we encounter in developing a mechanical heart—namely those related to anatomical conditions, mechanical or functional requirements, choice of prosthetic materials, and rejection or infection. The rapid development of cardiovascular surgery during the past 25 years has been possible to an important extent because of prosthetic devices. Consequently, cardiac surgeons now have the capability of replacing virtually all of the cardiac components—the cardiac septa, the valves, the great vessels and even the conduction system by electronically controlled pacemakers. The technology which has developed in cardiac prostheses now sup-ports a major industry in the health care delivery system. Improved devices appear almost daily and the future of partial cardiac replacement seems promising. Yet the one component which has not been successfully replaced is the myocardium or the basic pumping element of the heart. To accomplish this, the research team must develop a device as small, as efficient, as durable, and as adaptable to the physiological requirements as demonstrated by a most remarkable organ—the human heart. Perhaps the medical profession will necessarily be resigned to accepting a prosthesis which is quite inferior but at the same time useful for urgent situations or short term support. Nonetheless the beginnings of success were established by our team in 1969 when a two-staged cardiac transplantation was accomplished in a patient using an artificial heart in the first stage and three days later replacing it with a donor heart. The artificial heart maintained the patient's life for three days. But today, almost a decade later, the artificial heart has been improved




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